Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues

Cardiac magnetic resonance (CMR) imaging has become a key tool in evaluating myocardial injury secondary to coronary artery disease (CAD), providing detailed assessments of cardiac morphology, function, and tissue composition. The integration of artificial intelligence (AI), including machine learning and deep learning techniques, has enhanced the diagnostic capabilities of CMR by automating segmentation, improving image interpretation, and accelerating clinical workflows. Radiomics, through the extraction of quantitative imaging features, complements AI by revealing sub-visual patterns relevant to disease characterization. This systematic review analyzed AI applications in CMR for CAD. A structured search was conducted in MEDLINE, Web of Science, and Scopus up to 17 March 2025, following PRISMA guidelines and quality-assessed with the CLAIM checklist. A total of 106 studies were included: 46 on classification, 19 using radiomics, and 41 on segmentation. AI models were used to classify CAD vs. controls, predict major adverse cardiovascular events (MACE), arrhythmias, and post-infarction remodeling. Radiomics enabled differentiation of acute vs. chronic infarction and prediction of microvascular obstruction, sometimes from non-contrast CMR. Segmentation achieved high performance for myocardium (DSC up to 0.95), but scar and edema delineation were more challenging. Reported performance was moderate-to-high across tasks (classification AUC = 0.66–1.00; segmentation DSC = 0.43–0.97; radiomics AUC = 0.57–0.99). Despite promising results, limitations included small or overlapping datasets. In conclusion, AI and radiomics offer substantial potential to support diagnosis and prognosis of CAD through advanced CMR image analysis.

El síndrome de OHVIRA, anteriormente conocido como síndrome de Herlyn-Werner-Wunderlich, es una malformación urogenital femenina rara, que se caracteriza por la coexistencia de anomalías müllerianas y renales, entre las que se destacan un útero didelfo, hemivagina obstruida y agenesia renal ipsilateral. El diagnóstico suele establecerse después de la menarquia. La sintomatología clínica más común consiste en dolor pélvico inespecífico asociado a amenorrea y masa abdominopélvica palpable secundaria a hematocolpos. Entre las complicaciones más frecuentes se encuentran dolor pélvico crónico, infecciones, infertilidad y endometriosis. En este escenario, la contribución de las imágenes diagnósticas (ecografía y resonancia magnética) son esenciales para una caracterización precisa de estos hallazgos. Asimismo, la comprensión integral de este síndrome, sus múltiples manifestaciones y clasificación son cruciales para implementar un tratamiento adecuado y oportuno. Se describe el caso de una paciente femenina de 11 años de edad acompañado de una revisión actualizada de la literatura.

Clinical and ultrasound experience has revealed that after soft tissue injections of the lateral cheek, the filler may displace from the zygoma to the caudal temporal area. To obtain more data to provide insight into product distribution when soft tissue fillers are injected in the zygomatic region. Two hundred patients were examined with facial ultrasound imaging of the zygomatic and temporal region. Inclusion criteria were simply a positive response on the screening questionnaire as to whether or not they had filler injections placed in their lateral cheek. Control injections were also performed to the zygomatic regions of a body donor and in 10 patients ultrasound-guided. A correlation was found between the layers in which filler was detected on the zygoma and where it was ultimately found in the temples. Four different redistribution patterns were observed: (1) migration of filler within the superficial muscular aponeurotic system (SMAS) on the zygoma into the superficial temporal fascia. Migration of filler from the lateral suborbicularis oculi fat to (2) the deep interfacial plane of the temple or (3) to the superficial temporal fat pad; (4) migration from the supraperiosteal layer of the zygoma to the superficial temporal fat pad. Body donor and patients: filler deposits injected on the zygoma were witnessed to shift during injection into the caudal part of the temple. Soft tissue filler aliquots may be redistributed into the temples after injections of the lateral side of the zygomatic arch. The displacement follows a distinct pattern depending on the initial layer of injection.

Citation: del Puerto C, Wortsman X, Downey C. Lingual Epidermal Choristoma: Ultrasonography as a Diagnostic Tool. Dermatol Pract Concept. 2024;14(1):e2024014. DOI: https://doi.org/10.5826/dpc.1401a14

Skin cancer may recur at or around the surgical site despite wide excisions. Prompt clinical and sonographic detection of local recurrence is important since subjects with relapsing melanomas or nonmelanoma malignancies can be managed efficaciously, with a relevant impact on morbidity and survival. Ultrasound is being employed with increasing frequency in the assessment of skin tumors, but most of the published articles relate to initial pretherapeutic diagnosis and staging. This review aims to offer an illustrated guide to the sonographic evaluation of locally recurring skin cancer. We introduce the topic, then we provide some sonographic tips for patient follow-up, then we describe the ultrasound findings in case of local recurrence, illustrating the main mimickers, and finally, we mention the role of ultrasound in guiding diagnostic and therapeutic percutaneous procedures.

