Tumours and pseudotumours of the soft tissue in adults: Perspectives and current role of sonography

Abstract

Soft tissue tumours of the musculoskeletal system are reported relatively frequently. The quality of the information gained from different imaging modalities (Doppler sonography, multislice CT, MRI spectroscopy, and diffusion MRI) means that in a growing number of situations, we can envisage determining with great accuracy not only the usual information of tumour size and topography, but often the exact nature of the tissue, almost always identifying whether a lesion is aggressive or not. Of all these techniques, Doppler sonography has become the most widely used due to the striking improvements in its sensors, especially for superficial applications. Some other recent developments are: panoramic imaging, elastography (although its current contribution is still to be determined but it seems to offer promising potential), and, most importantly, specific contrast agents. These techniques have considerably refined the quality of the information obtained, and have particularly enhanced the degree of sensitivity with which lesion progression can be assessed. Ultrasonography is the very first investigation in our protocol. It is also very often used to close investigations, as it accurately guides core needle biopsy from these generally accessible lesions. The purpose of this article is to bring together updated information on the various collections of sonographic features seen in soft tissue tumours and pseudotumours and to emphasise the considerable contributions of these new technological developments, in particular contrast-enhanced sonography. The discussion will follow the World Health Organisation's anatomical pathology classifications of soft tissue tumours. We will close with a synthesis that summarises the main steps in our diagnostic process.

Real-time monitoring of magnetic drug targeting using fibered confocal fluorescence microscopy

“…3. m -NCs were injected at 0 h and a magnetic field was then applied to one tumor for 1 h. Multiple imaging was performed at 1, 4 and 24 h. Tumors are heterogeneous and contain irregular capillary networks and non-vascularized areas of necrosis [20], [21], [22]. FCFM imaging was performed focusing on the highly vascularized regions.…”

Analysis on diagnostic failure of US-guided core needle biopsy for soft tissue tumors

“…What's more, the isoechoic and hyperechoic tumors owned lower diagnostic yield than hypoechoic ones, but the echogenicity cannot be used as an independent indicator of diagnostic failure. We deemed that the echogenicity was correlated to the discrepancy in acoustic impedance among the composition of the tumors which included tumor cells, fatty tissue, vascular, fibers, collagen, and cartilage [43] . The inflammatory cell infiltration, hemorrhage and fatty tissues in the tumors with isoechoic and hyperechoic may hinder the acquisition of tumor cells during the biopsy [44] .…”

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

“…46 It is also useful to guide aspiration for bacteriology sampling and drainage. 47 US also has a role in the treatment of FBs. Realtime examination can guide FB removal.…”