Contemporary medical contrastive learning faces challenges from inconsistent semantics and sample pair morphology, leading to dispersed and converging semantic shifts. The variability in text reports, due to multiple authors, complicates semantic consistency. To tackle these issues, we propose a two-step approach. Initially, text reports are converted into a standardized triplet format, laying the groundwork for our novel concept of observations'' and verdicts’‘. This approach refines the {Entity, Position, Exist} triplet into binary questions, guiding towards a clear ``verdict’‘. We also innovate in visual pre-training with a Meijering-based masking, focusing on features representative of medical images’ local context. By integrating this with our text conversion method, our model advances cross-modal representation in a multimodal contrastive learning framework, setting new benchmarks in medical image analysis.

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