OBJECTIVEDeveloping a high-frequency ultrasonic skin imaging system to obtain the high resolution ultrasonic image of the skin. And further analyzing the ultrasonic images of skin to explore the imaging characteristics of skin structure and then explore the value of high-frequency imaging in the application of skin diagnosis.

METHODS50 MHz single element ultrasonic transducer, mechanic linear scanning method is used in the imaging system. The resolution and the ability of recognize the skin issue is verified by linear target scanning and clinical trials.

RESULTSBoth the axial and lateral resolution of the system reaches 50 microm. The subtle structure of normal skin tissue is clearly visible. Some diseases have obvious appearance in the image.

CONCLUSIONS50 MHz ultrasonic skin imaging system is of high resolution and is valuable to skin structure detect and disease diagnosis.

Humans ; Skin ; diagnostic imaging ; Ultrasonography ; methods

To construct an intelligent assistant diagnosis model based on the clinical images of basal cell carcinoma (BCC) and pigmented nevi in Chinese by using the advanced convolutional neural network (CNN).
 Methods: Based on the Xiangya Medical Big Data Platform, we constructed a large-scale clinical image dataset of skin diseases according to Chinese ethnicity and the Xiangya Skin Disease Dataset. We evaluated the performance of 5 mainstream CNN models (ResNet50, InceptionV3, InceptionResNetV2, DenseNet121, and Xception) on a subset of BCC and pigmented nevi of this dataset. We also analyzed the basis of the diagnosis results in the form of heatmaps. We compared the optimal CNN classification model with 30 professional dermatologists.
 Results: The Xiangya Skin Disease Dataset contains 150 223 clinical images with lesion annotations, covering 543 skin diseases, and each image in the dataset contains support for pathological gold standards and the patient's overall medical history. On the test set of 349 BCC and 497 pigmented nevi, the optimal CNN model was Xception, and its classification accuracy can reach 93.5%, of which the area under curve (AUC) values were 0.974 and 0.969, respectively. The results of the heatmap showed that the CNN model can indeed learn the characteristics associated with disease identification. The ability of the Xception model to identify clinical images of BCC and Nevi was basically comparable to that of professional dermatologists.
 Conclusion: This study is the first assistant diagnosis study for skin tumor based on Chinese ethnic clinical dataset. It proves that CNN model has the ability to distinguish between Chinese ethnicity's BCC and Nevi, and lays a solid foundation for the following application of artificial intelligence in the diagnosis and treatment for skin tumors.
Area Under Curve ; Carcinoma, Basal Cell ; diagnostic imaging ; Humans ; Neural Networks, Computer ; Nevus, Pigmented ; diagnostic imaging ; Skin Neoplasms ; diagnostic imaging

Diagnosis, Differential ; Histiocytosis, Sinus/diagnostic imaging* ; Humans ; Skin Diseases/diagnostic imaging*

