Echocolor Power Doppler with contrast medium to evaluate vascularization in lesions of the soft tissues of the limbs.

PURPOSE: Echocolor Power Doppler with contrast medium forms a non-invasive vascular image; the purpose of the study is to evaluate the effectiveness in differentiating benign and malignant tumors in the soft tissues of the limbs. MATERIAL AND METHOD: Echocolor Power Doppler with contrast medium was used to study 80 patients with swelling in the soft tissues of the limbs: there were 54 benign lesions, 22 sarcomas, and 4 aggressive desmoid fibromatoses. RESULTS: Were identified 4 patterns of wash-in and wash-out curves that could be correlated to the histological diagnosis: type I was present in 85% of benign lesions, type III in 91% of malignant lesions and in 3.7% of the benign ones, type II in aggressive fibromatoses, anomalous type in 4 benign lesions and 2 sarcomas; the curve was absent in 2 benign lesions. CONCLUSIONS: Power Doppler Echocolor with contrast medium can become a useful method to be associated with traditional imaging methods in the differential diagnosis of swelling of the soft tissues of the limbs.

["Empty cysts" of the jaws]. / Le "cisti vuote" dei mascellari.

BACKGROUND: The extensive use of orthopantomography contributed to the occasional discovery of the so called empty cysts (EC) also defined as traumatic or hemorrhagic, which are benign mainly asymptomatic lesions. There are different opinions on empty cysts (even on the proper term to define them) particularly regarding their epidemiology, etiopathology, and clinical and radiological aspect. The purpose of this study is to compare the literature and personal experience and to underline the peculiar aspects not only from a semantic point of view, but also from a more elaborate perspective. MATERIALS AND METHODS: Forty-five osteolytic lesions, which can be considered as empty cysts, taken out of a group of 30,000 patients in a period of 5 years have been examined retrospectively. Radiologic documentation included: orthopantomography, occlusal radiographs, intraoral periapical radiographs, intraoral tube panoramic radiographs and TC in 4 cases. Several parameters among which: trauma, symptoms, location, dimension and the radiological aspect of the lesion were taken into account. RESULTS: The authors concluded: trauma in 4 cases, location of 44 out of 45 empty cysts in the mandible, 67% of which distal to canines; displacement of adjacent teeth in four cases, without root resorbtion. The major axis of empty cysts varied from a minimum of 18 to a maximum of 80 mm. The morphology was oval or round, 37 cysts were monolocular, 8 were plurilocular. In 17 cases the authors noticed a reduction and a displacement of the corticals, but never discovered a pathological fracture. During the observed period an increase in growth of lesions was not found in the follow-up of 14 out of 44 patients. CONCLUSIONS: The personal data were compared to those of the literature where the authors found a larger incidence of patients with symptoms and a history of trauma and cementofibrousdysplasia. The authors suggested that the real incidence of empty cysts is higher than that of the literature. On the basis of personal experience empty cysts are very stable. Therefore, it is questionable if oral surgery should be avoided when radiological picture is certain.

[The diagnostic reliability of percutaneous biopsy specimens obtained under instrumental guidance using 4 different types of needles]. / Attendibilità diagnostica dei prelievi bioptici percutanei eseguiti con guida strumentale utilizzando quattro diversi tipi di aghi.

To assess if the effectiveness of biopsy sampling, whose usefulness is widely recognized, can be influenced by different cutting mechanisms, we compared four different types of needles (A, B, C, D) in 76 patients, each needle being of the same length (15 cm) and calibre (18 G) but with different tip shapes. Forty biopsy samples were obtained with each type of needle for a total of 160 samples in 76 patients; 61 samples were acquired under CT guidance and 99 under US guidance. The results were subdivided in 6 categories based on biopsy result: PI (diagnosis histotype in malignant lesions), PN (diagnosis of malignancy in neoplastic lesions), P (correct diagnosis in benign lesions), S (suspicion of neoplastic lesion), E (misdiagnosis), NI (insufficient material). The results, respectively, for each needle type are: 32.5%, 30%, 2.5%, 7.5%, 12.5% and 15% with needle A; 35%, 30%, 7.5%, 0%, 15% and 12.5% with needle B; 27.5%, 17.5%, 10%, 7.5%, 22.5% and 15% with needle C; 30%, 15%, 7.5%, 15%, 17.5% and 15% with needle D. The sensitivity and specificity for each needle type were, respectively, 84.4% and 85.29% for needle A; 86.66% and 88.57% for needle B; 70% and 73.52% for needle C; 77.41% and 79.41% for needle D. No statistically significant difference was found in the effectiveness of the four needles (chi 2); on the contrary, lesions's size can affect sampling quality.