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. 2011 Oct;21(4):279-83.
doi: 10.4103/0971-3026.90688.

Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions

Sumit Goel  1 , Suma Gundareddy Nagendrareddy, Manthena Srinivasa Raju, Dayashankara Rao Jingade Krishnojirao, Rajul Rastogi, Ravi Prakash Sasankoti Mohan, Swati Gupta
Affiliations

Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions

Sumit Goel et al. Indian J Radiol Imaging. 2011 Oct.

Abstract

Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions.

Materials and methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed.

Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case.

Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions.

Keywords: Color Doppler; conventional intraoral radiography; histopathology; periapical lesions; power Doppler; ultrasound.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(A-C) Periapical cyst. Intraoral periapical radiograph (A) shows a well-circumscribed radiolucent periapical lesion (arrow) with a partial sclerotic border, measuring more than 1 cm in diameter. USG with color Doppler and power Doppler (B) shows a hypoechoic, well-contoured cavity (arrow) with no evidence of internal vasculature on color and power Doppler examinations. H and E stained section shows the presence of an epithelial lining (arrow) with underlying dense fibrocellular connective tissue stroma (arrowhead)
Figure 2 (A-C)
Figure 2 (A-C)
Periapical granuloma. Intraoral periapical radiograph (A) shows a well-circumscribed radiolucent periapical lesion (arrow) without a sclerotic border, measuring less than 1 cm in size. USG with color Doppler and power Doppler shows a poorly defined hypoechoic lesion (arrow) exhibiting a rich vascular supply on color and power Doppler examinations. H&E stained section (C) shows fibrocellular connective tissue stroma (arrow) consisting of chronic inflammatory cell infiltrate (mainly lymphocytes and plasma cells) and endothelium-lined blood capillaries with red blood cells, fibroblasts, and collagen fibers
Figure 3
Figure 3
Mean superoinferior (SI) measurements with both conventional radiography and USG
Figure 4
Figure 4
Comparison of the sensitivity and specificity of radiography and ultrasound in diagnosing periapical cysts and granulomas
See this image and copyright information in PMC

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