High-Frequency Ultrasound Imaging to Distinguish High-Risk and Low-Risk Dermatofibromas

Danhua Li; Feiyue Yang; Yang Zhao; Qiao Wang; Weiwei Ren; Liping Sun; Dandan Shan; Chuan Qin

doi:10.3390/diagnostics13213305

High-Frequency Ultrasound Imaging to Distinguish High-Risk and Low-Risk Dermatofibromas

Diagnostics (Basel). 2023 Oct 25;13(21):3305. doi: 10.3390/diagnostics13213305.

Authors

Danhua Li¹, Feiyue Yang^{2

3}, Yang Zhao¹, Qiao Wang^{2

3

4}, Weiwei Ren^{2

3

4}, Liping Sun^{2

3}, Dandan Shan^{2

3}, Chuan Qin^{1

5}

Affiliations

¹ Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China.
² Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
³ Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China.
⁴ Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200443, China.
⁵ Department of Ultrasound, Karamay Central Hospital, Karamay 834000, China.

Abstract

Background: Dermatofibroma has various pathological classifications, some of which pose a risk of recurrence and metastasis. Distinguishing these high-risk dermatofibromas based on appearance alone can be challenging. Therefore, high-frequency ultrasound may provide additional internal information on these lesions, helping to identify high-risk and low-risk dermatofibroma early.

Methods: In this retrospective study, 50 lesions were analyzed to explore the correlation between clinical and high-frequency ultrasound features and dermatofibroma risk level. Based on their pathological features, the lesions were divided into high-risk (n = 17) and low-risk (n = 33) groups. Subsequently, an identification model based on significant high-frequency ultrasound features was developed.

Results: Significant differences were observed in the thickness, shape, internal echogenicity, stratum basal, and Doppler vascular patterns between the high-risk and low-risk groups. The median lesion thickness for the high-risk dermatofibroma group was 4.1 mm (IQR: 3.2-6.1 mm), while it was 3.1 mm (IQR: 1.3-4.2 mm) for the low-risk dermatofibroma group. In the high-risk dermatofibroma group, irregular morphology was predominant (70.6%, 12/17), the most common being dermis-to-subcutaneous soft tissue penetration (64.7%, 11/17), and heterogenous internal echogenicity was observed in the majority of cases (76.5%, 13/17). On the other hand, regular morphology was more prevalent in the low-risk dermatofibroma group (78.8%, 26/33), primarily limited to the dermis layer (78.8%, 26/33), with homogeneous internal echogenicity also being prevalent in the majority of cases (81.8%, 27/33). Regarding the Doppler vascularity pattern, 69.7% (23/33) of low-risk dermatofibromas had no blood flow, while 64.7% (11/17) of high-risk dermatofibromas had blood flow.

Conclusion: High-frequency ultrasound is crucial in distinguishing high-risk and low-risk dermatofibromas, making it invaluable for clinical management.

Keywords: dermatology; diagnosis; fibrous histiocytoma; ultrasonography.

Abstract

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