Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2019 Sep 5;132(17):2021-2026. doi: 10.1097/CM9.0000000000000369.
Due to advances in high-frequency ultrasound technology, it is easier to detect fine structures of skin lesions. The aim of this study was to examine the ultrasonographic features and use recurrence risk stratification to assess the diagnostic performance of pre-operative ultrasound examination of basal cell carcinoma (BCC).
This was a retrospective study. Forty-six BCC lesions underwent pre-operative ultrasound examination using 50- and 20-MHz probes. Ultrasonographic shape, margin, internal echoes, hyper-echoic spots, posterior echoes, and depth of the lesion were evaluated and correlated with the risk of recurrence based on histological features.
Forty-two patients had 46 skin lesions in total. The high-risk (n = 6) and low-risk (n = 40) groups exhibited considerable overlap in the ultrasonographic manifestations and no significant difference in margin (χ = 3.231, P = 0.072), internal echo (χ = 1.592, P = 0.207), or posterior echo (P = 0.169). However, high-risk BCCs tended to be irregular in shape than low-risk lesions (χ = 4.313, P = 0.038). Both types presented hyper-echoic spots (χ = 1.850, P = 0.174). Additionally, 78% of low-risk lesions were confined to the dermis (31/40), and 100% of high-risk lesions infiltrated into the sub-cutaneous tissue, resulting in a significant difference between the two groups (χ = 10.951, P = 0.001). Ultrasound detected sub-clinical lesions in five patients.
High-frequency ultrasound can provide important information for pre-operative evaluation of risk in BCC foci and reveal hidden lesions. The technique may play a crucial role in guiding therapeutic options for BCC.
由于高频超声技术的进步，更易于检测皮肤病变的细微结构。本研究旨在探讨基底细胞癌（BCC）术前超声检查的超声特征和利用复发风险分层评估其诊断性能。
这是一项回顾性研究。使用 50MHz 和 20MHz 探头对 46 例 BCC 病变进行术前超声检查。评估超声形状、边界、内部回声、高回声点、后方回声和病变深度，并根据组织学特征与复发风险相关联。
42 例患者共 46 个皮肤病变。高危（n=6）和低危（n=40）组的超声表现有相当大的重叠，边界（χ²=3.231，P=0.072）、内部回声（χ²=1.592，P=0.207）或后方回声（P=0.169）无显著差异。然而，高危 BCC 倾向于呈现不规则形状，而低危病变则呈现规则形状（χ²=4.313，P=0.038）。两种类型均呈现高回声点（χ²=1.850，P=0.174）。此外，78%的低危病变局限于真皮（31/40），而 100%的高危病变浸润至皮下组织，两组之间存在显著差异（χ²=10.951，P=0.001）。超声在五例患者中检测到亚临床病变。
高频超声可为 BCC 病灶的术前风险评估提供重要信息，并揭示隐匿性病变。该技术可能在指导 BCC 的治疗选择方面发挥关键作用。
