High Frequency Ultrasound Examination Research Articles

The value of dermoscopy and high-frequency ultrasound in staging morphea.

Morphea is an autoimmune disease characterized by skin sclerosis. According to the disease progression, morphea can be divided into inflammatory, sclerotic, and atrophic stages. Dermoscopy and high-frequency ultrasound (HF-US) have been applied in the noninvasive evaluation of many inflammatory diseases, but studies on the skin imaging features of the different stages of morphea are limited. To analyze the dermoscopic and HF-US features of the different stages of morphea and explore their auxiliary value in staging the disease, we followed 34 patients with histopathology-confirmed morphea between April 2018 and July 2021 who underwent dermoscopy and 50 and 20 MHz HF-US. Fisher's exact test was used to assess the differences in dermoscopic and HF-US features among patients with different stages of morphea. Seven patients were classified as the inflammatory stage, 20 as the sclerotic stage, and seven as the atrophic stage by histopathology. The most common dermoscopic features of inflammatory lesions were red structureless areas (100%) and linear curved vessels (85.7%). White clouds and shiny white streaks could be seen in 100% and 90% of sclerotic lesions, respectively. Among atrophic lesions, pigmentary structures (100%) and red structureless areas (85.7%) were the main features. In the HF-US examination, inflammatory lesions showed hypoechogenicity around the appendages (85.7%), a hypoechogenic dermis (71.4%), and an unclear boundary between the dermis and the subcutaneous fat (71.4%). Among lesions of the sclerotic stage, the main HF-US characteristics included a hyperechogenic dermis (85.0%), acoustic attenuation of the dermis (70.0%), and an unclear boundary between the dermis and the subcutaneous fat (85.0%). All atrophic lesions showed a hyperechogenic dermis, and 28.6% showed an unclear boundary between the dermis and the subcutaneous fat. Dermoscopy and HF-US can reveal the characteristic features of the different stages of morphea and show good correspondence with the histopathology. Dermoscopy and HF-US can provide important information for the staging of morphea.

High-frequency echography of the eye in macular hole diagnosis

Purpose: a comparative estimation of ultrasound examinations of the posterior eye pole of patients with a macular hole using a long-focus high-frequency (20 MHz) and a standard 10 MHz probe with optical coherence tomography (OCT).Materials and methods. 20 patients with a macular hole in at least one eye were examined using OCT of the macular area and B-mode echography with a standard 10 MHz probe and a long-focus high-frequency 20 MHz probe.Results. The complex OCT/ ultrasound examination detected a macular hole in 22 (100 %) eyes, while OCT alone confirmed the diagnosis in 20 eyes (91 %). OCT could not be performed in 2 eyes due to a dense cataract. Ultrasound examination with a 20-MHz probe detected a macular hole in 16 eyes (73 %), whilst the standard ultrasound method (10 MHz probe) could only detect it in 10 eyes (45 %).Conclusion. High-frequency ultrasound examination of the eye can be used for screening aimed at detecting a possible macular hole in cases of opacities of the optical media of the eye.

Assessment of Basal Cell Carcinoma Using Dermoscopy and High Frequency Ultrasound Examination.

Basal cell carcinoma (BCC) is the most common form of cutaneous neoplasia in humans, and dermoscopy may provide valuable information for histopathological classification of BCC, which allows for the choice of non-invasive topical or surgical therapy. Similarly, dermoscopy may allow for the identification of incipient forms of BCC that cannot be detected in clinical examination. The importance of early diagnosis using the dermoscopy of superficial BCC forms is proven by the fact that despite their indolent clinical appearance, they can be included in high-risk BCC forms due to the rate of postoperative recurrence. Nodular pigmentary forms of BCCs present ovoid gray-blue nests or multiple gray-blue dots/globules associated with arborized vessels, sometimes undetectable on clinical examination. The management of BCC depends on this, as pigmentary forms have been shown to have a poor response to photodynamic therapy. High frequency ultrasound examination (HFUS) aids in the diagnosis of BCC with hypoechoic tumour masses, as well as in estimating tumour size (thickness and diameter), presurgical margin delineation, and surgical planning. The examination is also useful for determining the invasion of adjacent structures and for studying local recurrences. The use of dermoscopy in combination with HFUS allows for optimisation of the management of the oncological patient.

