From the Guidelines
I would recommend a high-resolution soft tissue ultrasound to investigate a mass superior to the groin fold. This type of ultrasound is ideal for evaluating superficial masses in the inguinal region as it provides excellent visualization of soft tissue structures with high spatial resolution 1. The examination should include both grayscale and color Doppler imaging to assess the mass's internal characteristics, vascularity, and relationship to surrounding structures. Some key points to consider when performing the ultrasound include:
- Determining if the mass is solid or cystic
- Assessing the mass's size, borders, internal echogenicity, and blood flow patterns
- Evaluating the relationship between the mass and adjacent neurovascular structures
- Performing the ultrasound with the patient in both supine and standing positions if a hernia is suspected According to the American College of Radiology, ultrasound is equally appropriate for small lesions that are superficial to the deep fascia 1, and it has been shown to be highly sensitive and specific for diagnosing superficial soft-tissue masses, particularly lipomas, vascular malformations, and epidermoid cysts 1. Ultrasound is particularly valuable in this anatomical location because it is non-invasive, does not use ionizing radiation, and allows for real-time dynamic assessment of the area.
From the Research
Ultrasound Investigation for Mass Superior to the Groin Fold
To investigate a mass superior to the groin fold, the choice of ultrasound technique is crucial for accurate diagnosis. Considering the location and the need for high-resolution imaging of superficial structures, the following points are relevant:
- High-Frequency Ultrasound: Studies have shown that high-frequency ultrasound is effective in imaging superficial structures such as skin, blood vessels, and musculoskeletal anatomy 2, 3, 4, 5.
- Ultra-High Frequency Ultrasound: Ultra-high frequency ultrasonography (UHFUS) with frequencies between 30 and 100 MHz offers high spatial resolution imaging, making it suitable for detailed examination of superficial masses 2.
- Linear Array Transducers: The use of high-frequency linear array transducers has been demonstrated in various studies for small animal imaging and for assessing articular cartilage, showing their potential for high-resolution imaging of superficial structures 3, 4, 5.
- Doppler Imaging: For masses that may involve vascular components, high-frequency Doppler ultrasound can provide valuable information on blood flow, aiding in the differentiation of various types of masses 6, 3, 4.
Given these considerations, a high-frequency or ultra-high frequency ultrasound system with a linear array transducer, potentially combined with Doppler capabilities, would be specified to investigate a mass superior to the groin fold, depending on the specific clinical suspicion and the need to assess vascular flow.