SUPERFICIAL MASSES WITH COLOR FLOW DOPPLER IMAGING

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.