By I. Yaghmai
Many bone lesions have a attribute roentgen visual appeal, whereas others create diagnostic dilemmas not just for the radiologist, but in addition for the pathologist and health practitioner. Arteriography is beneficial within the prognosis of those tough situations, which can't be clinically determined with simple task via the mixed information from simple radiographs and histologic fabric. on the grounds that treatment is depen dent at the particular analysis, and pointless radical surgical procedure has been played some time past for benign illness, the addition of arteriographic facts may perhaps make sure or refute a analysis and be particularly precious to the sufferer and orthopedic general practitioner. Issa Yaghmai has had a good curiosity within the angiography of bone lesions and has accumulated over 650 circumstances prior to now 10 years. He has tested sufferers with almost all types of bone lesion, and has faithfully cat alogued and recorded his findings besides these of the pathologist. The histologically uncertain situations have been despatched to different well known bone patholo gists for evaluations in order that he may be as actual as attainable in correlating his angiographic findings with particular histologic diagnoses. His choice of bone arteriograms is definitely the most huge on the planet. He has recorded during this quantity the illustrations and data he has accumulated, and supplemented it with pertinent info from an exhaustive evaluation of the literature. Bone angiography isn't for each sufferer with a bone lesion, and Issa conscientiously tells us whilst it is going to or won't support us in our differential diagnosis.
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Extra info for Angiography of Bone and Soft Tissue Lesions
11 A-D. Sclerotic osteosarcoma in an 18-year-old male. A Anteroposterior view of the tibia reveals a typical sunburst periosteal reaction. B-D Arteriogram in the early arterial (B), subtraction film (C) and late venous phases (D) reveals hypervascularity and abnormal vessels in the tumor area. Tumor vessels arise 40 from surrounding soft tissues and extend into the tumor mainly perpendicular to the shaft between elements of sunburst periosteal reaction. These findings are best seen in the subtraction film (C).
Sclerotic osteosarcoma in a lO-year-old male. A, 8 Anteroposterior (A) and lateral (8) views of the knee reveal an amorphous, sclerotic tumor in the proximal tibia. C Early arterial phase reveals nu- 44 merous arteries in the tumor area without noticeable tumor stain. D Modified subtraction film reveals arteries in white, veins in black, and tumor stain in gray color. (Yaghmai, 1977 c) B o 45 Fig. 14 A-E. Fibroblastic--chondroblastic osteosarcoma in a l7-year-old female. A, B Anteroposterior (A) and lateral (B) roentgenograms reveal a radiolucent bone lesion involving the medullary canal of the distal femur.
C, D Arterial (C) and venous (D) phases of the arteriogram reveal a few arteries in the tumor area with no definite stain. E, F Subtrac- 48 tion films of the same reveal numerous small arteries and a stain in the tumor area with uneven distribution. Note the presence of pooling of opaque material around the sequestered bone. At this time, the tumor was diagnosed as neoplastic and probably fibrosarcoma. Histopathologic findings were reported as fibroblastic osteosarcoma 49 Fig. 16 A-F. Osteosarcoma in a l7-year-old male.