Reposted Article Originally Published by Canon Medical USA.
Clinical Case Study
Ultrasound was performed to investigate a palpable lump in the proximal thigh/groin crease with associated “shooting” anterior thigh pain. High resolution ultrasound was performed on a Canon Medical Aplio i700 Prism Edition with an i18LX5 matrix transducer. iBeam+ technology provides excellent resolution with extraordinarily high frame rates to capture the detail required for imaging the minute nerves in the area.
The deeper parenchyma was well interrogated to exclude deeper extension of the lesion. At the region of interest, a distinct superficially located hypoechoic fusiform structure was identified using the i18LX5 transducer. On real time ultrasound the lesion was contiguous with a superficial branch of the anterior cutaneous nerve of the thigh. Tapering of the nerve was clearly visualised.
Advanced Dynamic Flow (ADF) allowed confident exclusion of vascularity, aiding in the diagnosis of a schwannoma.
Periodical monitoring or surgical excision may be recommended depending on the site and size of the lesion.
Discussion
iBeam+ technology on the Aplio i700 Prism system receives and processes ultrasound signals with greater speed to produce sharper images with increased contrast and spatial resolution. This enables the smallest of nerves and their outer fascial covering to be accurately visualised.
In this case, an alternative differential diagnoses of a sebaceous cyst or superficial thrombophlebitis were able to be confidently excluded. Excluding vascularity and feeding vessels was key in the diagnosis. ADF is highly sensitive to areas of increased vascularity with high frame rates. The combination of Prism iBeam+ architecture and improved performance of ADF ensured confident exclusion of vascularity in the structure.
Dr Angus Watts, MBBS, FRANZCR
Ashley Mills, AMS – Sonographer