Radial artery lumen diameter and intima thickness in patients with abdominal aortic aneurysm

ObjectiveAbdominal aortic aneurysm (AAA) is associated with dilatation of central elastic arteries, while it is uncertain whether peripheral muscular arteries are affected. The aim of this study was to investigate radial artery diastolic lumen diameter (LD), wall thickness, and circumferential wall stress (CWS) in patients with AAA. MethodsWe included 130 men with AAA (mean age, 70.4 ± 3.5 years) and 61 men without AAA (mean age, 70.5 ± 3.2 years) in the study. High-frequency ultrasound examination (50 MHz) was used to measure radial artery diameter, wall thickness, and CWS was calculated. ResultsMen with AAA exhibited smaller radial artery LD (2.34 ± 0.42 mm vs 2.50 ± 0.38 mm; P < .01), thicker intima (0.094 ± 0.024 mm vs 0.081 ± 0.018 mm; P < .001), similar intima-media (0.28 ± 0.05 vs 0.26 ± 0.05 mm; P = NS), and lower CWS (42.9 ± 10.2 kPa vs 48.6 ± 11.4 kPa; P < .001), compared with controls. Subgroup analyses including all patients showed smaller LD and thicker intima in patients on statin therapy versus no statin therapy and current/ex-smoking versus never smoking. Individuals with hypertension versus no hypertension also presented with thicker intima, but with no difference in LD. ConclusionsAAAs demonstrated a smaller LD and thicker intima in the radial artery, in contrast with the theory of a general dilating diathesis of the arteries. Apart from AAA, other factors such as atherosclerosis, smoking habits, and hypertension might also be determinants of radial artery caliber and thickness. Clinical RelevanceThe clinical relevance of this study is the added insight into the pathophysiology of abdominal aortic aneurysm (AAA). Today, the management of AAA is focused on reduction of general cardiovascular risk factors and treatment is based on surgical approaches when the AAA is already manifest. By shedding light on unknown pathophysiological aspects of AAA, it will eventually be possible to develop targeted pharmacological treatments to prevent the formation of AAA, to halt disease progression, and to find early cardiovascular markers of AAA.

ÖD YOLLARI DİSKİNEZİYALARININ VƏ XRONİKİ XOLESİSTİTİN KLİNİKİ TƏZAHÜRLƏRİNİN DİFFERENSİAL KRİTERİYALARI

For the diagnosis and differentiation of chronic cholesistoxolangiitis from the diseases of the biliary system, 20 patients used modern instrumental and laboratory methods. In these methods, excision cholesistorentgenography, retrograde cholangiography, high frequency ultrasound examination, and cholesterol in the blood, manometric tonometry. In the objective examination, patients were disturbed by the pain on the right side of the neck, on the right side of the breast and in the right rib. Dyspeptic symptoms such as lower appetite, nausea, vomiting, and meteorism have been discovered. Dietotherapy, spasmolitics, antibiotics, gallbladder and physiotherapy have also been used in the treatment. Thus, based on the results of our examination, it is recommended that they be used in early diagnosis of chronic cholesistoxolangitis. Key words: cholangiocholecystitis, gallbladder, symptoms, clinical, diagnosis

Clinical value of high frequency combined with low frequency of ultrasound for the diagnosis of acute appendicitis

Objective To analyze the clinical value of high frequency combined with low-frequency ultrasound examination for the diagnosis of acute appendicitis. Methods From September 2015 to September 2016, 150 patients with suspected acute appendicitis in the Traditional Chinese Medicine Hospital of Beilun District were selected in the research, the low frequency combined with high frequency ultrasound examination was performed.The diagnostic accuracy of high frequency combined with low frequency ultrasound for patients with acute appendicitis was compared with postoperative pathological findings. Results The diagnostic accuracy of high frequency combined with low frequency ultrasound for periappendicural abscess, simple appendicitis, suppurative appendicitis, gangrenous appendicitis was 95.5%, 94.4%, 97.8%, 97.9%, respectively.The diagnosis accuracy of high frequency combined with low frequency ultrasound for acute appendicitis at prepositional ileum, basin, upward behind cecum, behind ileum was 97.4%, 97.6%, 97.1%, 93.8%, respectively.The accuracy, specificity, sensitivity, the missed diagnosis rate and misdiagnosis rate of high frequency combined with low frequency ultrasound in the diagnosis of acute appendicitis were 96.9%, 90.0%, 96.9%, 3.1%, 10.0%, respectively , and compared with the results of postoperative pathologic examination, there were no statistically significant differences(all P>0.05). Conclusion High frequency combined with low frequency ultrasound in the diagnosis of acute appendicitis has high diagnostic accuracy. Key words: Ultrasonography; Appendicitis; Acute disease; Diagnosis

High-Frequency Ultrasound Examination in the Diagnosis of Skin Cancer.