OBJECTIVES: Accurate breast lesion surface localization can guarantee accurate biopsy and local treatment. But there is no guideline to regular equipment and methods for the localization of breast lesions. The conventional non-invasive localization method is marker-based localization. The advantages of this method are simple and efficient. The disadvantages are that markers disappear easily under coupling agents; the positioning length of markers cannot last long on skin; and healthcare associated infection due to many patients using the same marker pen is potentially unavoidable. Breast lesion sticker (called sticker for short) is a new-type localization medical instrument in 2020. Our study aims to explore the clinical value of a new lesion stickers in breast lesion surface localization via comparison of the sticker and marker pen localization methods. METHODS: This was a prospective cohort study. It was conducted in 67 patients who needed breast lesion surface localization before biopsy. The patients were randomly assigned into 2 groups. One group of patients used marker pen to mark breast lesion surface location by ultrasonography. The other group of patients used stickers. Patients labeled with markers on skin were swabbed agents before marking. Then the markers were checked by ultrasound scan. If the surface positions of breast lesion were not correct, the above procedure was repeated. In the sticker group, the stickers were released synchronously after the lesions were detected by ultrasound scan. Then locations were checked via scanning hole. If the surface positions of breast lesion were not correct, the above procedure was repeated. The accuracy of positioning, the length of positioning time and satisfaction of patients between the 2 groups were compared. The length of positioning time was calculated from the time when ultrasound detected the lesion to the time when the surface position of breast lesion was confirmed. The total score of patients' satisfaction was 5 points according to Service Quality Evaluation of SERVQUAL Scale, including sonographers' service attitude and their technical proficiency, other medical staffs' service attitude and their technical proficiency, hospital service procedures, positioning comfort, and positioning effects. RESULTS: All 67 patients were females, aged 18-66 (39.73±13.10). There were 35 patients in the marker pen group and 32 patients in the sticker group. The time length of group used marker pen to localization was 22-88 (52.20±2.90) s, and the sticker group was 3-15 (9.22±0.58) s in length. The length of positioning time for the stickers was significantly shorter than that of the marker (P<0.01). Both methods were accurate in the surface localization of lesions before operation. The total scores of patients' satisfaction was 4-5 (4.92±0.02) in the stickers group, and 1-5 (3.35±0.10) in the marker pen group. The patients' satisfaction scores with the sticker were significantly higher than those with the marker pen (P<0.01). The length of positioning time and patients' satisfication scores for sonographer with 20 years' working experience were shorter and higher than those of sonographer with 10 years' working experience, respectively (both P<0.05). CONCLUSIONS The new breast lesion positioning stickers have more advantages than the marker pen in localization efficiency. It could reduce the workload of medical workers and increase patients' satisfaction to some extent. The stickers can be used not only in the breast lesions surface localization, but also in the skin location of pleural effusion and ascites, the skin location of surface masses, the skin location of thyroid nodule, and many other clinical marker areas, to further expand the scope of clinical application and value of the stickers.
Breast/diagnostic imaging* ; Breast Neoplasms/diagnostic imaging* ; Female ; Humans ; Male ; Prospective Studies ; Skin

PURPOSE: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. METHODS: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. RESULTS: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was 12.7±3.2 years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). CONCLUSION: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.
Child* ; Contrast Media* ; Diagnostic Imaging ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Skin ; Skin Manifestations

Digital infrared thermographic imaging system is noninvasive, easy to reading, objective and physiologic instrument by measuring and imaging infrared energy emitted from skin surface. The authors present the result of digital infrared thermographic images of 83 patients of operated lumbar disc herniation from October, 1990 to March, 1991. 46 patients have received discectomy and the other 37 patients have received chemonucleolysis. We have done digital infrared thermographic imaging preoperatively and postoperatively. In preoperative digital infrared thermographic imaging, diagnostic sensitivity is about 76%, In postoperative digital infrared thermographic imaging, clinical results were well correlated in discectomy group. But in chemonucleolysis group, clinical results were not correlated with digital infrared thermographic images.
Diagnostic Imaging ; Diskectomy ; Humans ; Intervertebral Disc Chemolysis ; Skin

BACKGROUND: A skin temperature difference is one of the variables used in the diagnosis of complex regional pain syndrome. However, there have been no reports as to whether the real (DeltaT) or absolute value (|DeltaT|) of skin temperature differences should be used in the diagnosis of complex regional pain syndrome. This study was conducted to compare the diagnostic validity of DeltaT with |DeltaT| for complex regional pain syndrome using receiver operating characteristic curves (ROC). METHODS: Infrared thermographic images were obtained from the 144 patients who were suspected to have CRPS in a unilateral limb. After DeltaT and |DeltaT| calculation from the thermographic image, ROCs of DeltaT and |DeltaT| were developed, and the areas under the curve (AUC) for the ROC curves were compared. RESULTS: AUCs of DeltaT and |DeltaT| were 0.520 and 0.746 respectively, this difference was statistically significant (P < 0.001). CONCLUSIONS: Absolute skin temperature difference shows greater validity in the diagnosis of CRPS than DeltaT. Therefore, |DeltaT| is more useful when comparing the skin temperature of CRPS patients.
Area Under Curve ; Diagnostic Imaging ; Extremities ; Humans ; ROC Curve ; Skin ; Skin Temperature ; Thermography

