Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (12): 51-61.doi: 10.6040/j.issn.1671-7554.0.2023.0654

• The innovation and challenge of artificial intelligence in medical imaging-Clinical Research • Previous Articles    

Differentiation of benign and malignant skin focal protuberant nodules using microscope high-resolution MRI

JIN Xinjuan1, CAI Daxing2, FAN Jinlei1, DENG Zhanhao3, LI Nan2, YU Dexin1, LI Anning1   

  1. 1. Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Dermatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    3. Department of Imaging, Yantaishan Hospital, Yantai 264001, Shandong, China
  • Published:2024-01-11

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Abstract: Objective To explore the value of microscope high-resolution magnetic resonance imaging(MHR-MRI)in the differentiation of benign and malignant skin focal protuberant nodules. Methods A total of 45 patients with skin focal protuberant nodules admitted to Qilu Hospital of Shandong University during April 2020 and April 2023 and examined with preoperative MHR-MRI were prospectively analyzed. Based on pathological results, they were divided into benign group(n=19)and malignant group(n=26). The MHR-MRI characteristics of the lesions in the two groups were assessed. Differences between the benign and malignant groups, and among basal-cell carcinoma, protuberant skin fibrosarcoma and squamous cell carcinoma were compared. The sensitivity, specificity, Youden index and the area under the operating characteristic curve(AUC)and diagnostic efficiency of MHR-MRI were calculated. Results Lesions in the malignant group were more commonly characterized by sharp-angle-wedge sign(P<0.001), involvement of the epidermis and dermis(P<0.001), unclear boundaries(P=0.003), and the presence of surrounding vessels(P=0.003). The Youden index for a combined imaging parameters(sharp-angle-wedge sign, invasion of the epidermis and dermis, poorly defined borders, high signal intensity on T2WI, and combination of peripheral vessels)was 0.909(sensitivity 0.962, specificity 0.947)with an AUC of 0.995. The basal-cell carcinoma and protuberant skin fibrosarcoma were more often characterized by a wide base of the focus than the squamous cell carcinoma on MHR-MRI(P=0.021). The protuberant skin fibrosarcoma and squamous cell carcinoma were more often associated with sharp-angle-wedge sign than basal-cell carcinoma(P=0.001). Conclusion MHR-MRI is helpful in the differentiation of benign and malignant skin focal protuberant nodules and common malignant tumors.

Key words: Skin focal protuberant nodules, Microscope high-resolution magnetic resonance imaging, Benign and malignant, Differential diagnosis

CLC Number: 

