Superficial masses with color flow Doppler imaging.

Abstract

Color Doppler imaging findings and spectral waveforms were reviewed for 21 superficial masses in which color Doppler imaging revealed flow. This series included 5 benign hyperplastic lymph nodes, 5 malignant masses, 2 staphylococcus abscesses, and 9 pseudoaneurysms. Benign hyperplastic nodes had a vascular pattern consisting of prominent central flow with a branching radial pattern, reflecting the morphology of lymph nodes. One metastasis from melanoma demonstrated abundant peripheral flow and central avascularity, while the other 4 malignant masses and the 2 abscesses had sparse internal flow. All pseudoaneurysms had a to-and-fro imaging and spectral pattern (into the mass during systole, out during diastole), and/or a swirling pattern on real-time images (8 of 9 each). Doppler spectral analysis revealed continuous forward flow during diastole for all other masses and abscesses. Waveforms appeared similar for benign and malignant masses, and for abscesses. Conventional image-directed Doppler examinations performed prior to color Doppler studies failed to reveal flow in 2 partially thrombosed pseudoaneurysms, 1 malignant mass, and 1 abscess. Benign hyperplastic nodes, malignant masses, and pseudoaneurysms had distinctive color Doppler image appearances in this series, although demonstration of flow within a mass does not eliminate the possibility of abscess. Proper use of color and spectral Doppler analysis of superficial masses involves more than mere detection or exclusion of flow.