Aksyonova E. Radiation diagnostics of the inflammatory breast diseases.

The dissertation is devoted to the increasing of the efficacy of the radiation diagnosis of the inflammatory breast diseases, which are not connected with delivery. The diagnostic efficacy of the full screen digital mammography was studied, the necessity of the usage of the modified pneumocystography was proved with the 100 % accuracy. The pathognomonic sonographic appearances and frequency of the separate entities were established including abscesses (11,3%), galactophorities (12,9%), cysts complicated by inflammation, (36,5%), periductal mastities (31,9%) and inflammatory breast cancer (7,4%). The method of diagnosis of galactophoritis was elaborated, with the accuracy of 95,8% by considering the established sonographic appearances (ductectasia, flotation of the intraductal content, stream-effect). The typical sonographic appearance of the ductal pathology in cases of inflammatory breast diseases was shown, that allowed performing of the differential diagnosis between diffuse inflammatory changes, galactophoritis, periductal mastitis and inflammatory breast cancer with the accuracy 98,0% as well as dividing the data obtained according to the ACR BI-RADS™ - US categories. It was proved that the typical US appearance of the galactophoritis corresponds (71,2%) to BI-RADS™ - US - 2 category, presence of intraductal vegetations in the base of ductal dilatation (26,1%) corresponds to BI-RADS™ - US - 3 category, revealing of the additional infiltrates (2,7%) corresponds to BI-RADS™ - US - 4 category. It was shown that typical US picture of the periductal mastitis (76,8%) complies with BI-RADS™-US - 2 category, with the presence of homogeneous additional infiltrates (22,0%) complies with BI-RADS™ - US - 3 category, with existence of nonhomogeneous additional infiltrates (1,2%) complies with BI-RADS™ - US - 4 category. Thus, usage of improved and self-developed techniques of X-ray and US examinations as well as proposed algorithm of combined differential diagnosis between benign and malignant breast diseases on the base of inflammation made it possible to ensure high (98,1%) accuracy of the diagnostic approaches.