Comparing ultrasonography with magnetic resonance imaging in the detection of deep tissue injury

Deep tissue injury (DTI), a pressure-related injury to the subcutaneous tissue under intact skin, has been featured in several recent studies. DTI is hard to detect, and by the time the injury becomes visible, extensive injury to the underlying tissue has often already occurred, resulting in a potentially serious and difficult-to-heal full-thickness pressure injury. Thus, early detection of subcutaneous injuries is essential, and previous reports describe the use of ultrasonography and magnetic resonance imaging (MRI) for this purpose. The current report compares ultrasonography with MRI for detection of subcutaneous injuries.

In the 2 cases reported herein, the use of ultrasonography and MRI led to the detection of DTI and intervention before the injuries reached the skin surface. In case 1, DTI was suspected on MRI, and ultrasonography confirmed findings typical of DTI, leading to the diagnosis. In case 2, MRI was used to detect abnormal findings at a stage in which no abnormalities were found on ultrasonography.

In both cases, MRI clearly identified abnormal findings, which suggests that it is superior to ultrasonography for visualizing deeper tissue. Consequently, the authors of the current report propose that compared with ultrasonography, use of MRI for the detection of DTI would lead to earlier intervention and healing.