ULTRASONOGRAPHIC IMAGING OF MYCETOMA

Introduction The ultrasonographic appearance of mycetoma is described in this prospective study. Methods One hundred patients with foot swel lings had sonographic evaluation of the swelling and surgical excision within 2 weeks of ultrasonography. The histopathological findings wer e compared with the preoperative images. Some of the excised swellings and grains were also imaged and compared with the in vivo findings. R esults The mycetoma grains, their capsules and the accompanying inflam matory granulomas have characteristic ultrasonographic appearances. In eumycetoma lesions, the grains produce numerous, sharp hyper-reflecti ve echoes and there are single or multiple thick-walled cavities with no acoustic enhancement. In actinomycetoma, the findings are similar b ut the hyper-reflective echoes are fine, closely aggregated and common ly settle at the bottom of the cavities. None of the non-mycetoma foot swellings (which included lipoma, ganglion, foreign body granuloma an d others) studied had these features. Conclusion Ultrasonography is si mple, non-invasive, quick, reproducible and acceptable to patients. My cetoma has characteristic ultrasonographic features. Furthermore, ultr asonography delineates the extent of mycetoma more accurately than cli nical examination alone.