Rallan Deepak, Bush Nigel L, Bamber Jeff C, Harland Chris C
Department of Dermatology, Epsom and St Helier University Hospitals NHS Trust, Carshalton, UK.
J Invest Dermatol. 2007 Jan;127(1):189-95. doi: 10.1038/sj.jid.5700554. Epub 2006 Oct 26.
High-resolution ultrasound-reflex transmission imaging is a non-invasive method that can be performed in vivo. We have adapted and refined this technique for skin imaging. Scans can be analyzed to produce objective parameters. Previous work has highlighted sonographic differences between benign and malignant lesions. The aim of this study was to produce and test numerical parameters from ultrasound skin images that would quantify the acoustic differences between common pigmented lesions, which may aid their discrimination from melanoma. We report our findings for randomly selected patients referred from primary care with suspected melanoma. Those subsequently classified as malignant melanoma (MM), seborrheic keratosis (SK), and benign nevi by a consultant dermatologist (n=87) were imaged by high-resolution ultrasound-reflex transmission imaging. Using surrounding normal skin as a control, numerical sonographic parameters were derived for each lesion giving a relative measure of surface sound reflectance, intra-lesional sound reflection, total sound attenuation, and the relative uniformity of each parameter across the tumor. Significant quantitative differences existed between benign and malignant pigmented lesions studied. Sufficient discrimination was produced between MM (n=25), SKs (n=24) and other benign-pigmented lesions (n=38) to potentially reduce the referral of benign tumors by 65% without missing melanoma.
高分辨率超声反射透射成像术是一种可在体内进行的非侵入性方法。我们对该技术进行了调整和改进，用于皮肤成像。扫描结果可进行分析以生成客观参数。先前的研究突出了良性和恶性病变之间的超声差异。本研究的目的是从超声皮肤图像中生成并测试数值参数，以量化常见色素沉着病变之间的声学差异，这可能有助于将它们与黑色素瘤区分开来。我们报告了对从初级保健机构转诊来的疑似黑色素瘤患者随机抽样后的研究结果。那些随后被皮肤科顾问医生分类为恶性黑色素瘤（MM）、脂溢性角化病（SK）和良性痣的患者（n = 87），通过高分辨率超声反射透射成像术进行了成像。以周围正常皮肤作为对照，为每个病变得出数值超声参数，给出表面声反射、病变内声反射、总声衰减以及每个参数在肿瘤内相对均匀性的相对测量值。在所研究的良性和恶性色素沉着病变之间存在显著的定量差异。在MM（n = 25）、SK（n = 24）和其他良性色素沉着病变（n = 38）之间产生了足够的区分度，有可能在不遗漏黑色素瘤的情况下将良性肿瘤的转诊率降低65%。
