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PubMed1990

Clinical application of infrared thermography in diagnosis and therapeutic assessment of vascular ischemic pain.

Temperature is a very important and useful manifestation of various disease entities. The importance of body temperature as an indicator of disease has been known for centuries but in recent years attention has also been paid to how to conveniently and effectively make use of skin temperature as a diagnostic tool. Skin temperature can be measured with thermocouples, electronic thermistor-thermometers, electronic integrators, liquid crystal thermography, and infrared thermography. The temperature of extremities is largely dependent on the blood flow through peripheral vessels, and in the study of vascular diseases thermography has been, therefore, found to be useful. Blood flow can be assessed by many methods including washout techniques or laser Doppler flowmetry. Of these, infrared thermography has the advantages of being noninvasive, remote from the patient when in use, and capable of producing multiple recordings at short time intervals. Here we present a case of vascular ischemic pain which was diagnosed and therapeutically assessed by thermography.

Aged↗
PubMed1985

[Thermography in the diagnosis of recurrences of rectal cancer].

Thermography results of 126 patients were analysed for the diagnosis of recurrences of rectal cancer. Sixteen patients were examined after radical operations for rectal cancer without signs of recurrence to study the features of a thermal regimen in this area. The examination included thermoscopy, thermography and distant thermometry. The presence of the zone of hyperthermia in the perineum with the involvement of the sacral region and the coccygeal bone after extirpation of the rectum was shown to indicate cancer recurrence. The coincidence of thermography findings with those of computerized and ultrasound tomography was observed in 81.7% of the cases. As a result of a perineal fistula, chronic prostatitis, etc., false positive results of thermography were marked in 17 (18.3%) patients. False negative results were not observed. A rise of local temperature from +0.5 to 1 degrees C was considered suspicious of cancer recurrence. These patients were actively followed up and it allowed one to confirm cancer recurrence in them after 3-6 mos. The use of thermography as a screening test made it possible to detect cancer recurrence and to define a high risk group in need of an active follow up and more thorough clinical examination.

Adult↗
PubMed1976

Use of the thermography for the early diagnosis of deep vein thrombosis following hip operations.

Up to 50% of patients suffer from deep vein thrombosis (DVT) after major hip surgery. Frequently DVT cannot be diagnosed clinically. To the present, venography alone has been used in these patients, but it is time consuming, necessitates an intravenous dye injection and is not without complications. Now, however, the technique of thermography is available as an additional diagnostic aid. The results of thermography were assessed in 24 patients who had recently undergone major hip operations and compared with those obtained by venography. Thermography did identify DVT in the lower leg veins of patients with no clinical symptoms, but higher obstructions were only diagnosed by venography. Thermography gave one false-positive result later disproven by venography. Thermography has the advantage of being noninvasive and economical; it will become more useful when smaller portable systems are developed.

Aged↗
PubMed1997

Application of medical thermography to the diagnosis of Frey's syndrome.

BACKGROUND: In Frey's syndrome, the secretory parasympathetic fibers of the parotid gland are thought to communicate with the sympathetic nerve fibers of sweat glands and blood vessels of the skin following parotidectomy. Miscommunication results in subjective gustatory sweating and facial flushing, which appear early with postoperative mastication. In this study, we compared the efficacy of medical thermography to the Minor's starch-iodine test to determine the presence of gustatory sweating in Frey's syndrome. METHODS: Patients were considered to have Frey's syndrome if signs of gustatory sweating and localized skin flushing of the parotid region were present. In four patients who had undergone unilateral parotidectomy, gustatory sweating and facial flushing were present after gustatory stimulation, and the presence of Frey's syndrome was confirmed with Minor's starch test in all patients. Infrared thermography was then performed, and the same area measured. The contralateral side served as an internal control for each patient. RESULTS: Before gustatory stimulation, the isothermal pattern of the diseased side and the nonoperative side was similar. Stress thermography using a sialogogue (lemon, 3 mL) showed a cold spot at the operative site in all four patients with Frey's syndrome. The contralateral nonoperative side showed normal skin temperature distribution in all patients. Minor's test was positive in all patients. CONCLUSIONS: Thermography is a noninvasive, facile test that provides a qualitative visual analysis of the cutaneous capillary response in Frey's syndrome following parotid surgery.

Adenocarcinoma↗
PubMed1976

Improved liquid cholesterol ester crystal thermography of the breast.

The infrated detection apparatus used in breast thermography is relatively costly and therefore is not widely available to less populated areas in the country. The use of liquid cholesterol crystals, applied to the breast (applied over a water-base black dye) has already been described in the literature as an effective substitute for infrared instrument thermography. This method, however, has been hampered by the time and troublesome effort necessary for removal of the substances upon completion of the study. The object of this study was to devise a feasible method of cutaneous breast thermography using liquid cholesterol esters, as in prior studies, but by applying them to an easily removable black base. As a result the length of the examination has been shortened, and patients have found the examination to be aesthetically more acceptable. With this improved method, liquid crystal thermography of the breast (and other areas) should become more widely applicable.