  • R751
[1] Losquadro WD. Anatomy of the skin and the pathogenesis of nonmelanoma skin cancer [J]. Facial Plast Surg Clin North Am, 2017, 25(3): 283-289.
[2] Bassel A, Abdulkareem AB, Alyasseri ZAA, et al. Automatic malignant and benign skin cancer classification using a hybrid deep learning approach[J]. Diagnostics(Basel, Switzerland), 2022, 12(10): 2472.
[3] Wortsman X. Top Advances in dermatologic ultrasound [J]. J Ultrasound Med, 2023, 42(3): 521-545.
[4] Aswal P, Hemdani R, Johri N, et al. Unusual sites with variable presentation of de novo syringocystadenoma papilliferum: a case series [J]. J Family Med Prim Care, 2022, 11(10): 6593-6597.
[5] Krakowski AC, Hafeez F, Westheim A, et al. Advanced basal cell carcinoma: what dermatologists need to know about diagnosis [J]. J Am Acad Dermatol, 2022, 86(6S): S1-S13.
[6] Ridky TW. Nonmelanoma skin cancer [J]. J Am Acad Dermatol, 2007, 57(3):484-501.
[7] Bonilla X, Parmentier L, King B, et al. Genomic analysis identifies new drivers and progression pathways in skin basal cell carcinoma [J]. Nat Genet, 2016, 48(4): 398-406.
[8] Rogers HW, Weinstock MA, Feldman SR, et al. Incidence estimate of nonmelanoma skin cancer(keratinocyte carcinomas)in the U.S. Population, 2012 [J]. JAMA Dermatol, 2015, 151(10): 1081-1086.
[9] Tisack A, Fotouhi A, Fidai C, et al. A clinical and biological review of keratoacanthoma [J]. T Br J Dermatol, 2021, 185(3): 487-498.
[10] Leung AKC, Lam JM, Leong KF, et al. Infantile hemangioma: an updated review[J]. Curr Pediatr Rev, 2021,17(1): 55-69.
[11] Tanese K. Diagnosis and management of basal cell carcinoma [J]. Curr Treat Options Oncol, 2019, 20(2): 13.
[12] Fulton EH, Kaley JR, Gardner JM. Skin adnexal tumors in plain language: a practical approach for the general surgical pathologist [J]. Arch Pathol Lab Med, 2019, 143(7): 832-851.
[13] Catalano O, Roldán FA, Varelli C, et al. Skin cancer: findings and role of high-resolution ultrasound [J]. J Ultrasound, 2019, 22(4): 423-431.
[14] Wang Y, Liu S, Lou S, et al. Application of optical coherence tomography in clinical diagnosis [J]. J Xray Sci Technol, 2019, 27(6): 995-1006.
[15] Budak MJ, Weir-McCall JR, Yeap PM, et al. High-resolution microscopy-coil MR imaging of skin tumors: techniques and novel clinical applications [J]. Radiographics, 2015, 35(4): 1077-1090.
[16] 王传彬, 韦超, 李乃玉, 等. 隆突性皮肤纤维肉瘤的CT和MRI表现[J]. 中国医学装备, 2021, 18(4): 58-61. WANG Chuanbin, WEI Chao, LI Naiyu, et al. The manifestation of dermatofibrosarcoma protuberans on CT and MRI [J]. China Medical Equipment, 2021, 18(4): 58-61.
[17] 席凤均, 段晓岷, 高军, 等. 儿童毛母质瘤的影像及病理特征分析[J]. 临床放射学杂志, 2022, 41(5): 928-933. XI Fengjun, DUAN Xiaomin, GAO Jun, et al. Image and pathology features analysis of childhood pilomatricomas [J]. Journal of Clinical Radiology, 2022, 41(5): 928-933.
[18] Hao X, Billings SD, Wu F, et al. Dermatofibrosarcoma protuberans: update on the diagnosis and treatment [J]. J Clin Med, 2020, 9(6): 1752.
[19] Tang M, Huang R, Chen J, et al. Clinical value of high-resolution dynamic contrast-enhanced(DCE)MRI in diagnosis of cutaneous squamous cell carcinoma [J]. Skin Res Technol, 2021, 27(4): 511-520.
[20] 潘海锋, 王朝文, 谌力群, 等. 隆突性皮肤纤维肉瘤的CT及MRI表现与鉴别诊断[J]. 现代医用影像学, 2020, 29(7): 1210-1213,1217. PAN Haifeng, WANG Chaowen, ZHAN Liqun, et al. CT and MRI Features of Dermatofibrosarcoma Protuberans with Differential Diagnosis [J]. Modern Medical Imaging, 2020, 29(7): 1210-1213,1217.
[21] Cutler B, Posalaky Z, Katz HI. Cell processes in basal cell carcinoma [J]. J Cutan Pathol, 1980, 7(5): 310-314.
[22] 上官景俊, 李九文, 冯秀栓, 等. MRI诊断隆突性皮肤纤维肉瘤的价值[J]. 医学影像学杂志, 2022, 32(1): 147-150. SHANGGUAN Jingjun, LI Jiuwen, FENG Xiushuan, et al. Value of MRI in the diagnosis of dermatofibrosarcoma protuberans [J]. Journal of Medical Imaging, 2022, 32(1): 147-150.
