Breast cancer: zones of increased density mammographic features, correlated to clinical TNM and prognosis.

From January 1981 to December 1995, 8,421 patients having a mammographic opacity corresponding to breast cancer were examined. The opacities were divided into two groups: zones of increased density (ZID), (1,449 patients), and a reference group comprising all other types of opacities (6,972 patients). Mammograms were reviewed retrospectively, as well as clinical, histological and biological parameters in both groups. Diagnosis of ZID was often difficult, sometime's guided by the presence of microcalcifications, which were more frequent. Sonography and direct mammographic magnification proved to be particularly helpful for a correct diagnosis. Most prognostic factors were poorer in ZID as compared to the reference group. The 5 year survival rate was 78% (84% for the reference group). Breast cancer that appears on mammograms as a ZID is often more difficult to diagnose and factors of poor prognosis are more often observed than in breast cancer with other types of opacities. To improve their detection sonography and direct mammographic magnification can be very helpful.

C1-2 arthrography.

OBJECTIVE: To describe the technique of C1-2 arthrography and recommend it as a suitable treatment for pain due to C1-2 abnormalities. MATERIALS AND METHODS: One hundred patients with the following conditions were studied: cervical pain or neuralgia without radiographic changes (group 1, n = 23), osteoarthritis (group 2, n = 37), rheumatoid arthritis (group 3, n = 23), ankylosing spondylarthritis (group 4, n = 5) and diverse conditions (group 5, n = 12). The technique consists of lateral puncture of the posterior aspect of the C1-2 joint with a 20-gauge needle under fluoroscopic control, arthrography using 1 ml contrast medium, and a 1-ml long-acting steroid injection subsequently. RESULTS: The articular cavity has an anterior and a posterior recess. Sometimes the posterior recess is large. In 18% of cases the contralateral joint also opacifies. CONCLUSIONS: C1-2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-2 articular disorders.

[Value and results of radioguided deep spinal biopsy]. / Intérêt et résultats de la biopsie osseuse profonde rachidienne radioguidée.

MATERIAL AND METHODS. 76 percutaneous vertebral biopsies were performed with fluoroscopic guidance at the Radiology B Service, Hôpital Cochin in Paris, from November 1991 to March 1994. There were 12 cervical, 23 thoracic, 45 lumbar and sacral biopsies. There were 71 patients (28 women and 43 men), aged 22 to 88 years old (mean age 55.9). The needle used was either a trophine needle (Mazabraud) or a cutting needle (Surcut) or both. We have been doing vertebral percutaneous biopsies for 20 years in our radiology Service, and we published a review of 100 cases in 1983. The aim of this second review is to actualize the technique and the results. RESULTS. An accurate diagnosis was made in 80% of all cases. Diagnosis were: malignancy (34 cases), infection (21 cases), benign compression fracture (10 cases), miscellaneous (11 cases). There were two complications, one at the cervical spine (aggravation of a cervical cord compression) and one at the thoracic spine (pneumothorax). CONCLUSION. Percutaneous vertebral biopsy under fluoroscopic guidance is a safe and reliable method of obtaining a diagnosis in different spine lesions, avoiding thus, in most cases, a surgical procedure.