Morphea, an autoimmune connective tissue disease that affects the skin, can be supported by color Doppler ultrasound in its diagnosis and assessment of activity. To date, there are no reliable laboratory parameters to track activity, and ultrasound presents a higher axial spatial resolution than magnetic resonance imaging and computed tomography, which is critical for studying the superficial layers. The quality of the ultrasonographic assessment of activity in morphea depends on the standardization and features of the acquisition of the anatomical data. We propose a detailed ultrasound morphea activity scoring called modified US-MAS (mUS-MAS) that could allow us to systematically register the cutaneous abnormalities in the corporal regions and their subregions. The selection of the scanning sites will depend on the corporal regions of involvement and their adjacent segments. Through systematic and sequential ultrasound data analysis, we propose that this scoring system can better support description and activity tracking accuracy.

Retronychia is an inflammatory process of the proximal nailfold caused by backward ingrowth of the nail plate. It appears to be secondary to proximal nail plate rupture caused primarily by wearing tight shoes, or related to a traumatic origin such as sports or dance. The proximal nail fold appears painful and inflamed in the acute form, whereas in the chronic state, the nail plate appears yellowish and thickened in addition to the inflammation. It primarily affects the great toe, sometimes bilaterally, and occasionally the fingers. It is sometimes accompanied by the development of granulation tissue near the proximal nail fold. A notably female predominance has been reported, especially in young or middle ages. Its diagnosis is based on the clinical triad: interruption of nail growth, proximal paronychia with elevation of proximal nail plate over the proximal nail fold, and xantonychia. Nail avulsion is the treatment of choice and it is curative in most cases. However, mild cases may be initially treated with conservative therapies, including topical or intralesional steroids, chemical avulsion of the nail and clipping back the onycholytic nail plate. Retronychia is a potentially underdiagnosed disease, with only a few reports in the English, French, Spanish, and Asian literature. This topic is updated in this review, which is illustrated with clinical and ultrasound images.

The original version of the chapter "Ultrasound in Aesthetics" was inadvertently published with the following incorrect details. • Page 417, left column, under the heading "Hypoechoic or Heterogeneous": the subheading "Polycaprolactone" has been changed to "Polycaprolactone (PLC)". • Page 417, left column, 5 lines below the subheading "Polycaprolactone": "PAAG" has been changed to "PLC". • Page 417, right column: the subheading "Calcium Hydroxyapatite (CaOH)" has been changed to "Calcium Hydroxyapatite (CaHA)". • Page 417, right column: 4 lines below the subheading "Calcium Hydroxyapatite (CaOH)": "CaOH" has been changed to "CaHA". The chapter has been revised.

Advances in ultrasound technology and non-surgical treatments of basal cell carcinomas (BCCs) have raised the need to study the performance of high-frequency ultrasound (HFUS) in BCCs. We aimed to assess the performance of HFUS in the evaluation of BCCs to formulate recommendations for its uses and conducted a systematic review of the literature to do so. A search of Central, Medline, Embase, CINHAL, and Web of Science was performed using key/MESH terms “ultrasonography” and “basal cell carcinoma” (January 2005–December 2020). We included primary studies reporting biopsy-confirmed BCCs for which the target intervention was ultrasound assessment at 15 MHz or higher frequency. Thirty articles were included, studying a total of 1,203 biopsy-confirmed BCCs. HFUS provides accurate depth measurements, especially for BCCs >1 mm. The definition of lateral margins in vivo needs further studies; however, ex vivo margin assessment seems convincing. There is a diagnostic role for HFUS in identifying higher recurrence risk BCC subtypes, which can help in risk stratification. Performance of HFUS is significant in BCC management. Pre-surgical scans may support case selection for Mohs. HFUS can improve safety when used to plan brachytherapy treatments, help with case selection and adjunct treatment choice pre-photodynamic therapy. Finally, HFUS can help follow lesions after intervention, particularly non-surgical management, and support the decision to observe or re-intervene. HFUS can enhance clinical practice by providing useful information that cannot be deducted from the clinical examination. It would be recommended to evaluate the extent, mainly depth, and detect the aggressiveness of the BCCs.