[23] You X, Sun X, Yang C, et al. CT diagnosis and differentiation of benign and malignant varieties of solitary fibrous tumor of the pleura [J]. Medicine(Baltimore), 2017, 96(49): e9058. doi: 10.1097/MD.0000000000009058.
[24] Jiang ZY, Liu JB, Wang XF, et al. Current status and prospects of clinical treatment of osteosarcoma [J]. Technol Cancer Res Treat, 2022, 21: 15330338221124696. doi: 10.1177/15330338221124696.
[25] Shi F, Luo D, Zhou X, et al. Combined effects of hyperthermia and chemotherapy on the regulate autophagy of oral squamous cell carcinoma cells under a hypoxic microenvironment [J]. Cell Death Discov, 2021, 7(1): 227.
[26] Han M, Dermarkarian CR, Tao JP. Orbitomalar erosive basal cell carcinoma [J]. Ophthalmic Plast Reconstr Surg, 2023, 39(2): e70. doi: 10.1097/IOP.0000000000002240.
[27] 周璟. 高频超声的常见皮肤肿瘤表现及在基底细胞癌术前评估的应用研究[D]. 天津:天津医科大学, 2016.
[28] 唐文浩, 陈舜英, 赵宇靖. 107例基底细胞癌的高频超声特点[J]. 中国麻风皮肤病杂志, 2017, 33(9): 536-540. TANG Wenhao, CHEN Shunying, ZHAO Yujing. Features of ultrasound in skin basal cell carcinoma [J]. Chinese Journal of Leprosy and Skin Diseases, 2017, 33(9): 536-540.
[29] Gufler H, Franke FE, Rau WS. High-resolution MRI of basal cell carcinomas of the face using a microscopy coil [J]. AJR Am J Roentgenol, 2007, 188(5): W480-484.
[30] Stratigos AJ, Garbe C, Dessinioti C, et al. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment [J]. Eur J Cancer, 2020, 128: 83-102. doi: 10.1016/j.ejca.2020.01.008.
[31] Stratigos AJ, Garbe C, Dessinioti C, et al. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention [J]. Eur J Cancer, 2020, 128: 60-82. doi: 10.1016/j.ejca.2020.01.007.
[32] 唐梦晓, 盛美樱, 陈剑华, 等. 高分辨率MR成像在颌面部皮肤肿瘤中的应用价值[J]. 影像诊断与介入放射学, 2020, 29(1): 42-47. TANG Mengxiao, SHENG Meiying, CHEN Jianhua, et al. Application of high-resolution MRI in diagnosis of maxillofacial skin tumor [J]. Diagnostic and Interventional Radiology, 2020, 29(1): 42-47.
[33] 陈盈, 张忠伟, 姚婷. 隆突性皮肤纤维肉瘤的影像诊断价值[J]. 医学影像学杂志, 2020, 30(5): 839-842. CHEN Ying, ZHANG Zhongwei, YAO Ting. The value of imaging diagnosis of dermatofibrosarcoma protuberans before surgery [J]. Journal of Medical Imaging, 2020, 30(5): 839-842.
[34] 周俊芬, 闫卫鹏, 王明伟, 等. 隆突性皮肤纤维肉瘤的CT/MRI表现[J]. 临床放射学杂志, 2015, 34(11): 1800-1802. ZHOU Junfen, YAN Weipeng, WANG Mingwei, et al. CT and MR Imaging of Dermatofibrosarcoma Protuberans [J]. Journal of Clinical Radiology, 2015, 34(11): 1800-1802.
[35] Yang J, Zhao Y, Zhang H, et al. Periocular pilomatrixoma in childhood: Clinical feature and differential diagnosis [J]. J Fr Ophtalmol, 2023, 46(5): 495-500.
[36] 徐爱国, 裴宝强, 曾世华, 等. 405例毛母质瘤的临床回顾性分析[J]. 西南军医, 2021, 23(1): 12-15. XU Aiguo, PEI Baoqiang, ZENG Shihua, et al. A Retrospective Study of 405 Cases with Pilomatricoma [J]. Southwest Military Medicine, 2021, 23(1): 12-15.
[37] Hussein A, Malguria N. Imaging of vascular malformations [J]. Radiol Clin North Am, 2020, 58(4): 815-830.
[38] 贾姝颖, 解添松, 周良平, 等. 隆突性皮肤纤维肉瘤的影像学特征分析[J]. 肿瘤影像学, 2021, 30(4): 263-268. JIA Shuying, XIE Tiansong, ZHOU Liangping, et al. Imaging features of dermatofibrosarcoma protuberans [J]. Tumour Imaging, 2021, 30(04): 263-268.
[39] Hsieh MS, Bishop JA, Chang JYF. Sialadenoma papilliferum [J]. Surg Pathol Clin, 2021, 14(1): 43-51.
[40] Ito K, Muraoka H, Hirahara N, et al. Texture analysis of low-flow vascular malformations in the oral and maxillofacial region: venous malformation vs. lymphatic malformation [J]. Pol J Radiol, 2022, 87: e494-e499. doi: 10.5114/pjr.2022.119473.
[41] Gao Y, Wang P, Qian M, et al. A surface loop array for in vivo small animal MRI/fMRI on 7T human scanners [J]. Phys Med Biol, 2019, 64(3): 035009. doi: 10.1088/1361-6560/aaf9e4.
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