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Subcutaneous epidermal inclusion cysts: Ultrasound (US) and MR imaging findings

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Abstract

Objective

To describe the characteristic US and MR findings of subcutaneous epidermal inclusion cysts.

Materials and methods

Seventy-nine patients with subcutaneous epidermal inclusion cysts underwent US (n = 70), MR (n = 7), or both (n = 2). On US, the margin, shape, echogenicity, through-transmission, wall, internal debris and vascularity were evaluated. On MR, the shape, wall, signal intensity, internal debris, and enhancement pattern were evaluated.

Results

On US, characteristic findings were well circumscribed (n = 69, 96%), ovoid-shaped (n = 56, 78%), heterogeneously and mildly echogenic (n = 66, 92%), increased through-transmission (n = 66, 92%) and low echoic rim (n = 48, 67%). Internal debris was seen in 31 cases (43%) and often contained linear echogenic reflections (n = 12, 17%), dark clefts (n = 13, 18%), or a mixture (n = 5, 7%). Most masses showed no Doppler flow (n = 70, 97%). On MR, all cases demonstrated a well-demarcated oval-shaped mass with a surrounding rim. On T1-weighted image (WI), the mass showed slightly high T1 signal in 4/9 (44%) and iso-signal in 5/9 (56%). On T2WI, the mass showed high signal in 6/9 (67%), intermediate in 2/9 (22%), and a target appearance in 1/9 (11%). Internal linear dark T2 signal debris was observed in 4/9 (44%). All lesions showed peripheral rim enhancement without central enhancement.

Conclusions

On US, subcutaneous epidermal inclusion cysts are usually well-circumscribed, oval-shaped, mildly echogenic masses with occasional linear anechoic and/or echogenic reflections, increased through-transmission, hypoechoic rim and no Doppler flow. On MR, an intermediate to high T2 signal mass with occasional low signal debris and no central enhancement can strengthen the diagnosis.

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The authors declare that there are no conflicts of interest.

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Author notes

  1. Hee Kyung Kim & Judy M. Racadio

    Present address: Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

  2. Sung Moon Kim

    Present address: Department of Radiology, University of Michigan Hospitals, 1500 E Medical Center Dr., Ann Arbor, MI, 48109, USA

Authors and Affiliations

  1. Department of Radiology and Research Institute, University of Ulsan College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea

    Hee Kyung Kim, Sung Moon Kim, Sang Hoon Lee & Myung Jin Shin

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  1. Hee Kyung Kim
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  2. Sung Moon Kim
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Correspondence to Myung Jin Shin.

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Kim, H.K., Kim, S.M., Lee, S.H. et al. Subcutaneous epidermal inclusion cysts: Ultrasound (US) and MR imaging findings. Skeletal Radiol 40, 1415–1419 (2011). https://doi.org/10.1007/s00256-010-1072-4

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  • DOI: https://doi.org/10.1007/s00256-010-1072-4

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