Ultrasound above 14MHz images epidermis, dermis, and subcutaneous tissues in real time. Tumor depth is ascertained with B-mode. Three-dimensional imaging depicts nonpalpable, in-transit, and satellite lesions. Doppler blood flow technologies measure tumor neovascularity and map vascular structures. Three-dimensional Doppler histogram reconstruction measures tumor aggression and metastatic potential proportional to the percentage of malignant vessels. Subcutaneous investigation reveals nonpalpable metastatic disease and nodal basin lymphadenopathy. Adjacent nerves may be studied. Preservation of the fat-fascia border refines surgical staging of deeper malignancies. Image-guided biopsy is facilitated. Treatment under image guidance is optimized with radiation and various photo and thermal technologies.

2062511 High-Frequency Ultrasound Examination of The Deep Cervical Artery

2062511 High-Frequency Ultrasound Examination of The Deep Cervical Artery

High-Frequency Ultrasound Examination of the Cross-Shaped Arterial Circulation in the Rear of the Buttocks

High-Frequency Ultrasound Examination of the Cross-Shaped Arterial Circulation in the Rear of the Buttocks

Abstract 5626: FKBP51 is a crucial modulator of melanoma plasticity and promising molecular target for preventing melanoma metastasis

Abstract FKBP51, a protein with a relevant role in developmental stages in mammals and other organisms, is highly expressed in melanoma and correlates with tumor aggressiveness and resistance to therapy. We found that FKBP51 positively regulates melanoma cancer stem cell (CSC) phenotype at the transcriptional level. We also found that melanoma CSCs are endowed with epithelial to mesenchimal transition (EMT) traits. The immunochemistry study of 10 primitive cutaneous and 20 brain melanoma metastases showed that melanocytic cells capable of extravasation and subverting the architecture of metastatic tissue display intense FKBP51 nuclear signal and cytoplasmic positivity for the CSC marker nestin. These findings support the conclusion that the genetic programs of cancer stemness and invasiveness overlap in melanoma, and that FKBP51 plays a pivotal role in sustaining such a program. To confirm the role of FKBP51 in melanoma invasion, we utilized an experimental metastasis model. Animal studies were performed in accordance with NIH recommendations and the approval of the local institutional animal research committee. Injecting SAN melanoma cells into the tail vein of IL2γ-NOD-SCID mice produced prominent multifocal lesions in lungs and liver. We systemically administered two separate doses of FKBP51 siRNA to mice after the injection of melanoma cells. Organ colonization was evaluated both in live animals and post mortem. Qualitative PET/CT image analysis demonstrated low FDG uptake limited to small areas in lungs and liver. By contrast, untreated mice had diffuse metastatic liver and lung lesions and high FDG uptake in the same organs. Quantitative analysis performed on PET/CT images revealed that mean standardized uptake values (SUV) in treated mice were significantly lower than in untreated mice, both for lungs and liver. High Frequency Ultrasound examination revealed few or no liver metastases in treated mice versus untreated mice. Post-mortem organ examination showed a dramatic difference between the morphologically preserved organs dissected from treated mice, and severely compromised organs from untreated mice. The histological examination confirmed these findings. Most interestingly, invading cells co-expressed FKBP51 and nestin. Our study suggests a prominent role for FKBP51 in the pathogenesis of metastatic melanoma; we envision that targeting this protein for melanoma metastasis prevention may produce a successful outcome. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5626. doi:1538-7445.AM2012-5626

Value of High Frequency Ultrasonography in Diagnosis and Surgical Repair of Traumatic Finger Tendon Ruptures

Objective: To investigate the value of high frequency ultrasonography in the diagnosis of zone 2 flexor tendon injuries. Subjects and Methods: Ninety-two patients (49 males and 43 females, mean age 32.6 ± 11.2 years) with zone 2 flexor tendon injuries in one or more digits were randomly divided into a study (n = 46, 95 digits) and a control group (n = 46, 90 digits). In the study group, preoperative ultrasound was performed and surgical repair was conducted based on ultrasonographic findings. Diagnosis and surgical repair of the control group was based on history of trauma and physical examination. Results: Types of ruptures (complete or partial) and the location of the distal end of the ruptured tendon diagnosed by preoperative ultrasonography were consistent with surgical findings in all cases (95/95, 100%) of the study group, whereas the concordance rate between clinically diagnosed ruptures and surgical findings was only 34.4% (31/90) in the control group (p = 0.02). Conclusion: Preoperative high frequency ultrasound examination yielded excellent diagnostic accuracy for zone 2 flexor tendon injuries.

