Usefulness of Comprehensive High Resolution Ultrasound Imaging in Dermatologic Field: Epidermal Cyst
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 12, Issue 1
Abstract
Dermatologic ultrasound (US) has been growing rapidly in line with the development of more potent machines and high-frequency probes. The minimum frequency recommended for performing dermatologic examinations was 15 MHz. Epidermal Cyst is a common slow-growing dermal or subcutaneous epithelial cyst, which contains keratin and is lined by the epidermis. Epidermal cyst is considered as level 1 content of the training program in dermatologic ultrasound by the international working group, called DERMUS (Dermatologic Ultrasound). I review the characteristic findings of epidermal cyst on high-resolution US including gray-scale, color Doppler and Real-Time Tissue Elastography (RTE). Epidermal cyst has been reported as a pseudotestis pattern and nonpseudotestis one on gray scale US. In relation to color Doppler US, unruptured type of epidermal cyst represented no substantial blood flow signals and ruptured type shows pericystic and peripheral vascularity. It is reported that superficial epidermoid tumor shows a softer nature than dose malignant tumor on RTE. It is also reported that RTE is able to detect differences in tissue elasticity between ruptured and unruptured epidermal cysts. The comprehensive procedure using high-resolution ultrasound is useful for the accurate diagnosis of epidermal cyst.Dermatologic ultrasound imaging has been rapidly growing in recently years because of the development of high-resolution multifrequency transducers and multichannel color Doppler machines [1]. The international working group, called DERMUS (Dermatologic Ultrasound) was formed and provided the guidelines for performing dermatologic ultrasound examinations [1] and proposed for an assessment training program [2]. The minimum frequency recommended for performing dermatologic examinations was 15 MHz [2]. Epidermal Cyst is a common slow-growing dermal or subcutaneous epithelial cyst, which contains keratin and is lined by the epidermis [3]. It has been reported that epidermal cyst shows 2 types as pseudotestis and nonpseudotestis types on gray-scale US [4]. Epidermal cysts classically show a round-to-oval shape with posterior echo enhancement and lateral shadow on gray-scale US [5]. As the unruptured type of epidermal cyst represented no substantial blood flow signals, the ruptured type shows pericystic and peripheral vascularity [6] and prominent vascularity in the periphery [7] on color Doppler US. Real-time sonoelastography is an ultrasound-based technique using the property that the tissue strain due to compression is lower in hard tissues [8]. RTE is widely used for diagnosis of breast [9] and thyroid lesions [10] on tissue elasticity. There have been reported that the TRE is still uncommon in the dermatologic field. Patel et al. [11] reported that most epidermoid tumors show a predominant blue color, which represents their hard nature. Park HJ et al. [11,12] suggested that superficial epidermoid tumor exhibits a softer nature than dose malignant tumor but does not have a different strain elastography (SE) pattern from other benign tumors [12]. It has been reported that utility of sonoelastography in differentiating ruptured from unruptured epidermal cyst [5], suggesting the differences in tissue elasticity.
Authors and Affiliations
Kazumi Fujioka
Keywords
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- EP ID EP586814
- DOI 10.26717/BJSTR.2018.12.002184
- Views 151
- Downloads 0
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