[Comparative assessment of diagnostic methods in adenomas of the thyroid gland]. / Sravnitel'naia otsenka metodov issledovaniia pri adenomakh shchitovidnoi zhelezy.

The authors carried out comparative assessment of sensitivity and specificity of ultrasonic examination with color dopper mapping (USE with CDM), thin-needle aspiration biopsy--TAB (palpation- and US-assisted), express histologic examination--(EHE), intraoperative laser autofluorescent spectroscopy (IOLAS) with retrospective assessment by results of elective histologic examination in adenomas of thyroid gland (TG). Medical histories of 135 patients hospitalized with adenomas of TG of follicular cells were analyzed. Based on comparison of USE with CDM and morphologic analysis of TG adenomas three types of specific echographic symptomcomplexes were recognized. USE with CDM in combination with US-assisted TAB was the most effective diagnostic complex before operation. Comparative analysis of results of these methods with express histologic examination showed equal efficacy, that permitted to reject routene EHE. For the first time IOLAS was used as "optic instant-biopsy" for selection of optimum scope of surgery when "follicular neoplasia" was suspected. Combined use of USE with CDM and TAB before operation as well as IOLAS enabled correct diagnosis of the nature of TG lesion, it morphologic type, and based on these data adegnatechoice.

[Complex use of ultrasound in the diagnosis and treatment of surgical diseases of the lung and pleura]. / Kompleksnoe primenenie ul'trazvuka dlia diagnostiki i lecheniia khirurgicheskikh zabolevanii legkikh i plevry.

Since 1980 the N.N. Burdenko Faculty Surgical clinic, I.M. Sechenov Moscow Medical Academy, has been using a combination of high- and low-frequency ultrasounds for the diagnosis and treatment of surgical diseases of lung and pleura in 156 patients for the diagnosis of pleuritis of various genesis, in 40 patients for transthoracic aspiration biopsy of lung tumors in the preoperative period, in 156 patients for pleural puncture and drainage, in 40 patients for the intraoperative differential diagnosis of peripheral lung tumors and for the inspection of hematogenic and lymphogenic metastatic areas, in 100 patients for intraoperative prophylaxis, and in 20 patients for the treatment of acute postoperative pleural empyema. Ultrasound was demonstrated to be of high informative value in diagnosing different pleuritis. Transthoracic aspiration biopsy was shown to have some advantages over standard methods: use of needle catheters for pleural puncture permits one to avoid serious complications (pneumothorax, bleeding, etc). Ultrasound was used in intraoperative diagnosis of peripheral lung tumors for the first time. The use of low-frequency ultrasound for the intraoperative prevention of acute postoperative pleural empyemas promotes reliable sanitation of the pleural cavity, as confirmed by bacteriologic control data. Timely rethoracotomies with low-frequency ultrasound treatment of the pleura promote more rapid inflammation elimination in the pleural cavity and prevents irreversible complications.

[Diagnosis and treatment of breast cysts]. / Diagnostika i lechenie kist molochnoi zhelezy.

The results of examination and treatment of 62 patients with breast cysts are presented. Basing on ultrasound and cytological examination evidence, indications and contraindications for puncture treatment of breast cysts with simultaneous 96% ethanol sclerosing with have been worked out. This treatment was carried out in 45 patients, the rate of recurrences being 11.1% compared to 21.9% in the control group. The puncture treatment is indicated in the mass of regular shape of homogenous unechogenous structure with symmetric "lateral shades" revealed by US examination, absence of atypical intracystic epithelium according to cytologic examination data. Contraindications for this method are the following: presence of intracystic growth, irregular shape of the cyst, asymmetric "lateral shades", polycystic disease of the breasts, cellular atypia revealed by cytologic examination, recurrent cyst, previuns mastectomy for breast cancer, atypical ductal or lobular hyperplasia revealed in sectoral resection.

[Potentialities of ultrasound examination in differential diagnosis of benign nodules and breast cancer]. / Vozmozhnosti ul'trazvukovogo issledovaniia v differentsial'noí diagnostike dobrokachestvennykh uzlovykh obrazovanií i raka molochnoí zhelezy.

The results of examination of 410 patients with nodular masses of the breast are analysed. Benign tumors were present in 314 (76.6%) of the patients, cancer of the mammary gland--in 96 (23.4%) of the patients. The tumors were classified into 3 types, depending on the intensity of the ultrasound wave behind the tumor. Based on the clinical and morphological analyses it was demonstrated that the presence of the acoustic wave behind the tumor is typical for the invasive cancer of the duct, scirrous carcinoma and lobular cancer. In medullar and mucosous cancer the intensity of the ultrasound wave does not change. In case of intracystic cancer the symptom of "back magnification" is present. The sensitivity of the ultrasound in detection of mammary gland cancer is 88.5%, specificity--96.5%. The analogous parameters of mammography are: 91.0% and 97.8%. In the use of ultrasound control in fine needle aspiration biopsy (FNAB) the sensitivity and specificity of the method increases from 88.5% to 92.7%. If the diagnosis of mammary gland cancer was established with the use of ultrasound and FNAB the additional use of mammography is not obligatory.