High-frequency ultrasonographic study of finger joints synovial lesions in rheumatoid arthritis

Objective To study the synovial lesions of finger joint of rheumatoid arthritis (RA) with high frequency ultrasound ( HFUS). Methods HFUS examination of finger joints of both hands were performed in 42 patients with RA and 30 healthy volunteers. The ultrasound findings of the finger joints in RA patients included intra-articular fluid,the thickness of synovial membrane,vascular proliferation. and the blood flow characteristics. Results The intra-articular fluid was found in 256 joints and the detection rate was 42. 38% (256/840). Synovial membrane hyperplasia was found in 223 joints with the detection rate of 26.55% (223/840). The detection rate of HFUS for vascular proliferation was 6.07% (51/840). Conclusions HFUS is an easy, safe and effective method for the diagnosis of RA thus providing useful evidences for clinical diagnosis. Key words: Ultrasonography; Arthritis,rhumatoid; Finger joint; Synovial membrane

Ocular melanosis in the Cairn Terrier: clinical description and investigation of mode of inheritance

To describe the clinical features of ocular melanosis in Cairn Terriers. One hundred and fourteen Cairn Terriers diagnosed with ocular melanosis. A complete eye examination was performed on each dog. Four dogs (and two unaffected control dogs) underwent a high frequency ultrasound examination of the anterior segment. The pedigrees of affected dogs were analyzed. Forty-four (38.6%) dogs were male and 67 (58.7%) female; the sex of three dogs (2.6%) was not provided. A four-stage grading system of the ocular changes was developed. There was a variable age of onset, and the earliest change was a dark-colored thickening of the iris root. This was followed by the development of episcleral/scleral pigment plaques, release of pigment into the aqueous and deposition in the drainage apparatus, particularly ventrally. Secondary glaucoma developed in the most severely affected dogs. A slow progression of pigmentation in the tapetal fundus was observed and in some dogs pigment on the surface of the optic nerve head was seen. Three dogs developed uveal melanocytic neoplasms. Pedigree analysis suggested a possible autosomal dominant mode of inheritance. Ocular melanosis is an inherited, probably autosomal-dominant condition with a variable age of onset and rate of progression. It results in a thickening and pigmentation of the iris, release of pigmented material into the aqueous, pigment deposition in the sclera/episclera, and to a lesser extent posterior segment pigment deposition. Following extensive pigment deposition in the aqueous drainage pathways it can result in secondary glaucoma.

Staging of Esophageal Cancer Using High-Frequency Ultrasound (HFUS)

Purpose: Standard echoendoscopic evaluation of superficial esophageal tumors using frequencies of 7.5MHz and 12MHz has limited ability to optimally visualize the mucosal and submucosal layers. High-frequency catheter-based miniprobes operating at 20MHz permit improved imaging of the superficial layers of the esophagus. The diagnostic accuracy of HFUS staging in superficial esophageal tumors has not been definitively established. The aim of this study was to assess our institution's staging accuracy for superficial esophageal cancers using HFUS, and to determine whether the use of HFUS improves patient management. Methods: Between December 1999 and December 2004, 42 patients with esophageal cancer underwent preoperative EUS staging without neoadjuvant chemoradiotherapy. Within this group, five patients underwent staging with HFUS, and make up the study subset. Two patients were referred for Barrett's esophagus with high-grade dysplasia (HGD) on prior endoscopic biopsy, and three patients were referred for Barrett's esophagus with esophageal nodules found to be at least intramucosal adenocarcinoma on prior endoscopic biopsy. Overall staging accuracy, rate of complications, and impact on clinical management were assessed. Results: Four of the five patients (80%) had technically adequate HFUS imaging. By surgical pathology, all four patients had T1 disease (confined to the mucosa or submucosa). The accuracy of HFUS T staging in this group was 100% (95% CI 40–98%). No complications occurred as a result of HFUS examination. In both patients referred with HGD in the setting of Barrett's esophagus, demonstration of at least intramucosal adenocarcinoma changed management, prompting esophagectomy instead of endoscopic ablation with photodynamic therapy. Conclusions: 1. Use of HFUS at 20MHz frequency appears to be highly accurate in T staging of superficial esophageal cancers. However, larger studies will now be needed to confirm these results. 2. Use of HFUS appears to be safe. 3. HFUS staging has the potential to significantly impact patient management, particularly in its ability to detect intramucosal or more deeply invasive adenocarcinoma in patients with Barrett's esophagus with known HGD.

