Indian Journal of Radiology Indian Journal of Radiology  

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Year : 2000  |  Volume : 10  |  Issue : 4  |  Page : 233-236
Evaluation of skin lesions with color doppler and spectral analysis

Dept of Radiology Imaging & Dernatology, UCMS & GTB Hosp,Dilshad Garden, Delhi - 110 095, India

Correspondence Address:
Satish K Bhargava
E-3, GTB Hosp Campus, Dilshad Garden, Delhi - 110 095
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Objectives : Skin lesions in twenty-four patients were evaluated with the help of color Doppler and spectral analysis in an effort to characterize the ultrasonographic differentiating features of various benign and malignant lesions. Material and Methods : A 7.5 MHz linear array small parts probe was used on a Philips P700 scanner, a real time scanner with color Doppler facility. Twenty-four patients with skin lesions were evaluated with gray scale US, duplex and color flow Doppler US. The patients were referred from our dermatology department without a clinical diagnosis. The age of the patients ranged from 15-65 years. Gray scale US findings of the lesions were obtained and compared with the normal skin on the contralateral region of the body. The lesions were evaluated for vascularity with color flow Doppler imaging. Maximum systolic and end diastolic velocities were measured and RI was calculated. The lesion was examined from two and more regions in order to minimize the error and average values of velocities were obtained. The Doppler settings used were (VFW) variable focal windowing in which depth was selected according to the size of the lesion and maximum (EE) edge enhancement for optimum visualization of the lesion. Results : Twenty-four patients were studied. Out of twenty-four patients seventeen patients showed benign lesions and seven patients showed malignant lesions. Seven patients out of twenty four patients showed color flow, four in benign lesions and three in malignant lesions. Seven patients out of twenty-four (30%) showed color flow pattern. Four out of seventeen benign lesions (24%) showed color flow pattern. Three out of seven malignant lesions (42%) showed color flow pattern. The thickness of the lesions was measured and ranged between 0.27-2.21 cm. The diameter of the lesions was between 0.67-3.40 cm. In our study we found that the thickness and diameter of the lesions did not play a significant role in the color flow patterns obtained. The RI values obtained were found to be overlapping in benign and malignant lesions. However the mean peak systolic velocities obtained from benign and malignant skin lesions were 5.75 cm/sec and 35.40 cm/sec per second respectively with a significant P-value =0.000 (t-test). There was a significant difference between the peak systolic velocities obtained between the benign and malignant lesions. The mean end diastolic velocities of benign and malignant lesions were 3.00 cm/sec and 15.67 cm/sec respectively. The P-value=0.005 (t-test) was also significant. Conclusions : The Majority of the skin tumors are benign and therefore there is a need for a non-invasive method that aids the selection of malignant tumors for their removal. Color Doppler US and spectral analysis of skin lesions are a useful compliment to skin biopsy for differentiating between benign and malignant skin lesions. Our study proves that the flow velocities of skin lesion are very significant in differentiating between benign and malignant skin lesions and also work as a supporting diagnostic tool in doubtful and challenging cases. However excision biopsy is the gold standard for analysis of such lesions.

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