Color Doppler ultrasound signals of thoracic lesions. Correlation with resected histologic specimens.

Abstract

Sixty-eight patients with thoracic lesions (48 with lung cancer and 20 with benign lesions) underwent color Doppler ultrasound (US) examinations. Of those, 21 patients (13 with lung cancer and eight with benign lesions) also received resections, and the correlation between color Doppler US signals and resected histologic specimens was evaluated. Our results showed that three patterns of color Doppler US signals could be detected and confirmed: pulsatile flow (artery), constant flow, and triphasic flow (pulmonary vein). Among the 48 patients with lung cancer, pulsatile flow, constant flow, and/or triphasic flow were detected in 34 (71%), 24 (50%), and 14 (29%), respectively. Among the 20 patients with benign lesions, only pulsatile flow and/or triphasic flow were detected in nine (45%) and eight (40%), respectively. From the correlation between color Doppler US signals and histologic specimens, constant flow was representative of the true neovascularity of lung cancers, and it was valuable for differentiating lung cancers from benign lesions (p = 0.00008, sensitivity = 0.50, and specificity = 1.0). Although color Doppler US still had some limitations in detecting blood vessels in thoracic lesions, the correlation between the vascularity represented by color Doppler US signals and histologic specimens was excellent. We conclude that color Doppler US is a valuable method for assessing blood flow in thoracic lesions and differentiating lung cancers from intrapulmonary benign lesions.

Transthoracic ultrasonography for the clinician

“…The depth of these lesions is accurately measured using US; however, sonagraphic rib shadowing can prevent the accurate determination of their size in the longitudinal axis (Figure 7). Color Doppler may aid in distinguishing benign from malignant masses, with around two-thirds of malignant masses demonstrating a color Doppler signal (low-impedance flow) because of increased vascularity (34,35). A pulsatile or triphasic flow pattern is often observed in either benign or malignant mass lesions, whereas a constant flow pattern correlates better with malignancy (37).…”

Transthoracic Ultrasonography for Clinicians

“…The depth of these lesions is accurately measured using US; however, sonagraphic rib shadowing can prevent the accurate determination of their size in the longitudinal axis (Figure 7). Color Doppler may aid in distinguishing benign from malignant masses, with around two-thirds of malignant masses demonstrating a color Doppler signal (low-impedance flow) because of increased vascularity (34,35). A pulsatile or triphasic flow pattern is often observed in either benign or malignant mass lesions, whereas a constant flow pattern correlates better with malignancy (37).…”

Transthoracic Ultrasonography for the Respiratory Physician

“…Colour Doppler US may distinguish malignant from benign pulmonary masses [36,37,38]. Approximately 65% of peripheral malignant masses will demonstrate a colour Doppler signal (low-impedance flow) due to increased vascularity.…”

“…Approximately 65% of peripheral malignant masses will demonstrate a colour Doppler signal (low-impedance flow) due to increased vascularity. A constant flow pattern correlates with malignancy, whereas a pulsatile or triphasic flow pattern is often observed in either benign or malignant mass lesions [36]. At least one study found that residual peripheral metastases demonstrated a reduced colour Doppler signal following chemotherapy [39].…”