Comparison of low and high frequency transducers in the detection of liver metastases

Background and aims To evaluate the benefit of the additional use of a high frequency ultrasound probe (7.5 MHz) in finding suspicious liver lesions compared to the examination using a 3.5-MHz transducer only. Patients and methods One hundred and fifty-seven patients with underlying malignant disease were examined with both transducers using one of three ultrasound machines (Siemens Sonoline Elegra, GE Healthcare Logic 9, or Hitachi EUB-8500). Findings on hepatic lesions were collected on a standardised documentation sheet and evaluated by descriptive statistics. Results Ninety-three patients (59.2% of all patients) showed no evident liver lesion on conventional ultrasound with the 3.5 MHz probe. In 29 patients (18.5%) new suspicious liver lesions were found by using the high frequency transducer. Thirteen of these 29 patients (44.8%) were suspected to suffer from diffuse infiltration of the liver with malignant lesions or at least 10 additional visible lesions. In 14 patients, no liver lesion had been known before high frequency ultrasound examination. The size of newly described liver lesions ranged from 2 mm to 1.5 cm. Time needed for the additional examination with the high frequency transducer ranged between 1 and 15 min with an average of 4.0 min. Conclusion The additional use of a high frequency transducer in patients with underlying malignant disease slightly extends the examination time, but reveals new, potentially malignant hepatic lesions in almost every fifth patient.

Comparaison de l’échographie à 10 MHz, à 20 MHz et de la tomographie en cohérence optique dans l’évaluation des trous maculaires

To evaluate and compare the data provided by 10-MHz and 20-MHz ultrasonography and optical coherence tomography (OCT) in macular hole exploration. Sixty patients with macular hole at different stages were included in the study from January 2002 to April 2003. All patients received three successive examinations: an echographic examination with a 10- and 20-MHz probe (Quantel Medical Cinescan) and an examination with optical coherence tomography (OCT) (Humphrey Zeiss). In stages I and II, the 10-MHz examination was not a useful tool; in certain cases the 20-MHz examination highlighted stage II macular holes. OCT was better than ultrasonography in all these cases: it clearly defined the outline of the hole and perifovea posterior vitreous detachment (PVD). In stage III, the 10-MHz examination only allowed the visualization of the high reflectivity of the prefoveal operculum; the 20-MHz examination could also measure the thickness of the macular neuroepithelium. OCT very precisely visualized the hole as well as the opercula and the detachment of the posterior hyaloid located in the macular area but still attached to the papilla. In stage IV, the 10-MHz examination confirmed total PVD. High-frequency ultrasound examination and OCT provided somewhat similar information. OCT provided the advantage of measuring the hole. It is possible now to use probes of frequencies higher than 10 MHz for the study of the posterior pole and the vitreomacular junction at the cost of a more reduced exploration area than that usually obtained with a 10-MHz probe and a lower reflectivity of the interfaces encountered. One is indeed very quickly limited by noise if the gain is increased. Usually, the standard gain with 20 MHz is close to 90 dB and beyond 100 dB, the images are uninterpretable because of noise. The 10-MHz ultrasonography is very useful for an overall assessment of the vitreous body, its mobility, and in searching for PVD. The 20-MHz examination gives very valuable information on the analysis of the vitreomacular junction, approaching the precision level provided by OCT. It demands a very rigorous examination protocol. OCT, however, remains better for the fine morphological study of this zone, unless opaque media studies are necessary to determine the maximum frequency usable to increase the space resolution of the lesions of the posterior pole. In this case, the combined ultrasonographic study using 10 and 20 MHz provides a valid diagnosis and a therapeutic approach to the posterior pole.

The ultrasound investigation of scrotal swelling.

