There is a wide variety of soft tissue masses that includes non neoplastic lesions,
benign and malignant tumours (fig 1).
In this field the imaging characterization remains problematic,
A systematic interdisciplinary approach can identify quiescent,
active and aggressive lesions,
achieve histological diagnosis based on the World Health Organization (WHO) classification system for tissue tumors ,
allows a rapid clinical decision and optimises resources,
excessive costs both financial and human.
Several imaging modalities have been used to assess soft-tissue tumors...
Methods and Materials
A retrospective cohort series of 207 patients from January 2009 to December 2010 (range 18-83) with soft tissue masses of limbs and trunk were studied by US,
PD and CEUS: the intravenous contrast agent was SonoVue® (Bracco,
We used a Teknos MPX and MyLab 70 equipment (Esaote,
Italy) equipped with a wideband (5-10 MHz) linear array transducer.
Each study consisted of conventional grey-scale sonography to visualize the lesion,
followed by contrast- enhanced low-mechanical index (MI: 0.08,
40 Kp) real time examination,
All patients tollerated the sonographical examination well without side effects related to ultrasound contrast agent.
Eighty-eight benign and 117 malignant lesions were diagnosed by histology.
In all masses,
seven different CEUS patterns and three different vascular timing were observed.
90% of the malignant lesions (105/117) show a rapid early time of vascularisation (arterial phase) and 60% (70/117) an inhomogenous enhancement pattern with avascular areas.
Only 20% of benign lesions (11/88) show a pattern similar to malignant lesions and 50% (44/88) showed a rapid time vascularization:...
The inhomogenous CEUS enhancement pattern with avascular areas and the rapid vascular flow can be related with malignancy (Fig.
Also in our experience the absence of the contrast uptake is a good negative predictor for malignancy (Fig.
Other CEUS patterns are more frequent in benign lesions; rapid arterial flow in benign masses is present when hemangioma or artero-venous malformation are present.
These preliminary results suggest that CEUS can facilitate a rapid and easy identification of masses potentially malignant,
therefore CEUS could...
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Diagnostic and international imaging...