Diagnostic value of high-frequency ultrasound (HFUS) in evaluation of subcutaneous lesions

Yao Miao; Wei-Wei Ren; Fei-Yue Yang; Liang Li; Ling Wu; Dan- Dan Shan; Zi-Tong Chen; Li-Fan Wang; Qiao Wang; Le-Hang Guo

doi:10.1111/srt.13464

Diagnostic value of high-frequency ultrasound (HFUS) in evaluation of subcutaneous lesions

Skin Res Technol. 2023 Sep;29(9):e13464. doi: 10.1111/srt.13464.

Authors

Yao Miao^{1

2}, Wei-Wei Ren^{1

2}, Fei-Yue Yang¹, Liang Li³, Ling Wu³, Dan- Dan Shan^{1

2}, Zi-Tong Chen^{1

2}, Li-Fan Wang⁴, Qiao Wang^{1

2}, Le-Hang Guo^{1

2}

Affiliations

¹ Department of Medical Ultrasound, Shanghai Tenth People's Hospital; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, School of Medicine, Tongji University, Shanghai, China.
² Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.
³ Department of Dermatological Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.
⁴ Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Background: It is unknown whether high-frequency ultrasound (HFUS) can evaluate invisible subcutaneous lesions. We aimed to investigate the diagnostic value of HFUS in invisible subcutaneous lesions.

Method: Patients with invisible subcutaneous lesions were prospectively recruited from two centres. Before undergoing biopsy or surgery, each lesion was independently evaluated by two clinicians. One provides a clinical diagnosis by only clinical examination and the other provides an integrated diagnosis by combining clinical examination and HFUS information. Diagnoses were classified as correct, wrong, and indeterminate. A total of 391 lesions from 355 patients were enrolled, including 225 epidermoid cysts, 77 lipomas, 25 pilomatrixomas, 21 haemangiomas, 19 dermatofibromas, 11 dermatofibrosarcoma protuberans (DFSP), 7 neurofibromas, and 6 leiomyomas. Using pathological results as the gold standard, diagnostic performance was compared.

Results: The number of correct diagnoses increased from 185 (47.3%) by clinical examination alone to 316 (80.8%) after the addition of HFUS (P < 0.05). Meanwhile, the indeterminate diagnosis rate decreased from 143 (36.6%) to 10 (2.6%). Using HFUS, the accuracy improved significantly for epidermoid cysts (59.6% vs. 86.7%), lipomas (50.6% vs. 94.8%), pilomatrixomas (0% vs. 48.0%), haemangiomas (23.8% vs. 57.1%), and DFSPs (0% vs. 81.8%) (all p < 0.05). However, HFUS did not significantly improve the diagnostic accuracy of dermatofibromas (15.8% vs. 21.1%, p > 0.999), neurofibromas (42.9% vs. 71.4%, p = 0.625), or leiomyomas (16.7% vs. 100%, p = 0.063).

Conclusion: Combining HFUS and clinical examination can generally improve the diagnostic accuracy and decrease the indeterminacy of invisible subcutaneous lesions, especially epidermoid cysts, lipomas, pilomatrixomas, haemangiomas, and DFSPs. However, for some rare lesions, HFUS cannot provide useful information.

Keywords: dermatology; subcutaneous lesions; ultrasound.

MeSH terms

Epidermal Cyst* / diagnostic imaging
Hair Diseases*
Hemangioma* / diagnostic imaging
Histiocytoma, Benign Fibrous*
Humans
Leiomyoma*
Lipoma*
Neurofibroma*
Pilomatrixoma*
Skin Neoplasms* / diagnostic imaging

Abstract

MeSH terms

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