Tips for Reporting Dermatologic Ultrasound Examinations

Vera‐Kellet

2023

Morphea, an autoimmune connective tissue disease that affects the skin, can be supported by color Doppler ultrasound in its diagnosis and assessment of activity. To date, there are no reliable laboratory parameters to track activity, and ultrasound presents a higher axial spatial resolution than magnetic resonance imaging and computed tomography, which is critical for studying the superficial layers. The quality of the ultrasonographic assessment of activity in morphea depends on the standardization and features of the acquisition of the anatomical data. We propose a detailed ultrasound morphea activity scoring called modified US‐MAS (mUS‐MAS) that could allow us to systematically register the cutaneous abnormalities in the corporal regions and their subregions. The selection of the scanning sites will depend on the corporal regions of involvement and their adjacent segments. Through systematic and sequential ultrasound data analysis, we propose that this scoring system can better support description and activity tracking accuracy.

Section: Figuresupporting

confidence: 68%

mentioning

confidence: 99%

Ultrasound Morphea Activity Scoring (US‐MAS): Modified US‐MAS

Vera‐Kellet

2023

“…The ultrasound studies followed the guidelines for performing dermatologic ultrasound examinations published in the literature, 16 including the ultrasound protocols for studying patients with a history of cosmetic fillers. 17,18 The study protocol included, in all cases, a greyscale, a color Doppler, and a pulsed Doppler (spectral curve analysis) of the vessels in the corporal regions with a recording of the maximum peak systolic velocity (cm/s) to assess the presence of the fillers and the potential degree of inflammation. 17…”

Section: Ultrasound Study Protocolmentioning

confidence: 99%

Ultrasonographic Patterns of Calcium Hydroxyapatite According to Dilution and Mix With Hyaluronic Acid

Quezada

Peñaloza

et al. 2023

ObjectivesTo assess the ultrasonographic patterns of different calcium hydroxyapatite (CaHA) formulations, including the undiluted, diluted, and mixed with hyaluronic acid (HA) compounds.MethodsTo review the ultrasonographic images of patients ≥18 years with confirmed injections of CaHA clinically and ultrasonographically, and without different concomitant types of fillers in the same region or other systemic or localized cutaneous diseases.ResultsTwenty‐one patients met the criteria (90% female; 10% male; mean age: 52 years ± 12.8). Of these, 33.3% have been injected with an undiluted formulation, 33.3% with diluted, and 33.3% with a mixed formulation. All cases were studied with devices presenting frequencies that ranged from 18 to 24 MHz. Twelve cases (57%) were also studied with the 70 MHz.The ultrasonographic patterns of CaHA presented differences in the presence and intensity of PAS and the degree of inflammation according to the dilution and mix with HA. Diluted formulations show a milder intensity posterior acoustic shadowing (PAS) artifact than undiluted at 18–24 MHz. In mixed formulations, 57% showed mild PAS, and 43% demonstrated no PAS artifact at 18–24 MHz, besides fewer inflammatory changes in the periphery of the deposits.ConclusionsThe ultrasonographic patterns of CaHA show differences in the presence and intensity of PAS and the degree of inflammation according to the dilution and mix with HA. Awareness of these ultrasonographic variations can support better discrimination of CaHA.

“…The disadvantages of these high‐end machines are the high cost and lower portability; however, they are still portable within the same institution. The Shape and Footprint of the ProbesSome small devices present a bulky shape that difficult the clinical observation of the results of a guided‐ultrasound injection, such as, for example, the ultrasound‐guided injection of cosmetic fillers or hyaluronidase. This is not an irrelevant issue for injectors who ideally need to see the results while they inject.The most recommended shape and footprint for studying dermatologic lesions are the smallest linear probes; of these, it is recommended to use probes with a “hockey stick” shape because this can facilitate the examination of the concavities and convexities of the face, which is a highly involved area in dermatologic pathologies 4 StorageIt is necessary to extract the images of the examinations from the machines, keep them in a safe place, and maintain the privacy of the data 5 …”

mentioning

confidence: 99%

“…The most recommended shape and footprint for studying dermatologic lesions are the smallest linear probes; of these, it is recommended to use probes with a “hockey stick” shape because this can facilitate the examination of the concavities and convexities of the face, which is a highly involved area in dermatologic pathologies 4 …”

mentioning

confidence: 99%

Key Points to Select a Device for Dermatologic Ultrasound

2022

What points to consider when selecting a device for practicing dermatologic ultrasound is an excellent question. After we met the requisites published in the guidelines for practicing dermatologic ultrasound, it is necessary to consider the main objective of the use because it is not the same to be focused mostly on the avoidance of the puncture of important facial vessels such as the case of injectors of cosmetic fillers in comparison to the use of operators that need to deal with the diagnosis and monitoring of a wide range of dermatologic pathologies. Currently, a broad variety of ultrasound devices meets the minimum requirements for practicing these examinations in the market. Thus, small, portable, and high‐end devices may present advantages and limitations that must be balanced according to the primary purposes and the budget. Moreover, the shape and footprint of the probes can make difficult or facilitate a dermatologic procedure. Other points to consider are the type of storage and the need for technical service. In summary, there are key points that we need to consider when we select a dermatologic ultrasound device in dermatology or aesthetics.