# Mass lesions

Mass lesions

Mass lesions in muscle and soft tissue are examined by ultra - sound, which can be diagnostic in the majority of  cases, thereby avoiding the need for further imaging. This is most often the case when a lesion is purely cystic and, as most soft-tissue masses are cysts, ultrasound is a very e ff ective screening test. ). There are occasions w hen no mass lesion is found at the site of 

(b)

concern, and then reassurance can be o ff ered. If  the ultrasound examination is normal, this e ff ectively excludes soft-tissue neoplasia. A reasonable protocol is to perform ultrasound on all palpable ‘lesions’ to exclude cysts, and on patients without any identifiable mass, and to proceed to MRI only when there is a solid or partly solid element to an unidentifiable lesion. Tumour vascularity is best assessed by Doppler ultrasound. It can be studied by intravenous gadolinium DTPA-enhanced MRI; however, this is a more expensive and invasive technique, providing no more information than Doppler ultrasound. Summary box 8.12 Imaging of soft-tissue lesions /uni25CF /uni25CF /uni25CF /uni25CF 

Ultrasound is the best for screening; it is often the only imaging
required
MRI is best for local staging and follow-up
Doppler ultrasound can assess vascularity cheaply and
effectively
Ultrasound is useful for biopsy

Mass lesions

Mass lesions in muscle and soft tissue are examined by ultra - sound, which can be diagnostic in the majority of  cases, thereby avoiding the need for further imaging. This is most often the case when a lesion is purely cystic and, as most soft-tissue masses are cysts, ultrasound is a very e ff ective screening test. ). There are occasions w hen no mass lesion is found at the site of 

(b)

concern, and then reassurance can be o ff ered. If  the ultrasound examination is normal, this e ff ectively excludes soft-tissue neoplasia. A reasonable protocol is to perform ultrasound on all palpable ‘lesions’ to exclude cysts, and on patients without any identifiable mass, and to proceed to MRI only when there is a solid or partly solid element to an unidentifiable lesion. Tumour vascularity is best assessed by Doppler ultrasound. It can be studied by intravenous gadolinium DTPA-enhanced MRI; however, this is a more expensive and invasive technique, providing no more information than Doppler ultrasound. Summary box 8.12 Imaging of soft-tissue lesions /uni25CF /uni25CF /uni25CF /uni25CF 

Ultrasound is the best for screening; it is often the only imaging
required
MRI is best for local staging and follow-up
Doppler ultrasound can assess vascularity cheaply and
effectively
Ultrasound is useful for biopsy

Mass lesions

Mass lesions in muscle and soft tissue are examined by ultra - sound, which can be diagnostic in the majority of  cases, thereby avoiding the need for further imaging. This is most often the case when a lesion is purely cystic and, as most soft-tissue masses are cysts, ultrasound is a very e ff ective screening test. ). There are occasions w hen no mass lesion is found at the site of 

(b)

concern, and then reassurance can be o ff ered. If  the ultrasound examination is normal, this e ff ectively excludes soft-tissue neoplasia. A reasonable protocol is to perform ultrasound on all palpable ‘lesions’ to exclude cysts, and on patients without any identifiable mass, and to proceed to MRI only when there is a solid or partly solid element to an unidentifiable lesion. Tumour vascularity is best assessed by Doppler ultrasound. It can be studied by intravenous gadolinium DTPA-enhanced MRI; however, this is a more expensive and invasive technique, providing no more information than Doppler ultrasound. Summary box 8.12 Imaging of soft-tissue lesions /uni25CF /uni25CF /uni25CF /uni25CF 

Ultrasound is the best for screening; it is often the only imaging
required
MRI is best for local staging and follow-up
Doppler ultrasound can assess vascularity cheaply and
effectively
Ultrasound is useful for biopsy