Dhami Alysha, Vale S Max, Richardson Michael L, Schachtel April K, Fleckman Philip
Department of Radiology, Stanford University Medical Center, Palo Alto, CA, USA.
Division of Dermatology, University of Washington Medical Center, Seattle, WA, USA.
Skin Appendage Disord. 2023 Aug;9(4):262-267. doi: 10.1159/000530397. Epub 2023 May 26.
Subungual myxoid cysts and subungual glomus tumors demonstrate characteristic features on magnetic resonance imaging (MRI) and ultrasound (US). It is not yet well-established whether US is congruent to MRI in diagnostic evaluation of these subungual lesions.
Participants with clinical suspicion for subungual glomus tumors or subungual myxoid cysts were recruited. After clinical evaluation, participants underwent radiography, MRI, and US plus biopsy, aspiration, or excision where possible. Differential diagnoses were revised after review of imaging, and imaging findings were compared to definitive diagnosis by pathology, aspiration, or clinical course.
All lesions were visible on both US and MRI and size estimates agreed between the two modalities. US and MRI findings of subungual glomus tumors and subungual myxoid cysts agreed with their known respective imaging characteristics.
Diagnosis of subungual myxoid cysts and subungual glomus tumors agreed between US and MRI. We provide sample MRI and US imaging parameters for optimal evaluation of subungual myxoid cysts and glomus tumors. We demonstrate that subungual MRI evaluation can be performed without special equipment, allowing for evaluation by most radiology departments. Lastly, US is user-dependent and may be non-inferior for a sonographer familiar with subungual US.
甲下黏液囊肿和甲下血管球瘤在磁共振成像(MRI)和超声(US)上具有特征性表现。在这些甲下病变的诊断评估中,超声是否与MRI一致尚未完全明确。
招募临床怀疑为甲下血管球瘤或甲下黏液囊肿的参与者。经过临床评估后,参与者接受了放射照相、MRI以及超声检查,并在可能的情况下进行活检、抽吸或切除。在复查影像学检查后修订鉴别诊断,并将影像学表现与病理、抽吸或临床病程的明确诊断进行比较。
所有病变在超声和MRI上均可见,两种检查方式对病变大小的估计一致。甲下血管球瘤和甲下黏液囊肿的超声和MRI表现与其各自已知的影像学特征相符。
超声和MRI对甲下黏液囊肿和甲下血管球瘤的诊断结果一致。我们提供了用于甲下黏液囊肿和血管球瘤最佳评估的MRI和超声成像参数样本。我们证明,甲下MRI评估无需特殊设备即可进行,大多数放射科均可开展。最后,超声检查依赖操作人员,对于熟悉甲下超声检查的超声医师而言,其诊断效果可能并不逊色。