Introduction: Ultrasonography (USG) is a low cost, non-invasive,
readily available, safe and a patient comfortable modality.
With all USG parameters being complimented with the other
variables such as demography and anatomical location of the
swelling, USG has a specificity to accurately diagnose the type
of subcutaneous especially Doppler that increase
accuracy ,sensitivity and specificity to differentiate benign and
malignant subcutaneous masses.
Aim: The aim of this study was to evaluate the diagnostic
accuracy of ultrasound and Doppler ultrasound in the differentiation of different subcutaneous masses compared with that of clinical diagnosis, using surgical , other imaging modalities and histopathological findings as the reference standard.
Materials and Methods: All the subcutaneous masses were imaged
with high resolution USG transducer, and the following various
sonographic indices were noted; location/plane, nature, size, margin,
echo pattern, vascularity, calcification and relation to the surroundings .
Maneuvers such as panoramic views were obtained for large lesions for
better assessment. The low frequency curvilinear transducer was also
required for deep seated and larger swellings of superficial origin. The
ultrasonographic diagnosis was then correlated initially on the surgical
diagnosis , other imaging modalities and histopathological findings as
the reference standard. Subcutaneous pseudotumors such as hematomas
hernia ,foreign bodies and were readily confirmed to evaluate the
accuracy of USG in these lesions. Probable diagnosis obtained by USG
was then correlated with other imaging ,surgical data and or histopathology. The data obtained was statistically analysed using SPSS
(Software Package used for Statistical Analysis) software and
was analyzed using sensitivity, frequency and other appropriate statistical tests.
Results: Ultrasound (gray scale ) accuracy is about 85.2% while the accuracy after the use of both ultrasound and Doppler increased reaching about 92.5% , also the combined use of gray scale and color Doppler helps in differentiating between benign and malignant masses with its sensitivity about 100%, specificity 91.4% positive predictive value (PPV) 64.7% and negative predictive value 100%
Conclusion: we conclude that sonography is considered modality of choice in subcutaneous masses. It is easily available, cost effective and carries no inherent radiation hazards. Gray scale ultrasonography helps in characterizing the subcutaneous masses and in making etiological diagnosis .Sonography has high accuracy in the evaluation of superficial masses, particularly lipomas. combined use of gray scale and color Doppler helps in differentiating between benign and malignant.
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