Superficial Soft Tissue Swellings: Accuracy of Ultrasonography in Diagnosis with Pathological Correlation

Abstract

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 superficial soft tissue swelling. Aim: To determine the accuracy of ultrasonographic findings in the diagnosis of superficial soft tissue swellings with histopathological correlation. Materials and Methods: All the soft tissue swellings 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 compressibility. 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. Soft tissue swellings such as foreign bodies and haematomas were readily confirmed to evaluate the accuracy of USG in these lesions. Probable diagnosis obtained by USG was then correlated with histopathology. The data obtained was statistically analysed using SPSS (Software Package used for Statistical Analysis) software and was analysed using sensitivity, frequency and other appropriate statistical tests. Results: The sensitivity of the study was 97% with confidence interval of 91.48% to 99.38%. The positive likely hood ratio was 0.97. Positive predictive value of the study was 100% with confidence interval of 96.27% to 100%. Conclusion: We conclude that USG has high specificity and predictive value to diagnose superficial soft tissue swellings and it wouldn’t be erroneous to infer that USG is almost equivalent to the pathological diagnosis especially in non tumoural superficial soft tissue swellings.

Keywords

• foreign body granuloma
• ganglion cyst
• lipoma