Adult↗
PubMed1990

A comparison of thermography and electromyography in the diagnosis of cervical radiculopathy.

We studied 20 asymptomatic control subjects and 14 patients with clinically unequivocal cervical radiculopathy to compare the diagnostic value of thermography with that of electromyography. We measured the average skin temperature of designated regions over the neck, shoulder, and upper extremities. We then compared the temperature between corresponding regions of the two limbs, and between fingers innervated by different roots in the same hand. Thermography was abnormal in 6 patients (43%), whereas electromyography was abnormal in 10 (71%). Thermographic abnormalities were seen only in the hands and fingers, and the pattern did not follow the dermatome of the clinically involved cervical root. When compared to electromyography, thermography provided no additional diagnostic information. Thus, thermography does not have an established role in the evaluation of patients with cervical radiculopathy.

Arm↗
PubMed1975

Facial thermography in the diagnosis of cerebrovascular disease and in evaluation of carotid endarterectomy.

Some 60% of strokes are due to extracranial occlusive arterial lesions, most frequently at the bifurcation of the common carotid artery. Since these lesions are accessible to endarterectomy, their prestroke diagnosis is very important. Facial thermography quickly supplies reliqble information on the circulatory area in which these lesions occur, and this information can be atraumatically obtained in an out-patient setting. The success rate of facial thermography versus aortic arch angiography was 83% and 80%, respectively, in our case material, and this rate corresponds with data in the literature. In a series of 23 patients with facial thermograms and angiograms obtained before and after endarterectomy, facial thermography proved to be a useful diagnostic and prognostic aid in neurological out-patient guidance after carotid endarterectomy. By virtue of its rapidity and atraumatic character, because it can be carried out by technicians and because the findings are suitable for computer data processing, facial thermography would seem to be suitable for potential stroke screening of a high-risk asymptomatic population.

Adult↗
PubMed2006

Thermography as potential real-time technique to assess changes in flow distribution in hemofiltration.

Flow distributions are critical determinants in the function of hemofilters. Despite their importance, however, flow distributions cannot currently be measured in filters during experimental or clinical applications. Here, we demonstrate that the thermal conduction properties of extracorporeal circuits may provide a tool to overcome this limitation. More specifically, we show that thermography provides an indirect approach to visualize differences in regional perfusion rates through temperature profiles on the filter surface. Thermograms were recorded using a TVS700 system (Ca. Goratec) during recirculating in vitro hemofiltration of porcine blood. Different test protocols were executed to characterize the contribution of thermal conduction and convection to the measurable changes in the temperature at the surface of the filter housing. For comparison and validation, these experiments were supplemented by computer tomography (CT) of filters after dye injection. Thermography enabled real-time visualization of the flow distributions in a hemofilter. Moreover, 'point' trends taken from different regions of the filter provided quantitative information about changes of flow distributions in response to changing experimental conditions. Our preliminary data suggest that thermography is a promising new approach for assessing the principles and time-related changes in flow distributions in hemofiltration. As expected, resolution is lower than that in CT measurements and further studies will be necessary to determine the smallest temperature gradient that still identifies differences in regional perfusion rates. Given its potential to develop into an inexpensive tool for the 'bedside' level monitoring of flow distributions during clinical studies, further investigation of thermography is highly desirable.

Animals↗
PubMed2001

The role of thermography in the management of equine lameness.

Equine thermography has increased in popularity recently because of improvements in thermal cameras and advances in image-processing software. The basic principle of thermography involves the transformation of surface heat from an object into a pictorial representation. The colour gradients generated reflect differences in the emitted heat. Variations from normal can be used to detect lameness or regions of inflammation in horses. Units can be so sensitive that flexor tendon injuries can be detected before the horse develops clinical lameness. Thermography has been used to evaluate several different clinical syndromes not only in the diagnosis of inflammation but also to monitor the progression of healing. Thermography has important applications in research for the detection of illegal performance-enhancing procedures at athletic events.

Animals↗
PubMed2003

[Thermography of the skin covering a cochlear implant--temperature as an indicator for blood circulation].

