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Delfino M. 1, Farina D. 1, De Fata Salvatores G. 1, Mancini M. 2, Scotto Di Santolo M. 3
1 Dipartimento di Medicina Clinica e Chirurgia, Dermatologia, Università degli Studi di Napoli “Federico II”, Napoli;
2 Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli;
3 Dipartimento Assistenziale Diagnostica per Immagini e Radioterapia, Università degli Studi di Napoli “Federico II”, Napoli
Aim: The aim of this study was to evaluate the possibility of implementing clinical and instrumental dermatological diagnosis, to improve the accuracy of differential diagnosis between benign and malignant skin lesions, and optimize therapeutic approach.
Methods: A total of 104 skin lesions were examined with 17-MHz ultrasound probe and color-Doppler. For each lesion, morphometric parameters and vascular patterns were evaluated by sonography. Once excised, lesions were histologically analyzed in a blinded study. Resulting data were correlated with the corresponding ultrasound parameters. This comparison were statistically tested.
Results: By sonography, malignant skin lesions showed inhomogeneous structure in 66% of cases, deep location in 61%, irregular margins in 66% and intratumoral vascular signal in 80% of cases. Obtained data were statistically tested using χ2 test. Statistical analysis revealed a significant correlation of these ultrasound parameters and diagnosis of malignancy; a stronger correlation (P<0.001) between vascular pattern and malignancy was proved. Analysis of vascular signal and its intralesional distribution, outlined 4 different vascular patterns.
Conclusion: The study confirms that high-resolution ultrasound and ecocolor-Doppler, is a simple and non-invasive method, which provides, in the pre-operative assessment, a reliable instrumental to support, in addition to clinical and dermoscopical evaluation, differential diagnosis between benign and malignant skin lesions.