[High resolution real-time sonographic evaluation of superficial lesions]

One hundred and thirty-one cases of suspected superficial soft tissue lesions, excluding parotid, thyroid, parathyroid, breast and scrotum, were collected in 7-year-period in Veterans General Hospital-Taichung. High resolution (10MHz transducer) real-time ultrasound was applied as imaging modality. Among them, 46 cases were proved pathologically or clinically. We retrospectively evaluated the sonographic features and divided them into five major patterns. I. Cystic lesion with smooth margin, II. Cystic lesion with blurred margin, III. Solid lesion with smooth margin, IV. Solid lesion with blurred margin, V. Diffuse infiltrative lesion. In addition, gas or calcification in the lesion and the echogenicity were included in the evaluation. Some of the lesions considered to be of vascular origin were evaluated with doppler. Ultrasonography can accurately recognize cystic, solid, or infiltrative lesions. In spite of the fact that most of the findings are non-specific, several lesions do have characteristic sonographic patterns that can easily be diagnosed, especially in conjunction with the anatomical location, ie. Backer's cyst, branchial cyst, lymphangioma, and abscess. Lesions with cystic or hyperechoic solid patterns can be considered as benign, if the margin is smooth. Lesions with hypoechoic solid pattern and blurred margin, however except for abscess, can be considered as malignant. We conclude that high resolution real-time sonography is a good imaging modality for evaluating superficial soft tissue lesions.