Differentiation of Benign and Malignant Skin Lesions with Color and Power Doppler Ultrasonography

Aim: The aim of this study was to prospectively evaluate the usefulness of color Doppler ultrasonography, power Doppler ultrasonography, and gray scale ultrasonography in differentiating benign and malignant skin lesions. Material and Method: Patients were histopathologically divided into two groups as benign and malignant skin tumors. The dimensions of the lesion, the contour characteristics, existence of pagoda echo, levels of invasion, the internal echogenicities and vascular patterns were investigated. We analysed velocity waveforms and determinated peak systolic velocity, end-diastolic velocity, resistive index, and pulsatility index. Results: Eighty patients (35 female, 45 male) with populo-nodular lesions on the surface of the cutaneous and subcutaneous tissues were prospectively enrolled in this study. A significant difference was noted between malign and benign skin lesion groups as for color and power Doppler ultrasonographic findings such as blood flow analysis and as for the gray scale ultrasonographic findings such as irregular contour, pagoda echo and hypoechoic echogenicity. Blood flow was observed in 33 patients. The existence of the flow was mostly observed in 92.2% of the malign skin lesions and in 33.3% of the benign lesions. The analysis of peak systolic velocity, end-diastolic velocity, resistive index, and pulsatility index between the study groups did not reveal a significant difference (p>0.005). Discussion: Doppler ultrasound is a non-invasive and powerful technique for the differentiation of benign and malignant skin lesions.