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Figure 4c. Color Doppler US images obtained in a 71-year-old patient. (a) Longitudinal scan shows chondrosarcoma in left femur, with SWA in tumor vessel (curved arrow), with maximal systolic flow velocity increase of 110 cm/sec (straight arrow), representing a stenosed tumor vessel. Flow velocity prior to stenosed vessel segment was 45 cm/sec (image not shown). (b) Transverse scan shows chondrosarcoma. SWA of occluded tumor vessel shows reduced systolic flow of 9 cm/sec (solid arrow) and no diastolic flow (open arrow), suggesting that this vessel is distally occluded. (c) Longitudinal scan shows chondrosarcoma in left femur, with SWA of arteriovenous shunt showing a delayed systolic peak (left arrow) and high diastolic flow (right arrow), with resulting RI of 0.35, suggesting direct connection from arterial to venous tumor vessel.