Purpose or Case Report: This educational exhibit introduces a layer-based framework for evaluating pediatric superficial soft-tissue lesions using high-frequency ultrasound. The goal is to help radiologists and sonographers determine the anatomic layer of origin (epidermis, dermis, subcutaneous fat, or superficial fascia) and demonstrate how this topographic information guides lesion characterization and differential diagnosis. By emphasizing an anatomy-oriented approach rather than a purely echogenicity-based one, the exhibit aims to support diagnostic reasoning and strengthen communication with referring clinicians in daily pediatric imaging practice.
Methods & Materials: Normal high-frequency ultrasound anatomy of the pediatric skin and subcutaneous tissues is first reviewed, highlighting the sonographic appearance of the epidermis, dermis, subcutaneous fat, and fascial planes. Lesions are then categorized according to their layer of origin, focusing on those arising from the epidermis, dermis, subcutaneous fat, and superficial fascia. Representative pediatric cases ranging from newborns to adolescents are presented from institutional archives to illustrate each category.
For each layer, characteristic grayscale features, color Doppler findings, and the impact on adjacent structures are described, emphasizing key diagnostic clues for identifying lesion depth and relationships with anatomic boundaries. Schematic diagrams and a color-coded decision algorithm are used to demonstrate step-by-step localization of lesions relative to skin layers. This anatomy-based approach aims to improve reproducibility, facilitate pattern recognition, and provide a clear mental framework for interpreting pediatric superficial lesions on ultrasound.
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