Original Research Article http://doi.org/10.18231/j.jooo.2020.003 Journal of Oral Medicine, Oral Surgery, Oral Pathology and Oral Radiology, January-March 2020;6(1):5-11 5 Ultrasonography and Doppler ultrasonography in the evaluation of intraosseous lesions of the jaws Saima Tariq 1* , Altaf Hussain Chalkoo 2 , Rizwan Hamid 3 1,3 Postgraduate, 2 Professor, Dept. of Oral Medicine & Radiology, Government Dental College, Srinagar, India *Corresponding Author: Saima Tariq Email: saima.ashawari5@gmail.com Abstract Objectives: To evaluate the efficacy of ultrasonography and colour and power Doppler ultrasonography for diagnosis of intraosseous lesions of the jaws and to correlate the contents of the lesion with the histological findings. Materials and Methods: 30 patients with intraosseous jaw lesions in the maxilla or mandible were included in the study. Ultrasonographic examinations were performed and, according to the ultrasonography findings, the jaw lesions were classified into three groups: cystic, semisolid and solid. Further, colour Doppler ultrasonographic examination was performed to evaluate blood flow in all patients following which surgical treatment was done. The correlation between ultrasonography and Doppler ultrasonography findings of the lesions and histological findings was investigated. Results: Thirty intra-osseous lesions from twenty nine patients were evaluated in this study. Twenty two lesions were located in the mandible and eight were in the maxilla. Of the thirty lesions, the ultrasound examination was inconclusive in one lesion because of the thick cortical vestibular bone plate and for two lesions histopathology was not available. Conclusions: Information regarding the content of intraosseous jaw lesions can be obtained using ultrasound before any surgical procedure. Further, vascularization of the lesion can be assessed via Doppler ultrasonography. Also, there was a correlation between the ultrasound findings and the definitive histological diagnosis. Keywords: Intraosseous, Ultrasonography, Doppler ultrasonography, Histopathology. Introduction Embryologically, the jaws originate from ectomesenchyme. As a result of this Odontogenic cysts and tumors are a commonly occurring lesions in the jaws. 1 Correct early diagnosis and treatment of these lesions is necessary as some of these lesions show aggressive behaviour and even neoplastic transformation. 2 Because of similar radiographic appearance diagnosing these Intraosseous jaw lesions often becomes confusing. 3 Imaging, thereby, plays an important role in the diagnosis of these lesions. Various imaging modalities include radiography, computed tomography, magnetic resonance imaging, ultrasonography with Nuclear Medicine, Positron Emitting Tomography (PET), Single- photon emission computed tomography (SPECT) among advanced modalities. Although computed tomography (CT) is of immense importance in diagnosing bone lesions but the radiation hazard and high cost limits its use. 4 Ultrasonic imaging is one of the most important, developing diagnostic tools today. State-of-the-art ultrasonic scanners offer real-time gray scale images of anatomical details with millimeter spatial resolution superimposed on which a map of Doppler blood flow information is displayed in full color. 5 Despite being use in medicine for years ultrasonography in dentistry is used mostly for soft tissue lesions. 6 It is useful in differentiating soft-tissue tumors, cysts, salivary stones, relationship of swelling to adjacent structures, consistency whether solid or cystic, and also it is extremely suitable for follow-up examination of tumor patients. 7 Diagnosing Intraosseous jaw lesions using ultrasonography usually becomes difficult due to overlying cortical bone thereby limiting its use, but the thin cortical bone in case of well grown and expanding lesions makes ultrasonograhy useful in diagnosis of such lesions. USG helps in differentiating solid and cystic components of the Intraosseous jaw lesions and in determining the site of biopsy. 8 Improvements in the ultrasound technology and the introduction of high resolution ultrasonography have led to routine use of USG in examination and diagnosis of bone pathology. 9 The use of color Doppler in ultrasound allows evaluation of the presence, nature and velocity of blood flow in ultrasound images of the examined tissue. It can also reveal the progressive formation of new vessels in bone during the initial healing period. 10 Aims & Objectives of the Study 1 To evaluate the ability of ultrasonography and Doppler ultrasonography for diagnosing Intraosseous jaw lesions. 2 To determine a correlation between ultrasonographic findings regarding the contents of the lesion with the histological findings. Study design After getting approval from the Institutional Ethics Committee, the study was conducted in the Department of Oral Medicine & Radiology, Govt. Dental College, Srinagar over the period of a one and a half year commencing on 1 st June 2016. Materials and Methods 1 A total of 30 patients with intraosseous jaw lesions based on their symptoms, clinical and panoramic radiographic findings were included in the study.