The Alfred Hospital, Melbourne, Victoria, Australia.
Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.
J Eur Acad Dermatol Venereol. 2024 Jul;38(7):1305-1313. doi: 10.1111/jdv.19939. Epub 2024 Mar 1.
High-resolution ultrasound (HRUS), operating at frequencies of 20-25 MHz, is a non-invasive imaging tool that offers dermatologists the ability to visualize structures beneath the skin surface. The objective of this review is to present a comprehensive overview of HRUS applications, emphasising its utility in diagnosing, characterising and managing various dermatological conditions. We undertook a comprehensive literature review on the dermatological application of HRUS across Medline, Embase and Cochrane Library databases, while also incorporating our own clinical experience of over 16 years with the tool. In normal skin, the epidermis and dermis are hyperechoic, and the subcutaneous layer is hypoechoic. Basal cell carcinomas appear hypoechoic with irregular margins, while the presence of hyperechoic inclusion bodies suggests aggressive pathology. Squamous cell carcinomas pose challenges due to acoustic shadow artefacts from the thickened stratum corneum. Melanomas are homogenous hypoechoic lesions, with HRUS used to accurately predict Breslow thickness. HRUS provides dermatologists with a valuable adjunct to traditional clinical examination. Future advancement in image resolution and the standardisation of diagnostic parameters may further expand its utility.
高分辨率超声（HRUS），工作频率为 20-25MHz，是一种非侵入性的成像工具，为皮肤科医生提供了观察皮肤表面以下结构的能力。本综述的目的是全面介绍 HRUS 的应用，强调其在诊断、特征描述和管理各种皮肤科疾病方面的效用。我们对 Medline、Embase 和 Cochrane Library 数据库中关于 HRUS 在皮肤科应用的文献进行了全面回顾，同时也纳入了我们自己 16 年多来使用该工具的临床经验。在正常皮肤中，表皮和真皮呈高回声，皮下层呈低回声。基底细胞癌呈低回声，边缘不规则，而存在高回声包涵体提示侵袭性病理。鳞状细胞癌由于增厚的角质层产生的声影伪像而带来挑战。黑色素瘤是均匀的低回声病变，HRUS 可用于准确预测 Breslow 厚度。HRUS 为皮肤科医生提供了传统临床检查的有价值的辅助手段。未来图像分辨率的提高和诊断参数的标准化可能会进一步扩大其效用。
