[The possibilities of mammography within the framework of early diagnosis of breast neoplasms].
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Biomedical subjects
Publications and source records attributed to G Friedmann.
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Basing on selected cases, the efficiency spectrum of modern CT apparatus in the diagnosis of orbital disease is described. Besides exact localisation of retrobulbar space-occupying growths, CT scanning enables good identification of pathological processes at the bulbus and those of parabulbar location, at the lacrimal gland, the optic nerve and the ocular muscles. Extraorbital changes are clearly identifiable.
The accuracy of vertebral angiography in the diagnosis of tumours was reviewed on the basis 368 selective angiograms. The greatest accuracy was achieved with space-occupying lesions situated centrally in the cerebellum in the region of the fourth ventricle or in the vermis. However, tumours growing eccentrically, but arising in this region, were occasionally missed. Least reliable is the angiographic diagnosis of tumours is the cerebellar hemispheres. Of these, only about two-thirds could be demonstrated. Only 60% of cerebello-pontine tumours were diagnosed from displacement of various structures, another 10% by the presence of pathological vessels or tumour staining. The classic angiographic picture of pontine tumours is rare. Brain stem tumours are frequently eccentric and may simulate cerebello-pontine angle tumours. The demonstration or exclusion of brain stem involvement can be difficult. In view of the implications for treatment, this should, however, always be attempted.
The role of computer tomography in the diagnosis of cardiac tumours was demonstrated by three patients with myxomas of the left atrium. After intravenous contrast administration these tumours appeared as relatively translucent space-occupying lesions on the computer tomograph. The invasive method of angio-cardiography is unlikely to provide any additional information concerning tumour size or localisation when compared with non-invasive computer tomography or echo cardiography.
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CT-x-ray examination of 98 patients yielded pathologic results in 42 patients; in 33 patients results of CT could be controlled by surgery or at autopsy. In 14 cases necrotizing pancreatitis or pancreatic pseudocysts were suspected and these cases were operated upon; only 1 case turned out to be a falsely positive diagnosis. In 15 cases pancreatic carcinoma were found at surgery; 13 of these cases had been diagnosed preoperatively by CT; the diameters of the 2 tumors not diagnosed were below 3-4 cm. Differentiation between cysts, pancreatitis and tumors was possible in 2/3 of all cases; in 1/3 of the cases differentiation was neither possible by applying morphological criteria nor by evaluating absorption spectra. It turned out to be advantageous to examine the parenchymatous organs surrounding the pancreas by CT as well; in about 12% of cases with pathological findings the processes were found to be localized extrapancreatically.
The utilization of transverse layers in computer tomography opens up a new level of examination for localization of pathologic processes in the thorax and their spread. The good resolution of roentgen absorption differences in the soft parts enables the use of computer tomography in the diagnosis of pericardial effusions and for further differentiation of known mediastinal growing and displacing processes. This method is also suitable for the identification of aneurysms, since it is not invasive and places hardly any strain on the patient. Finally, computer tomography can also be used for radiotherapy and operation planning, as well as in target biopsy on account of the true-to-scale and reproducible image of the body cross-sections.
In 12 patients with tumorous or chronic-inflammatory diseases of the skull and the skullbase the results of conventional and computer-tomography were compared with the operative findings. The computer-tomography of the most important regions is demonstrated by individual examples. The preliminary results indicate, that computer-tomography is reliable in evaluation of the extend of pathological processes. Therefor follow-up data after treatment were obtained by computer-tomography only.
An accurate analysis of calcifications and of their localization enables a tentative diagnosis, not as rarely as is often assumed, especially if anamnestic and clinical findings are utilized for better interpretation. However, an accurate determination of the area covered by the disease, and of the kind of process, is possible only via neuroradiologic contrast medium diagnostics and computed tomography.
Attention is drawn to the incidence rate of the various types of obliterations of the carotid artery in the extracranial area. The evaluation is based on 242 carotid stenoses from a total of 1283 angiograms. Over and above this, the paper presents initial results of computertomography in 15 patients with obliterations of the carotid arteries in the cervical region.
Computerized tomography has proved to be of great value in the assessment of aortic aneurysms; since it provides all necessary information about length, width, intraluminal thrombi, and calcification of the wall. Especially in cases of ruptured aneurysms the hemorrhage and its extent to retroperitoneal and intraperitoneal space can be well demonstrated.
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The radiological criteria of juvenile, rheumatic, cervical synostosis discovered in adult life are described and illustrated. These include: involvement of few or many segments, a tendency to bony ankylosis of the diseased intervertebral joints, dysplasias or hypoplasia of the vertebral body and intervertebral disc and dysplasias of the neural arches and hypoplasia of the transverse processes. Pathological ossification may involve the ligamentum flavum, the annulus, or the entire disc. The differential diagnosis of juvenile, rheumatic, cervical synostosis includes congenital block vertebrae, Klippel-Feil syndrome, acquired block vertebrae, juvenile ankylosing spondylitis, synostosing, intervertebral osteochondrosis and myositis ossificans progressiva.
The report deals with the computer tomographic investigation of a space-occupying intra-abdominal process in which there were polycystic lesions of the liver, kidneys and pancreas. CT scanning combined with biochemical investigations provided clear proof of the presence of cysts, their morphology and extent. The possibility of the neoplasm could be excluded; it proved unnecessary to carry out any invasive procedures and a laparotomy also became unneccessary.
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