title: Soft-tissue tumor differentiation using 3D power Doppler ultrasonography with echo-contrast medium injection.
abstract: BACKGROUND
  We aimed to evaluate the ability of 3-dimensional power Doppler ultrasonography to differentiate soft-tissue masses from blood flow and vascularization with contrast medium.
  
  
  METHODS
  Twenty-five patients (mean age, 44.1 years; range, 12-77 years) with a palpable mass were enrolled in this study. Volume data were acquired using linear and convex 3-dimensional probes and contrast medium injected manually by bolus. Data were stored and traced slice by slice for 12 slices. All patients were scanned by the same senior sonologist. The vascular index (VI), flow index (FI), and vascular-flow index (VFI) were automatically calculated after the tumor was completely traced. All tumors were later confirmed by pathology.
  
  
  RESULTS
  The study included 8 benign (mean, 36.5 mL; range, 2.4-124 mL) and 17 malignant (mean, 319.4 mL; range, 9.9-1,179.6 mL) tumors. Before contrast medium injection, mean VI, FI and VFI were, respectively, 3.22, 32.26 and 1.07 in benign tumors, and 1.97, 29.33 and 0.67 in malignant tumors. After contrast medium injection, they were, respectively, 20.85, 37.33 and 8.52 in benign tumors, and 40.12, 41.21 and 17.77 in malignant tumors. The mean differences between with and without contrast injection for VI, FI and VFI were, respectively, 17.63, 5.07 and 7.45 in benign tumors, and 38.15, 11.88 and 16.55 in malignant tumors. Tumor volume, VI, FI and VFI were not significantly different between benign and malignant tumors before and after echo-contrast medium injection. However, VI, FI and VFI under self-differentiation (differences between with and without contrast injection) were significantly different between malignant and benign tumors.
  
  
  CONCLUSIONS
  Three-dimensional power Doppler ultrasound is a valuable tool for differential diagnosis of soft-tissue tumors, especially with the injection of an echo-contrast medium.
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C. hjchiou@vghtpe.gov.tw
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Chiou
authors.forename: Yi-Hong
authors.initials: YH
authors.lastname: Chou
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Chen
authors.forename: Winby
authors.initials: W
authors.lastname: Chen
authors.forename: Hsin-Kai
authors.initials: HK
authors.lastname: Wang
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D003287:Contrast Media