Role of color Doppler imaging in differentiating between pseudocystic malignant tumors and fluid collections

The differentiation between a pseudocystic solid tumor and a fluid collection containing echoes is sometimes difficult. The purpose of this study was to evaluate the contribution of color Doppler sonography in confirming the solid nature of pseudocystic malignant tumors by demonstrating internal vascularity. Fourteen consecutive masses with an indeterminate solid or cystic appearance on conventional sonograms were evaluated with color Doppler sonography for the presence of blood flow within the boundaries of the mass. Color Doppler sonography demonstrated the presence of some blood flow in all 12 solid malignant tumors, whereas no flow was visualized in the two fluid collections. By demonstrating the presence of internal blood flow in solid tumors, color Doppler sonography can rapidly confirm the solid nature of markedly hypoechoic malignant tumors that mimic fluid collections on conventional sonograms.