Journal of Medical Ultrasound

CASE REPORT
Year
: 2018  |  Volume : 26  |  Issue : 3  |  Page : 163--165

Color doppler ultrasonography to evaluate hypoechoic areas in pressure ulcers: A report of two cases


Koichi Yabunaka1, Gojiro Nakagami2, Tomomitsu Miyagaki3, Sanae Sasaki4, Chieko Hayashi4, Hiromi Sanada2 
1 Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2 Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3 Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
4 Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan

Correspondence Address:
Dr. Koichi Yabunaka
7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-0033
Japan

Ultrasound (US) is frequently used for evaluating inflammation of subcutaneous tissue caused by pressure ulcers (PUs), but color Doppler mode (CDM) helps to better identify inflammatory edema in subcutaneous fat and necrotic tissue in PUs. We report two cases where inflammatory edema in subcutaneous fat and necrotic tissue in PUs are identified using small US equipment with CDM. Case 1 – An 82-year-old male presented with cerebral infarction and a Category III PU in the sacral region. B-mode gray-scale US imaging (B-mode imaging) revealed a thickened layer of subcutaneous fat with fat lobules and homogeneous cobblestone appearance with fluid accumulation within the echo-free space. CDM did not identify any color signal (CS) in hypoechoic areas. Case 2 – A 29-year-old female presented with cytopenia and decreased renal function with a Category IV PU with undermining in the coccyx region. B-mode imaging distinguished the necrotic tissue, indicating a diffuse hypoechoic area with no layers, unclear borders, and uneven gray level (cloud-like image) in the subcutaneous fat. Similar B-mode imaging findings were obtained in inflammatory edema with cobblestone appearance. CDM did not detect a CS in the hypoechoic areas but confirmed peripheral hypervascularity. CDM imaging identified inflammatory edema in the subcutaneous fat and necrotic tissue in PUs. Specifically, CDM may better evaluate early-stage PUs with necrotic tissue by distinguishing necrosis from intense inflammatory edema.


How to cite this article:
Yabunaka K, Nakagami G, Miyagaki T, Sasaki S, Hayashi C, Sanada H. Color doppler ultrasonography to evaluate hypoechoic areas in pressure ulcers: A report of two cases.J Med Ultrasound 2018;26:163-165


How to cite this URL:
Yabunaka K, Nakagami G, Miyagaki T, Sasaki S, Hayashi C, Sanada H. Color doppler ultrasonography to evaluate hypoechoic areas in pressure ulcers: A report of two cases. J Med Ultrasound [serial online] 2018 [cited 2021 Nov 30 ];26:163-165
Available from: http://www.jmuonline.org/article.asp?issn=0929-6441;year=2018;volume=26;issue=3;spage=163;epage=165;aulast=Yabunaka;type=0