Diagnostic Use of High-Frequency Ultrasound in Differentiating Benign and Malignant Pigmented Skin Lesions

This study aims to assess the clinical utility of high-frequency ultrasound in the preoperative differentiation of benign and malignant pigmented skin lesions.

A cohort of 126 patients with pigmented skin lesions who underwent high-frequency ultrasound examination and subsequent surgical treatment at the First Affiliated Hospital of Henan University of Science and Technology between October 2022 and July 2024 were included in this prospective study. Pathological findings served as the reference standard, and the clinical and ultrasonographic features of benign and malignant pigmented skin lesions were compared. Key ultrasonographic indicators for preoperative differentiation were identified.

Among the 126 pigmented skin lesions, 50 were malignant, and 76 were benign. High-frequency ultrasound correctly identified 41 of the 50 malignant lesions and 68 of the 76 benign lesions. The diagnostic accuracy, sensitivity, and specificity were 86.5%, 94.0%, and 93.4%, respectively. Strong punctate echogenic foci within the lesion (χ²= 45.390, P < 0.001), the resistance index of the feeding artery (Z= -6.057, P=0.021), and rapid lesion progression (χ²= 46.140, P < 0.001) were identified as effective indicators for distinguishing benign from malignant pigmented skin lesions.

The combination of high-frequency ultrasound and clinical data aids in the preoperative differential diagnosis of benign and malignant pigmented skin lesions. The type of disease progression, the resistance index of the responsible artery and the presence of intranodular hyperechoic foci are independent risk factors for evaluation.