Evaluation of Ultrasonography and CT for Imaging of Head and Neck Pilomatricoma in Children and Adolescents

Abstract

Background and Objectives Pilomatricoma is a frequently diagnosed skin lesion of thehead and neck that may often be misdiagnosed as other skin lesions. This study evaluatedwhether ultrasonography (USG) or computed tomography (CT) is the most helpful imagingmodality for the accurate preoperative diagnosis of pilomatricoma in head and neck regions ofchildren and adolescents. Subjects and Method A retrospective review was conducted for 59 patients with pilomatricomaunder the age of 19 years. All cases were pathologically confirmed with pilomatricomain the head or neck. Results Preoperative imaging examinations were performed with USG in six cases and withCT in nine cases. The accuracy of preoperative diagnosis was compared between three groups:1) with clinical findings only, 2) with USG, and 3) with CT. The correct preoperative diagnosiswas made in 18 (30.5%) of the total of 59 cases. Using only clinical findings, 10 (22.7%) out of44 patients were diagnosed as pilomatricoma. With the addition of USG, pilomatricoma wasdiagnosed in 1 (16.7%) out of six cases, whereas with the addition of CT, 7 (77.8%) out of 9cases (77.8%) were diagnosed correctly. Preoperative diagnosis of pilomatricoma with CT imagingwas more accurate than clinical findings only (vs. CT; odds ratio [OR]=11.900, 95%confidence interval [CI] 2.126-66.615; p=0.001) or USG (vs. CT; OR=17.500, 95% CI 1.223-250.357; p=0.020). Conclusion In the preoperative diagnosis of pilomatricoma, imaging modalities such as CTand USG are helpful, with CT offering higher diagnostic accuracy and USG procedural benefitsin younger children.