High-frequency ultrasound-assisted diagnosis and margin delineation in eyelid lesions: clinical and surgical implications
Author: Efstathios T Detorakis
Base Hospital / Institution: Department of Ophthalmology, University Hospital of Heraklion
Rapid fire oral presentation
Abstract ID: 25-316
Purpose
To assess the clinical utility of high-frequency ultrasound (HFUS) and elastography in diagnosing eyelid
lesions and guiding surgical planning through accurate lesion characterization and margin delineation.
Methods
Nine patients (M/F ratio 6/3) with eyelid lesions underwent imaging using the GE LOGIQ E9 system.
HFUS was performed with an 18 MHz transducer, strain elastography with a 12 MHz head, and shear
wave elastography with a 9 MHz head. All scans were conducted by a radiology consultant. Parameters
assessed included lesion size, shape, margins, internal morphology, echogenicity, anatomical layer
involvement, vascularity (via Doppler ultrasonography), elasticity pattern, strain ratio, and stiffness.
Histopathological results served as the reference standard.
Results
HFUS provided detailed multimodal lesion depiction in all cases. It enabled precise assessment of lesion
extent, both in surface dimensions and depth, accurately identifying all anatomical layers involved.
Characteristics such as suspicious or poorly defined margins, tissue extensions not clinically evident,
irregular depth, indistinct borders, increased stiffness, and irregular vascular patterns on Doppler
imaging were considered factors for modifying surgical planning. In 3 out of 9 cases (33%) that
presented these findings, excision margins were adapted compared to those initially planned based
solely on clinical examination and palpation. The technique demonstrated high reliability in accurate
lesion border depiction, as final histopathological analysis confirmed that all 9 lesions (7 benign, 1
malignant, 1 uncertain) were completely excised without the need for reoperation.
Conclusion
HFUS is a valuable tool for both diagnostic evaluation and surgical planning in eyelid lesions. It reveals
lesion characteristics not appreciable on clinical exam alone, guiding safe and accurate resection. The
integration of elastography and Doppler further enhances preoperative insight and surgical confidence.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Vasileios | Batis | Department of Ophthalmology, University Hospital of Heraklion |
| Eleni | Drakonaki | Department of Anatomy, University of Crete |