The objectives of this study were to: (1) establish the causes of scrotal swelling in the hospital catchment population; (2) define the role of high frequency ultrasound examination in the management of scrotal swelling. A retrospective study of 582 patients who had high frequency ultrasound examination was carried out. Those requiring more information on perfusion had colour doppler examination. Forty-four per cent of examinations were performed for scrotal swelling. The cause of the scrotal swelling was mainly extratesticular (75% of all scrotal swellings), hydrocele being the commonest. Of the intratesticular causes, infection (50.8%) and tumour (20.6%) were the commonest. In conclusion ultrasound examination distinguishes extratesticular (almost always benign) from intratesticular (potentially malignant) causes of scrotal swelling. Infection, trauma and torsion mimic the ultrasound appearance of tumour as do rare benign entities.

High-frequency ultrasound examination of the wrist and hand.

High-frequency ultrasound (US) is an efficient, rapid and inexpensive altenative to magnetic resonance imaging (MRI) for investigation of diseases in the soft tissues of the wrist and hand. US allows detection of foreign bodies and the reliable identification of a variety of traumatic lesions affecting tendons, annular pulleys, ligaments, vessels and nerves. Inflammatory diseases of tendons, including acute and chronic tenosynovitis and some degenerative conditions in the wrist and hand, can also be diagnosed. In entrapment neuropathies, US is able to identify nerve shape changes and possible extrinsic space-occupying lesions that may cause nerve compression within the tunnels. In patients with localized swelling of the hand or wrist, US is able to assess the presence of an expansile lesion and to characterize its nature in most cases. The objective of this article is to review the main findings and the primary indications of US in the investigation of disorders of the hand and wrist.

Molecular mechanisms of vertebrate limb initiation and specification

To evaluate the benefit of the additional use of a high frequency ultrasound probe (7.5 MHz) in finding suspicious liver lesions compared to the examination using a 3.5-MHz transducer only.One hundred and fifty-seven patients with underlying malignant disease were examined with both transducers using one of three ultrasound machines (Siemens Sonoline Elegra, GE Healthcare Logic 9, or Hitachi EUB-8500). Findings on hepatic lesions were collected on a standardised documentation sheet and evaluated by descriptive statistics.Ninety-three patients (59.2% of all patients) showed no evident liver lesion on conventional ultrasound with the 3.5 MHz probe. In 29 patients (18.5%) new suspicious liver lesions were found by using the high frequency transducer. Thirteen of these 29 patients (44.8%) were suspected to suffer from diffuse infiltration of the liver with malignant lesions or at least 10 additional visible lesions. In 14 patients, no liver lesion had been known before high frequency ultrasound examination. The size of newly described liver lesions ranged from 2 mm to 1.5 cm. Time needed for the additional examination with the high frequency transducer ranged between 1 and 15 min with an average of 4.0 min.The additional use of a high frequency transducer in patients with underlying malignant disease slightly extends the examination time, but reveals new, potentially malignant hepatic lesions in almost every fifth patient.

Localization of dermal edema in lipodermatosclerosis, lymphedema, and cardiac insufficiency: High-frequency ultrasound examination of intradermal echogenicity

Background: Chronic edema in venous insufficiency is associated with leg ulceration, whereas in lymphedema skin ulceration is less frequent and edema from cardiac failure does not cause major skin changes. The reason for these differences is unclear. Objective: Our purpose was to investigate, by means of ultrasound, the distribution of intradermal fluid in patients with edema associated with lipodermatosclerosis, lymphedema, or cardiac insufficiency. Methods: Sixteen patients with lipodermatosclerosis, 10 with lymphedema, 16 with leg edema from heart insufficiency, and 16 healthy control subjects were studied. Ultrasound images were obtained with a 20 MHz scanner. The echogenicity of the dermis was quantified by image analysis and the echogenicity of the upper (subepidermal) and lower portions of the dermis were measured. Results: In any type of edema the dermal echogenicity was lower than that of the control group, indicating intradermal edema. In normal skin the upper dermis was only slightly less echogenic than the lower dermis. In patients with lipodermatosclerosis a low-echogenic area was present in the upper dermis, which suggests the papillary dermis as a preferential site of edema formation. In contrast, in lymphedema dermal echogenicity was uniformly distributed, whereas in patients with heart failure the lower portion of the dermis was less echogenic than the upper dermis. Conclusion: This study demonstrates that intradermal echogenicity shows characteristic patterns in different types of edema, which indicates that localization of fluid varies in the dermis, from subepidermal (lipodermatosclerosis), uniform (lymphedema), to deep dermal (heart failure). These differences may help in understanding the origin of different skin sequelae of edema.