Low-frequency ultrasound can increase the transdermal delivery of many drugs, including macromolecular drugs. The main mechanism is ultrasonic cavitation. Most researchers pointed out that it could change the form-structure of stratum corneum keratinocytes and, in this way, it can improve the permeability of skin. Low-frequency sonophoresis has been in use for in-vitro experiments and in-vivo animal experiments, and so far, both small-molecules transdermal delivery and macromolecules transdermal delivery have been successfully performed in many experiments. However, there are few reports about the real low-frequency sonophoresis for clinical treatment. A large number of clinical trials are necessary to confirm its safety and practicality. Once its safety is confirmed and the suitable low-frequency sonophoresis devices are developed successfully, Low-frequency Sonophoresis will come to be a safe, effective, controllable, and economic new delivery method.
Administration, Cutaneous ; Animals ; Humans ; Skin ; diagnostic imaging ; metabolism ; Skin Absorption ; radiation effects ; Ultrasonography

OBJECTIVETo collect the data of measuring skin thickness of children of both genders of different ages and parts of body with non-invasive high-frequency ultrasound method.

METHODSTwo hundred and twenty-one children from 1 to 18 years of age,without systemic disease or injury in skin, were enrolled in the study and divided into 4 groups: i.e., infant group (112 years of age), pre-school age group (3-6 years of age), school age group (7-12 years for boys and 7-11 years for girls), adolescent age group (13-18 years for boys and 12-18 years for girls), and each group was subdivided into 2 groups according to the gender. The skin thicknesses of children in cheek, chest, abdomen, forearms, fundament and thigh was respectively measured by 13 MHz high-frequency ultrasound.

RESULTSThe region with thinnest skin in children was the cheek, and the thickest was the back and buttock. (1) There were no significant differences in thickness of skin in the same region between genders and also among different age groups (P > 0.05). (2) There were also no obvious differences of thickness of the dermis and the whole skin in the same region between male and female, or among infants, pre-school age and school age groups (P > 0.05). In adolescent group, the average thickness of dermis in male was (1.16 +/- 0.04 ) - (1.98 +/- 0.47) mm, the average whole thickness of skin in male was (1.27 +/- 0.12) - (2.20 +/- 0.45) mm, while those of female were (1.00 +/- 0.18) - (1.60 +/- 0.30) mm and (1.10 +/- 0.17) - (1.83 +/- 0.29) mm (P < 0.05).

CONCLUSIONIt is reliable to measure the skin thickness by 13MHz ultrasound as a non-invasive method. The main factor which determined the thickness of the skin is dermal thickness, especially in males. The significant differences of skin thickness among cheek, back and buttock provide the basis for us to choose the appropriate thickness of skin grafts harvested from different body parts.

Adolescent ; Child ; Child, Preschool ; Dermis ; diagnostic imaging ; Epidermis ; diagnostic imaging ; Female ; Humans ; Infant ; Male ; Sex Factors ; Skin ; diagnostic imaging ; Skinfold Thickness ; Ultrasonography

OBJECTIVETo investigate the clinical efficiency of electrocoagulation for the treatment of noninvoluting congenital hemangioma.

METHODSSixteen infants with noninvoluting congenital hemangioma who were admitted to our hospital from January 2011 to June 2013 were included in this study. Color Doppler ultrasound was used to determine the hemangioma location, as well as its size and depth. High frequency electrocoagulation was adopted for the treatment. The output power was set at 10-20 W. The probes were inserted around the tumor or at the surface of the tumor. After switching on for 1-2 seconds, the direction and position of the probe was modulated until covering the whole tumor. After the treatment, the absorption of tumor was about 3-6 months. The efficiency was evaluated during the follow-up.

RESULTSTumor atrophy was obvious after treatment in all patients. The temperature around the tumor mass was decreased, and the aberrant blood signals were decreased under the ultrasonic examination. Complete or partial atrophy were observed. The efficiency was graded as level I, II, III, IV in 0, 2, 9 and 5 patients, respectively. One patient showed local infection due to improper nursing, which was completely relieved after corresponding treatment. No severe adverse events were observed.

CONCLUSIONSHigh-frequency electrocoagulation is effective for treating noninvoluting congenital hemangioma through coagulating the aberrant blood vessels in the tumor, interrupting the vascular endothelial cell, blocking the aberrant blood flow, as well as leading to atrophy and absorption of tumor mass. Besides, no obvious scar is observed after the surgery.

Electrocoagulation ; methods ; Hemangioma ; congenital ; diagnostic imaging ; surgery ; Hemangioma, Capillary ; congenital ; diagnostic imaging ; surgery ; Humans ; Infant ; Skin Neoplasms ; congenital ; diagnostic imaging ; surgery ; Temperature ; Ultrasonography