Happe M, Freitag M, Stücker M, Altmeyer P, Hoffmann K
Dermatologische Klinik, Ruhr-Universität Bochum im St. Josef-Hospital Bochum.
Z Arztl Fortbild Qualitatssich. 1997 Jul;91(4):347-53.
For years, high-resolution b-scan ultrasound is a well established technique in dermatology regarding the preoperative determination of thickness of skin tumors like malignant melanoma or basal cell carcinoma. Most tumors appear as echopoor areas in high-frequency sonography. Until today, a differentiation between skin tumors by means of high-frequency ultrasound is not possible. This is also true concerning the differentiation between the tumor tissue itself and its subtumoral inflammatory infiltration. Therefore, this lack of differentiation leads to the fact that sonometric thicknesses of tumors often exceed the originally measured tumor thickness in histology. By means of three-dimensional reconstruction of serial b-scan images, it is possible to determine each tumor's volume and surface as well as the topographical arrangement of echopoor areas and sonographical structures. Besides high-frequency ultrasound, additional non-invasive techniques like MRI, ultrasound- or laser-doppler, computer-aided image analysis and epiluminescence microscopy are also available for diagnosing malignant melanoma. Epiluminescence microscopy is used today as a standard technique in the diagnosis of malignant melanoma due to the possibility of differential diagnosis. Latest techniques like OCT (optical coherence tomography) are not ready yet to be applied regularly in diagnosis of tumors in the field of dermatology.
多年来,高分辨率B超扫描超声在皮肤科一直是一项成熟的技术,用于术前确定皮肤肿瘤(如恶性黑色素瘤或基底细胞癌)的厚度。在高频超声检查中,大多数肿瘤表现为低回声区。直到现在,通过高频超声对皮肤肿瘤进行鉴别诊断是不可能的。在肿瘤组织本身与其肿瘤下炎性浸润的鉴别方面也是如此。因此,这种鉴别能力的缺乏导致肿瘤的超声测量厚度常常超过组织学中最初测量的肿瘤厚度。通过对连续B超扫描图像进行三维重建,可以确定每个肿瘤的体积、表面以及低回声区和超声结构的地形排列。除了高频超声外,还有其他非侵入性技术,如MRI、超声或激光多普勒、计算机辅助图像分析和表皮透光显微镜检查等,也可用于诊断恶性黑色素瘤。由于具有鉴别诊断的可能性,表皮透光显微镜检查如今被用作诊断恶性黑色素瘤的标准技术。像光学相干断层扫描(OCT)这样的最新技术尚未准备好常规应用于皮肤科领域的肿瘤诊断。