Eosinophilic gastroenteritis: percutaneous biopsy under ultrasound guidance.

Eosinophilic gastroenteritis (EG) is an unusual disorder that is characterized by diffuse or scattered eosinophilic infiltration of the digestive tract. The diagnosis is based on histology obtained by capsule, endoscopic, laparoscopic, or laparotomy biopsy. The eosinophilic infiltration produces thickening of the small bowel wall that can be observed by using sonography. The appearance produces the pseudokidney sign that can be used to guide biopsy. We report the first case of EG diagnosed by percutaneous biopsy under ultrasound guidance.

Ultrasound-guided skeletal biopsies.

OBJECTIVE: Percutaneous biopsy of skeletal lesions is a widely used diagnostic technique that involves fluoroscopic or computerized tomography guidance. The objective of this report is to describe the use of ultrasonography in the guidance of percutaneous biopsy of skeletal lesions. DESIGN AND PATIENTS: We employed ultrasound to guide percutaneous biopsy in 65 skeletal lesions in 63 patients (30 male and 33 female) whose ages ranged from 1 to 82 years (mean 47.2 years ). The lesions were divided into four groups: group 1 ( n=41) were lytic with a soft tissue mass, group 2 ( n=14) were lytic with a disrupted cortex without a soft tissue mass, group 3 ( n=4) were lytic with an intact cortex and group 4 ( n=6) were sclerotic lesions. Different techniques and materials were used in each group. RESULTS: Cytologic assessment obtained the diagnosis in 50 cases, (success rate 76.9%), histology in 56 cases (86.1%) and a combination of both in 60 cases (92.3%). There were no complications. CONCLUSIONS: Ultrasound is a highly accurate and safe method of guidance in percutaneous biopsy of bone lesions, either lytic or sclerotic, because it can identify subtle changes in the cortical and the associated soft tissue component.

Characterization of solid liver lesions with color and pulsed Doppler imaging.

BACKGROUND: To assess the usefulness of color Doppler and duplex sonography in the characterization of solid liver lesions. METHODS: We performed color Doppler and duplex sonography on 106 solid hepatic lesions. With color Doppler, we evaluated the aspect and distribution of tumoral vessels. The pulsed Doppler parameters considered were only those showing the highest systolic peak velocity values. RESULTS: Intratumoral color and pulsed Doppler signals were obtained in 81% (59/73) of malignant tumors (p < 0. 0001) but only in 18% (6/33) of benign tumors. Ninety-six percent (45/47) of the lesions with arterial intratumoral and peritumoral signals were malignant, whereas 4% were benign (p < 0.0001). Only eight (11%) malignant lesions had intratumoral venous signal vis-a-vis 23 (70%) benign. Twelve cases showing intratumoral venous Doppler signal as a single finding were benign. No statistically significant differences were observed in the quantitative parameters recorded by pulsed Doppler (Student t test, p < 0.05), there having been a clear overlapping in the values obtained in benign and malignant lesions. CONCLUSIONS: (a) The type of signal (arterial or venous) and its distribution detected by color and pulsed Doppler is more helpful than the assessment of the spectral quantitative parameters obtained by pulsed Doppler. (b) The presence of intratumoral venous flow remarkably suggests benignancy. (c) The presence of both intra- and peritumoral arterial flow in the same lesion strongly suggests malignancy.

[Echography-guided percutaneous biopsy of pleural lesions and effusions]. / Biopsia percutánea de lesiones y derrames pleurales dirigida por ecografía.

Our experience in the use of ultrasonic echography (UE) is exposed as a guide for directing small lesions and pleural effusions percutaneous lesions with an unknown grounds. We have done pleural percutaneous biopsy using UE as guide in 45 patients. The needle diameter ranges between 17 and 19.5 G. Lesions were benign for 16 patients and malignant for 29. The right result was obtained in 93% of the cases. There were not complications. We conclude that echography-directed pleural biopsy presents an excellent diagnostic profitability, it improves the results obtained with blind biopsy with Cope's needle and it must precede thoracoscopy by means of its less aggressiveness.