BACKGROUND: Sufficient blood supply of the flap is a significant factor for proper wound healing and lifelong integration of a cochlear implant. Superficial temperature as an indicator of cutaneous blood circulation can be visualized easily by thermography. QUESTION: We examined the correlation between temperature distribution and the anatomic course of defined arteries, the significance of different types of incisions in this regard, and local irritations of skin temperature/blood circulation by the implant itself. MATERIALS AND METHOD: The partially shaved heads of 15 patients were examined by thermography after cochlear implantation, using the Agema thermovision system. RESULT: Temperature distribution of the skin can be closely related to the arterial blood supply. In our group of patients, no significant alterations could be found in the skin covering the implant. Hair growth in the area tested does not allow valid thermographies. DISCUSSION: By the pattern of temperature-distribution/blood circulation some conclusions about typical incisions can be drawn. While most types of incisions respect the patterns of blood circulation, the retroauricular C-incision may cause problems. Postoperative scars can be regarded as places of minor resistance. CONCLUSIONS: Thermography of the skin is an easy method for estimating the blood circulation of the skin above the implant. It is, however, limited to hair-free or shaved skin areas.

Adolescent↗
PubMed2004

The percutaneous assessment of regional and acute coronary hot unstable plaques by thermographic evaluation (PARACHUTE) study: a prospective reproducibility and prognostic clinical study using thermography to predict future ischemic cardiac events.

Intravascular thermography is currently being considered as a valuable tool in assessing macrophage-rich plaques. Since it is unknown what the prognostic value is of non-obstructive atherosclerotic plaques showing temperature heterogeneity, we designed the PARACHUTE study, a prospective, reproducibility, and prognostic clinical study using thermography in patients presenting with an unstable coronary syndrome. The primary endpoint of the study is the predictive value of temperature heterogeneity towards the occurrence of ischemic coronary events and hospitalization for ischemia and/or angina. The secondary endpoints are the predictive value of high-risk plaques associated with the development of future cardiac events, assessment of safety of the procedure, assessment of temperature reproducibility and heterogeneity in coronary arteries, as defined by the total thermal burden towards the occurrence of any cardiac event. Based on an event rate of death and myocardial infarction at 1 year of 10%, a sample size of 260 patients with presumed coronary artery disease, and positive troponin level who are scheduled to undergo an intervention will be included. All three main epicardiac vessels will undergo angiography and thermography at baseline after revascularization of the flow-limiting vessel. At 12 months, angiography of all vessels and thermography of the vessel with the highest thermographic burden will be performed. Independent core laboratories will assess outcomes and a clinical endpoint committee will assess clinical events.

Acute Disease↗
PubMed1987

Thermography after subcutaneous mastectomy and reconstruction with silicone gel prosthesis: a pilot study.

Patients with subcutaneously placed silicone gel prostheses, for reconstruction after subcutaneous mastectomies, often complain of cold breasts as well as of slow regaining of warmth after cooling. We have used thermography in 7 such women and in 7 healthy women of the same age group as controls. Thermography has also been used in 3 women after repositioning of the subcutaneously placed prostheses to a submuscular position in order to study any possible changes in temperature. In 2 cases thermography also was found to aid in the diagnosis of a suspected subcutaneous displacement of a submuscular prosthesis; the technique has an advantage over mammographic examination, since thermography is a simple, less expensive, and safer method.

Bioprosthesis↗
PubMed1989

Thermography in diagnosis of radiculopathies.

Infrared imaging (thermography) has developed rapidly over the past 10-15 years as a diagnostic imaging procedure. Despite scientific validation and proven use in the clinical setting, neuromuscular thermography has met with much criticism and skepticism. The emotional and political controversy surrounding thermography has distracted the medical community to such an extent that the real issue of utmost importance to the practicing physician is often ignored. The basic scientific foundation of medicine should preclude the prejudicial influence of emotion, politics, and anecdotes. Scientific investigations, for more than 2 decades now, have demonstrated that neuromuscular thermography is of proven value in the clinical evaluation of various pain disorders and neuromuscular conditions, including radicular pathology.

Humans↗
PubMed1991

Diagnostic accuracy and clinical utility of thermography for lumbar radiculopathy. A meta-analysis.

The role of thermography for diagnosing lumbar radiculopathy was evaluated by literature review and meta-analysis. From 81 relevant citations, 28 studies could be analyzed for diagnostic-accuracy data (sensitivity and specificity) and method. Diagnostic-accuracy data varied significantly between studies; therefore meaningful pooled summary statistics could not be reported. Twenty-seven studies had major methodologic flaws including biased test interpretations, faulty cohort assembly, poor clinical descriptions, and small sample size. The only study of reasonably high quality found no discriminant value for liquid-crystal thermography. The role of thermography remains unclear. Rigorous clinical research is required to establish its diagnostic accuracy and clinical utility. Thermography cannot be recommended currently for routine clinical use in evaluating low-back pain.

Back Pain↗
PubMed1979

Noninvasive diagnosis of acute deep vein thrombosis. A comparison between thermography, plethysmography and phlebography.

