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Usefulness of strain elastography in the differential diagnosis of ruptured epidermal cyst and superficial abscess

Ultrasonography 2022년 41권 1호 p.198 ~ 203
김지나, 박희진, 김명섭, 문주희, 박재형, 김유진, 김영환,
소속 상세정보
김지나 ( Kim Ji-Na ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
박희진 ( Park Hee-Jin ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
김명섭 ( Kim Myung-Sub ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
문주희 ( Moon Ju-Hee ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
박재형 ( Park Jae-Hyung ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Radiology
김유진 ( Kim Eu-Gene ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Orthopedic Surgery
김영환 ( Kim Young-Hwan ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Nuclear Medicine

Abstract


Purpose: The aim of this study was to evaluate the usefulness of strain elastography (SE) in the differential diagnosis of ruptured epidermal cyst and superficial abscess.

Methods: This retrospective study included 34 patients with ruptured epidermal cysts and 17 patients with superficial abscesses who underwent ultrasonography (US) including SE. The SE characteristics were classified into four grades (1 to 4) according to elasticity. The largest length and height of the lesion and their ratio were evaluated on the US images. Involvement of more than half of the depth of the dermis and the presence of the submarine sign were assessed.

Results: The inter-reader agreement of US and SE findings showed excellent or almost perfect agreement. The height, length, ratio of height to length, and more-than-half-depth sign did not significantly differ between ruptured epidermal cysts and superficial abscesses for either reader (reader 1, P=0.071, P=0.129, P=0.806, and P=0.102, respectively; reader 2, P=0.173, P=0.053, P=0.669, and P=0.060, respectively). The submarine sign was significantly more frequent in ruptured epidermal cysts than in superficial abscesses (both readers, P<0.001). The difference in SE scores between ruptured epidermal cysts and superficial abscesses, which are harder than ruptured epidermal cysts, was statistically significant (reader 1, P=0.046; reader 2, P=0.028).

Conclusion: The SE score and submarine sign may be useful characteristics for distinguishing ruptured epidermal cyst from superficial abscess.

키워드

Strain elastography; Ultrasound; Epidermal cyst; Abscess

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