Color doppler ultrasound

Abstract

Ultrasound (US), being a readily available, noninvasive and relatively inexpensive imaging modality, plays a significant part in the diagnostic workup of soft tissue masses. Owing to the nonspecific sonographic characteristics of most soft tissue masses, the particular roles of US are to confirm the presence of a suspected lesion, and to identify its size, volume and configuration, to determine its internal characteristics, to guide percutaneous biopsy and, in selected cases, to monitor response to chemotherapy. Furthermore, it may help in differentiating a localized mass from diffuse edema, and solid from cystic lesions. After an initial US examination, the role of other imaging modalities can be determined. Magnetic resonance imaging (MRI) should be reserved for cases in which US fails to establish a specific diagnosis or fails to demonstrate the margins of a soft tissue mass accurately. Advantages of US over MRI are the lack of partial volume averaging effects, the availability and low cost of the technique, and the short examination time. Moreover, motion artifacts,which may occur in noncooperative patients and children, are of less relevance when US is used. A limitation of US is encountered in the evaluation of the extension of a soft tissue tumor, in particular to adjacent bony structures. For specific tissue diagno- sis, US-guided percutaneous needle biopsies are generally less time-consuming and less expensive than those using computed tomography (CT) or MRI, with easier patient access. The use of color Doppler US (CDUS) as an additional means of describing the biological activity, structure, and extension of bone and soft tissue tumors and the blood supply to them has been described only incidentally. This chapter aims to summarize the potential value of this technique in the diagnosis and treatment of soft tissue tumors.