Abstract
Objective. To study echographic and hemodynamic features of the nail plate and surrounding tissues in patients with different clinical variants of onychomycosis of the feet using an ultrasonic transducer with a scanning frequency of 15–22 MHz and on this basis to define the most significant ultrasound signs of this pathology. Patients and methods. 52 patients with onychomycosis of the feet (the main group) and 20 volunteers (the control group) without a fungal nail infection were examined. Ultrasonic scanning was performed using a transducer with a frequency of 15–22 MHz. The sonographic structure and sizes of nail components were registered. Features of blood supply were studied in the area of the nail bed and root using duplex scanning. Results. In patients with onychomycosis in the nail plate, the change in lateral dimensions of its layers was revealed. Structural imperfection and uneven increase in the thickness of intermediate layer of the nail plate, misalignment of ventral and dorsal layers were detected. Discontinuity and blurring of the structure of the ventral layer were observed in this context. In patients with subungual onychomycosis, a thickening of the nail bed and change in its acoustic properties were revealed. When the nail root was involved in the pathological process, an increase in echogenicity and blurring of boundaries in the matrix area were recorded. Decreased value of hemodynamic indices and smoothing of the dopplerographic curve, in comparison with the control group, were observed. Conclusion. Detected ultrasound signs broaden the understanding of changes in the nail echostructure and hemodynamics indices under the influence of a fungal infection, and can be useful in comprehensive diagnostics of onychomycosis of the feet. Key words: sonographic and hemodynamic signs of onychomycosis, nail ultrasonography
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