Preorbital masses present a diagnostic challenge because clinical examination alone often cannot reliably distinguish benign from malignant lesions. This retrospective study assessed whether a higher-resolution 18 MHz Color Doppler ultrasound (CDU) probe (L8-18i) provides better characterization of preorbital masses than a conventional 11 MHz probe (L3-12). The primary aim was to compare imaging features from both probes against postoperative pathological diagnosis.
Seventeen patients (7 male, 10 female) aged 5 to 80 years who underwent ultrasound evaluation for preorbital masses between May 2021 and April 2024 were included. All patients received imaging with both the L8-18i (18 MHz) and the L3-12 (11 MHz) probes. Recorded imaging variables included mass anteroposterior diameter, internal echo characteristics, and blood flow parameters measured by color Doppler. Pathological examination after surgery served as the reference standard. Statistical comparisons used Wilcoxon signed-rank and Mann–Whitney U tests as appropriate, with P values reported in the abstract for key comparisons.
Lesion sites among the cohort were: upper eyelid (4 patients), lower eyelid (10), inner canthus (1), brow (1), and conjunctiva (1). Postoperative histopathology identified a mix of benign and malignant conditions. Benign diagnoses included chronic inflammation, nevi, cysts, and hemangiomas. Malignant diagnoses included sebaceous gland carcinoma, basal cell carcinoma, and squamous cell carcinoma. The abstract provides these diagnostic categories but does not give a per-diagnosis count in the source text.
Measurement of the anteroposterior diameter of lesions by the two probes showed no statistically significant difference (P = 0.320). Likewise, assessments of internal echo characteristics were not significantly different between the probes (P = 0.891). These findings indicate that both probes produced comparable results for basic size and gross echotexture metrics in this cohort.
The study found a significant difference between the probes in detecting blood flow signals within lesions (P = 0.014), with the 18 MHz L8-18i probe demonstrating superior visualization of vascular signals. Using the L8-18i probe, peak systolic velocity and end-diastolic velocity measurements differed significantly between benign and malignant lesions (P = 0.048). The lower-frequency L3-12 probe did not show significant differences in these hemodynamic parameters between benign and malignant groups. The abstract emphasizes that the higher-frequency probe improved detection of blood flow and provided clearer depiction of internal features such as hemorrhage, necrosis, and septation.
According to the abstract, the 18 MHz probe improved differentiation between benign and malignant preorbital masses by more accurately depicting vascularity and internal structural details. The L8-18i probe’s measurements of peak systolic and end-diastolic velocities were able to distinguish benign from malignant lesions in this sample, whereas the L3-12 probe’s measurements were not. The source text does not report numerical sensitivity, specificity, receiver operating characteristic curves, or exact diagnostic accuracy percentages.
The authors conclude that high-frequency Color Doppler ultrasound (18 MHz, L8-18i) offers better visualization of preorbital lesion structure and blood flow than an 11 MHz probe, facilitating improved differentiation of benign and malignant masses. Enhanced imaging clarity for features such as hemorrhage, necrosis, and septation, and more sensitive detection of vascular signals, are highlighted as reasons the 18 MHz probe aligned more closely with pathological findings. Clinically, these results suggest that higher-frequency CDU may be a useful adjunct for preoperative evaluation and planning in patients with eyelid and periocular masses.
The study is retrospective and includes a small cohort of 17 patients, which limits generalizability. The abstract does not provide detailed breakdowns of how many lesions fell into each pathological category, nor does it report sensitivity, specificity, positive or negative predictive values, or confidence intervals for the imaging comparisons. Information on interobserver variability, imaging acquisition settings, or patient selection criteria beyond dates and demographics was not reported in the abstract. These unreported details limit assessment of reproducibility and clinical applicability from the abstract alone.