Suh Pae Sun, Jeong So Yeong, Baek Jung Hwan, Kim Tae Yong, Lee Yu-Mi, Song Dong Eun, Park Yun Seo, Ahn Je Young, Chung Sae Rom, Choi Young Jun, Lee Jeong Hyun
Department of Radiology and Research institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Ultrasonography. 2024 Mar;43(2):141-150. doi: 10.14366/usg.23210. Epub 2024 Jan 23.
This study investigated the clinical and ultrasonographic (US) findings of suture granulomas and recurrent tumors, and aimed to identify specific characteristics of suture granulomas through an experimental study.
This retrospective study included 20 pathologically confirmed suture granulomas and 40 recurrent tumors between January 2010 and December 2020. The clinical findings included suture material, surgery, and initial TNM stage. The US findings included shape, size, margin, echogenicity, heterogeneity, vascularity, and internal echogenic foci. The distribution, paired appearance, and "knot-and-ear" appearance of internal echogenic foci were assessed. An experiment using pork meat investigated the US configuration of suture knots.
Eighteen patients with 20 suture granulomas (15 women; mean age, 52±13 years) and 37 patients with 40 recurrent tumors (24 women; 54±18 years) were included. Patients with suture granulomas exhibited earlier initial T and N stages than those with recurrent tumors. The knot-and-ear appearance, defined as an echogenic dot accompanied by two adjacent echogenic dots or lines based on experimental findings, was observed in 50% of suture granulomas, but not in recurrent tumors (P<0.001). Central internal echogenic foci (68.8%, P=0.023) and paired appearance (75.0%, P<0.001) were more frequent in suture granulomas. During follow-up, 94.1% of suture granulomas shrunk.
The knot-and-ear appearance is a potential pathognomonic finding of suture granuloma, and central internal echogenic foci with paired appearance were typical US features. Clinically, suture granulomas showed early T and N stages and size reduction during follow-up. Understanding these features can prevent unnecessary biopsy or diagnostic surgery.
本研究调查了缝线肉芽肿和复发性肿瘤的临床及超声（US）表现，并旨在通过实验研究确定缝线肉芽肿的特定特征。
本回顾性研究纳入了2010年1月至2020年12月期间20例经病理证实的缝线肉芽肿和40例复发性肿瘤。临床发现包括缝线材料、手术及初始TNM分期。超声表现包括形态、大小、边界、回声性、异质性、血管分布及内部回声灶。评估了内部回声灶的分布、成对表现及“结耳”表现。使用猪肉进行的实验研究了缝线结的超声形态。
纳入了18例有20个缝线肉芽肿的患者（15例女性；平均年龄52±13岁）和37例有40个复发性肿瘤的患者（24例女性；54±18岁）。缝线肉芽肿患者的初始T和N分期早于复发性肿瘤患者。根据实验结果定义为一个回声点伴有两个相邻回声点或线的“结耳”表现，在50%的缝线肉芽肿中观察到，但在复发性肿瘤中未观察到（P<0.001）。中央内部回声灶（68.8%，P=0.023）及成对表现（75.0%，P<0.001）在缝线肉芽肿中更常见。随访期间，94.1%的缝线肉芽肿缩小。
“结耳”表现是缝线肉芽肿的潜在特征性表现，中央内部回声灶伴成对表现是典型的超声特征。临床上，缝线肉芽肿表现为早期T和N分期且随访期间大小缩小。了解这些特征可避免不必要的活检或诊断性手术。
