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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2001 December;52(6):231-8
A diagnostic proposal in the study of soft tissue tumors of the limbs
Imazio P., Albertini U., Marone S., De Marchi A., Pozza S., Faletti C., Linari A., Pucci A., Forni G., Gino G., Comandone A., Brach Del Prever E. M.
Background. Echo color Power Doppler is a technique for soft tissue tumor diagnosis giving non-invasive vascular imaging. The intravenous echo-enhancing contrast agent (Levovist®) showed a significant echo-enhancing effect and good visualization of vascular supply in brest and other soft tissue tumors. The aim of the study was to evaluate the efficacy of the method in differentiating benign from malignant soft tissue lesions in the limbs.
Methods. Forty patients with soft tissue lesions in upper and lower limbs were studied: 27 benign lesions, 11 sarcomas and 2 extra-abdominal fibromatosis. In each lesion, the automatic quantification of ultrasound signal intensity after contrast agent injection (wash-in and wash-out curves) were studied and related with pathology and clinical data.
Results. Four different pattern of wash-in and wash-out recordings were identified and related with the histology: type I pattern with regular frequency and range peaks was found in 23 benign lesions (85% of all benign lesion); type III with irregular peaks was identified in 1 benign lesion (3,7% of all benign lesion) and ten soft tissue sarcomas (91% of all malignant lesion); type II was found in the 2 fibromatosis and the anomalous type in 2 benign lesions and 1 malignant lesion. One benign lesion had an insufficient vascularization to evaluate the wash-in and wash-out curve.
Conclusions. Automatic enhancement quantification could be useful to distinguish between benign and malignant lesions in the study of soft tissue tumors (sensibility 85%, specificity 91%).