Fifty-six patients with soft tissue masses of the limbs (36 benign, 20 mali
gnant) prospectively underwent sonography (color Doppler and pul;ed Doppler
examinations) to assess the role of Doppler interrogation in differentiati
ng benign from malignant lesions. Sonography showed 60% sensitivity, 55% sp
ecificity: 71% negative predictive value, 42% positive predictive value, an
d 57% accuracy. Color Doppler evaluation showed 85% sensitivity, 88% specif
icity, 91% negative predictive value, 80% positive predictive value, and 87
% accuracy. Diastolic and venous velocities nd pulsatility index values wer
e not statistically significant. Mean systolic velocity was 0.27 m/s in ben
ign lesions and 0.55 m/s in malignant lesions. By combining sonographic and
Doppler data, a correct diagnosis was obtained in 51 of 56 patients (90% s
ensitivity, 91% specificity, 85% positive predictive value, 94% negative pr
edictive value, 91% accuracy). Color Doppler and pulsed Doppler evaluations
represent a useful adjunct to sonography and should be routinely included
in the evaluation of musculoskeletal soft tissue masses by ultrasonography.