[The urethrocystogram and perineal sonography compared]. / Urethrozystogramm und Perinealsonographie im Vergleich.

Perineal sonography and urethrocystography were performed on 45 patients in the same sitting to evaluate the sonographical method with regard to its applicability as a routine examination method. Corresponding results were obtained 14 times (= 30%). In 31 patients (= 70%) urethrocystographic and ultrasonic measurements diverged. The urethrocystogram must therefore remain an integral part in the work-up of urinary incontinence.

[Breast ductal carcinoma in situ. The clinical image in the mammogram]. / Das duktale Mammakarzinom in situ. Erscheinungsbild im Mammogramm.

Thirty-one consecutive cases of ductal carcinoma in situ (DCIS) were retrospectively analysed to determine the spectrum of mammographic appearances. 68 per cent of the lesions appeared as microcalcifications, 52% as structural or irregular, poorly defined soft-tissue abnormalities, respectively. A mass lesion was noted in 23% of cases. 4 patients presenting with DCIS had negative mammograms and were diagnosed by means of additional examination techniques such as galactography, sonography, and cytologic evaluation in case of bloody nipple discharge. The authors conclude that there is a wide spectrum of mammographic imaging of DCIS.

[Extensive intraductal components of invasive ductal breast carcinoma--value of mammography]. / Die extensiv intraduktale Komponente von invasiven duktalen Mammakarzinomen--Stellenwert der Mammographie.

The presence of an extensive intraductal component (EIC) in patients with infiltrating ductal carcinoma is a major factor for predicting local recurrence after breast-conserving surgery and radiotherapy. A retrospective study including 67 consecutive cases of stage I and II infiltrating ductal carcinomas of the breast was conducted to determine the predictive values of mammographic features associated with the presence or absence of EIC. 43% of the lesions contained a pathologically verified EIC. 63% (25/40) of lesions showing mammographic evidence of calcifications with or without a mass were associated with an EIC. In contrast, only 17% (4/24) of carcinomas without calcifications demonstrated an EIC. This difference was statistically significant (p < 0.001). Lesions with calcifications greater than 3 cm in extent were significantly (p < 0.01) more likely to have an EIC (8/9; 89%) than those with calcifications less than 3 cm in extent (17/31; 55%). Furthermore, no patient with a palpable mass who had normal findings on mammograms was diagnosed to have an EIC.

[The experiences of a hospital radiology department with outside referrals for the preoperative marking of suspicious breast lesions]. / Erfahrungen einer radiologischen Spitalsabteilung mit auswärtigen Zuweisungen zur präoperativen Markierung suspekter Mammaläsionen.

PURPOSE: To outline the experience of a referral radiology department with preoperative localisation procedures on the basic of mammograms obtained by other facilities. MATERIAL AND METHODS: 342 consecutive female patients aged 56.5 +/- 11.9 years underwent preoperative breast localisation procedures prior to surgery. Of these patients 241 had their mammograms obtained in various private practices and 101 in the radiology department. Retrospectively all mammograms were classified by lesions morphology, lesion size and presence or absence of calcifications. RESULTS: The overall benign-to-malignant ratio (B/M-ratio) was 1.7:1. In the referred patient group the B/M-ratio was 1.9:1, compared to a B/M-ratio of 1.3:1 obtained by the radiology department. Referred patients presented significantly (p < 0.001) more often with calcifications that patients from the radiology department. CONCLUSION: Possible factors for the higher B/M-ratio in referred patients are prompt referral to surgical biopsy, misinterpretation of mammograms, failure in the written report, lack of a second opinion and lack of feedback and communication between surgeon, pathologist and radiologist.

Hysterosalpingography with a new contrast medium.

This article reports on the use of iotrolan--a new contrast medium and the first dimeric, nonionic, hexaiodinated, water-soluble preparation--in hysterosalpingography. This randomized, double-blind study compared an ionic and a nonionic monomeric preparation. The better results were achieved with iotrolan. Its unusual lack of local irritation and its high contrast quality, especially definition of contrast, merit particular mention.

[Comparison of the diagnostic value of the individual examination steps (triple diagnosis) in breast cysts]. / Ein Vergleich der Aussagekraft der einzelnen Untersuchungsschritte (Triple-Diagnostik) bei Mammazysten.

Basic examination (palpation and mammography) as well as triple diagnosis (sonography, aspiration cytology, pneumocystography) are employed in the diagnosis and therapy of mamma cysts. Among 133 aspirated cysts we found by sonography 6 complicated cysts; 4 of these were cyst wall carcinomas. We found one further complicated cyst by aspiration cytology with a PAP IV; therefore, this sonographically uncomplicated cyst was extirpated as well resulting in cystic mastopathy without any signs of malignancy. Sonography and pneumocystography agreed perfectly in the diagnosis of cysts. Additionally mammography revealed 3 occult carcinomas located beside uncomplicated cysts. Hence, in no case should mammography be omitted. Sonography is a reliable instrument in judging cysts; therefore, aspiration cytology or pneumocystography may be left out in special cases.

[Sonography of small and occult breast cancer]. / Sonographie des kleinen und okkulten Mammakarzinoms.

The importance of sonography in the diagnosis of the small palpable and occult carcinoma of the female breast is discussed on the basis of the authors' own studies. Of a total of 98 carcinomas in this group, 80 were identified by means of mammography, 7 by ductography and 11 by sonography; a total of 3573 women were examined sonographically in whom results of palpation and x-ray examination required further clarification. Sonography is a valuable additional examination that should be employed strictly on-target according to previously worked-out criteria.

[Ultrasound-guided cyst puncture of the human breast]. / Ultraschallgeleitete Zystenpunktion der weiblichen Brust.

For mammadiagnosis sonography should be used only carefully directed as a supplement investigation. Excellent results in diagnosis, treatment and follow up examinations are obtainable, if sonography is employed together with mammography and puncture-cytology as triple-diagnosis. With the help of sonography localisation and puncture of not palpable cysts is possible. Together with pneumocystography the diagnosis is reliable, biopsies can be reduced. Follow up examinations must be done periodical. The employment of sonography reduces the numbers of radiographs. In a scheme our procedure is clearly arranged.

Urodynamic and radiologic parameters before and after loop surgery for recurrent urinary stress incontinence.

In recent years, accurate preoperative diagnosis has been increasingly emphasized as an important therapeutic aspect of urinary incontinence in women. Forty patients suffering from recurrent stress incontinence underwent a dura-sling operation, i.e. loop surgery. The mean period od incontinence complaints prior to secondary surgery was 2.6 years. Follow-up urodynamic parameters revealed a slight improvement in urethral closure pressure (UCP) as well as significant improvement in functional urethral length and depression quotient. Radiologic investigations before and after sling surgery demonstrated good morphological results (angle beta). One year after surgery, 85% of the women had both clinical and urodynamic continence. Medium-term micturition complaints, however, have to be accepted in some of the patients.

[Clinical and radiologic findings before and following sling operation for recurrent incontinence]. / Klinische und radiologische Befunde vor und nach Schlingenoperation wegen Rezidivinkontinenz.

In recent years, accurate preoperative diagnosis has been increasingly emphasized as an important therapeutic aspect of urinary incontinence in women. One of the diagnostic modalities employed is the lateral urethrocystogram. 25 patients with recurrent stress induced urinary incontinence were subjected to a dura-sling operation. The median duration of incontinence-related problems until secondary surgery (loop surgery) was 2.6 years. Radiological investigations before and after loop surgery showed, that this operation produces good morphological results, if the preoperative diagnosis is accurate. In 84% of the patients the continence obtained was verified by clinical evidence and radiologic findings.