Color Doppler sonographic mapping of pulmonary lesions: evidence of dual arterial supply by spectral analysis.
OBJECTIVE
Within pulmonary lesions, flow signals of pulmonary arteries can be discriminated from flow signals of central bronchial and peripheral bronchial arteries on color Doppler sonography. Our aim was to evaluate the evidence and frequency of different arterial supplies of pleural-based pulmonary lesions using qualitative and quantitative color Doppler sonography.


METHODS
Forty-one patients with roentgenologically confirmed pleural-based pulmonary lesions were investigated by color Doppler sonography. The following parameters were investigated: (1) qualitative color Doppler sonographic evidence of vascularization, (2) quantitative color Doppler sonographic evidence of arterial flow signals (resistive index and pulsatility index), and (3) number of different arterial flow signals in 1 lesion by color Doppler sonographic mapping.


RESULTS
We found no vascularization in 5 patients, sparse vascularization in 21, and pronounced vascularization in 15. Quantitative color Doppler sonographic parameters were as follows: mean pulmonary artery resistive index, 1.2; mean central bronchial artery resistive index, 0.5; mean peripheral bronchial artery resistive index, 0.7; mean pulmonary artery pulsatility index, 7.8; mean central bronchial artery pulsatility index, 0.7; and mean peripheral bronchial artery pulsatility index, 1.6. There was a significant difference between all types of flow signals for resistive and pulsatility index values but not between pulmonary and peripheral bronchial arteries (P = .068). In 41 patients, 57 different arterial flow signals were determined; 19 (46%) of these patients had 2 or more different arterial flow signals in a lesion. There was no significant difference between benign and malignant lesions regarding the number of flow signals.


CONCLUSIONS
Evidence of at least a dual arterial supply can be found on quantitative color Doppler sonography in almost 50% of pulmonary lesions. A single spectral analysis is not suitable for characterization of the arterial supply of pulmonary lesions.
Görg
Christian
C
Medizinische Universitätsklinik, Marburg, Germany. goergc@mailer.uni-marburg.de
Seifart
Ulf
U
Görg
Konrad
K
Zugmaier
Gerhard
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011673:Pulsatile Flow; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance