High resolution ultrasound characterization of soft tissue masses in children

Abstract

Forty-two soft tissue masses in infants and children were examined with high resolution ultrasonography. Sonography was diagnostically specific in 17/42 (40%), useful but not diagnostic in 24/42 (58%), and misleading in 1/42 (2%) of soft tissue masses. Lesions with diagnostic sonographic features included cystic hygroma, fibromatosis colli, lymphadenopathy with abscess formation, and one case of osteomyelitis.

Fibromatosis colli of infancy: Variability of sonographic appearance

“…However, the variable sonographic appearances in our cases have not been clearly illustrated before. In contrast to the hypoechoic mass seen in previous case reports, 7-9 most of the masses seen in our cases were hyperechoic and similar to those seen by Chan et al 11 In the earlier reports, 8,9 sonography appears to have been performed with B-mode compound scanners, whereas we used high-resolution, real-time equipment. Occasionally, a mass may be of mixed echogenicity ( Figure 3), which indicates a mix of atrophic muscle fibers and fibrous tissue that create more sonographic interfaces.…”

“…6 The initial reports in the imaging literature described the sonographic appearance of fibromatosis colli as a hypoechoic mass in the sternocleidomastoid muscle. [7][8][9] Although some variation in its echogenicity was mentioned, 10 these reports understated the variability of the sonographic appearance of the disease later described by Chan et al 11 Our objective was to illustrate this variability in greater detail than previously shown.…”

The value of sonography in the detection of osteomyelitis

“…For some years now, ultrasound has also been used to an ever increasing degree for the diagnosis of joint and soft-tissue changes [3,6,7,[10][11][12]17]. In the meantime, the technique is able not only to demonstrate small amounts of effusion in the joints of the extremities, particularly in the hip and knee, but also to visualize various changes of the soft-tissue structures of different origin and consistency.…”

“…The tools now available include scintigraphy [1,2], via computed tomography [3], and magnetic resonance imaging (MRI) [4,5]. In view of the still limited number of reports on ultrasound in this field [6][7][8][9][10][11][12][13][14][15], it seemed interesting, as well as important to determine the value of sonography especially in establishing the diagnosis of osteomyelitis in the limbs of infants and children within the framework of a clinical study.…”

High resolution ultrasonography of the parotid gland in children. Part II

“…The development of an abscess is heralded by irregularity to the wall of the node with the center becoming more hypoechoic. Also, adjacent nodes will become confluent with hypoechoic centers as abscess formation occurs [5]. Doppler ultrasound has become extremely valuable in detecting whether masses within or adjacent to the parotid are vascular structures.…”