Power Doppler ultrasound assessment of vascularization in hidradenitis suppurativa lesions

Abstract

Background

Ultrasound and Power Doppler (PD) ultrasound are useful tools to study and monitor Hidradenitis Suppurativa (HS) patients.

Objective

Describe the Power Doppler signal of HS nodules, abscesses, fistulas.

Methods

A retrospective analysis of PD in mild, moderate, severe HS patients, collecting all demographic and clinical data. The lesions were classified according to their ultrasound morphology, describing the vascular degree - high, moderate, minimal - and distribution - peripheral, internal, mixed. Statistical analysis was performed using odds ratio and bivariate regression.

Results

A total of 241 lesions, 62 nodules, 64 abscesses, 99 simple fistulas, 16 complex fistulas, from 61 HS patients, were included. Vascular distribution was defined peripheral in 143/241, mixed in 55/241, internal in 0/241 lesions, regardless the clinical type. Qualitative Doppler showed high vascularization in 44/241 lesions, moderate in 79/241, minimal in 75/241, despite the clinical type. All lesions showed resistive index <0.7. Age, disease's duration, size of the lesions, high Sartorius score, high BMI, showed positive statistically correlation with both PD signal and mixed vascular distribution. No statistically significance was evidenced for vascular degree measurements.

Limitations

Ultrasound cannot detect lesions <0.1 mm.

Conclusion

Vascular distribution of HS lesions can be evaluated by PD with additional relevant information for earlier and better disease management.

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