Fifty-five patients with clinical signs of acute DVT were investigated with thermography, plethysmography and phlebography. A comparison between phlebography and thermography showed a diagnostic agreement of 84%. Thermography was found, however, to have a low reliability for the localization of acute thrombi and was therefore combined with plethysmography in an attempt to obtain better results in this respect. Compared to the invasive phlebography, the noninvasive combination of thermography and plethysmography adequately located acute DVT in 95% of the cases.

Acute Disease↗
PubMed1991

Liquid crystal thermography as a screening test for deep vein thrombosis in patients with cerebral infarction.

Pulmonary embolism secondary to deep vein thrombosis is a frequent cause of death in stroke patients. In a multicentre study of deep vein thrombosis prophylaxis, 112 patients with cerebral infarction and leg paresis were given aspirin 300 mg three times a day (t.d.s.) alone or with dipyridamole 100 mg t.d.s. To screen for deep vein thrombosis liquid crystal thermography of the legs was performed daily for 15 days on all patients. Those patients with positive thermography underwent immediate X-ray venography of the appropriate limb as the definitive investigation for venous thrombosis. Twenty-two patients had positive thermograms, of whom 16 had confirmed deep vein thrombosis as demonstrated by X-ray venography. Only 8 of the 22 had clinical signs of deep vein thrombosis and 2 of those had a negative venogram. Of the 14 patients with positive thermography but negative clinical signs 10 had positive venograms. Difference in the incidence of deep vein thrombosis in the two treatment groups was not demonstrated. It is concluded that occult deep venous thrombosis is common after ischaemic stroke and it can occur without clinical signs. Liquid crystal thermography is a simple, rapid and cheap screening test that will allow the detection of clinically unrecognized thrombosis.

Aged↗
PubMed2006

Comparison of MR-thermography and planning calculations in phantoms.

A systematic comparison of three-dimensional MR (magnetic resonance) thermography and planning calculations in phantoms for the hyperthermia (HT) SIGMA-Eye applicator. We performed 2 x 6 experiments in a homogeneous cylindrical and a heterogeneous elliptical phantom by adjusting 82 different patterns with different phase control inside an MR tomograph (Siemens Magnetom Symphony, 1.5 Tesla). For MR thermography, we employed the proton resonance frequency shift method with a drift correction based on silicon tubes. For the planning calculations, we used the finite-difference time-domain (FDTD) method and, in addition, modeled the antennas and the transforming network. We generated regions according to a segmentation of bones and tissue, and used an interpolation technique with a subgrid of 0.5 cm size at the interfaces. A Gauss-Newton solver has been developed to adapt phases and amplitudes. A qualitative agreement between the planning program and measurements was obtained, including a correct prediction of hot spot locations. The final deviation between planning and measurement is in the range of 2-3 W/kg, i.e., below 10%. Additional HT phase and amplitude adaptation, as well as position correction of the phantom in the SIGMA-Eye, further improve the results. HT phase corrections in the range of 30-40 degrees and HT amplitude corrections of +/- 20-30% are required for the best agreement. The deviation /MR-FDTD/, and the HT phase/amplitude corrections depend on the type of phantom, certain channel groups, pattern steering, and the positioning error. Appropriate agreement between three-dimensional specific absorption rate distributions measured by MR-thermography and planning calculations is achieved, if the correct position and adapted feed point parameters are considered. As long as feed-point parameters are uncertain (i.e., cannot be directly measured during therapy), a prospective planning will remain difficult. However, we can use the information of MR thermography to better predict the patterns in the future even without the knowledge of feed-point parameters.

Algorithms↗
PubMed1987

Thermography as a predictor of the more involved side in bilateral carotid disease: case history.

Contact thermography using liquid crystals provides a simple, inexpensive method of evaluating carotid disease. It does not duplicate information provided by other noninvasive methods, because, whereas Dopplers give an indication of flow and degree of stenosis in the artery, thermography measures the actual hypoperfusion as demonstrated by diminished temperature in areas of the forehead supplied by branches of the ophthalmic artery. A 74-year-old man presented with bilateral carotid distribution TIAs. Carotid Dopplers and angiography revealed 99% occlusion of both internal carotid arteries. Contact thermography showed diminished temperature in the right supraorbital artery territory. The patient subsequently underwent carotid endarterectomy. Following induction of anesthesia but prior to carotid clamping, the patient became transiently hypotensive. Intraoperative EEG monitoring showed marked attenuation of the background rhythm on the right with preservation of background on the left. Normal rhythm was quickly restored with pharmacologic restoration of the blood pressure. This case illustrates the usefulness of thermography, which predicted the hemisphere in jeopardy when Dopplers and angiography showed equal bilateral disease.

Aged↗