The significance of ultrasounds and MRI scans becomes apparent when considering the common medical procedure of removing cysts and lipomas. Although these growths are typically non-cancerous, they can occasionally conceal underlying complexities that remain imperceptible to the naked eye. This underscores the essential role of preoperative imaging, encompassing ultrasounds and MRI scans.

Why do we perform scans before surgery?

1. Accurate diagnosis

An ultrasound or MRI can provide a pre-diagnosis, ensuring that the surgery is appropriate. While cysts and lipomas are often straightforward, there are instances when other structures or conditions can mimic their appearance.

2. Identifying size and location

It is recommended that lumps that are greater than 5cm are scanned ahead of the surgery. Knowing the size and precise location of the cyst or lipoma is crucial. This information guides the surgeon in planning the incision site and surgical removal. It also helps minimise tissue damage, reduce scarring and ensure the complete removal of the growth.

3. Determining depth and relationship to surrounding structures

Scans provide insights into the depth of the growth and its relationship with adjacent tissues, muscles, nerves and blood vessels. It is good practice to know these aspects ahead of the surgery in order to minimize the risk of damage, which can lead to complications.

What do we look out for in preoperative scans?

1. Characteristics of the growth

Ultrasound scans and MRI scans help determine the consistency of the lump. This information guides the surgeon in understanding the nature of the lesion and its complexity.

2. Vascularity:

Assessing blood flow to the growth is of high importance. Highly vascularised lesions may require special precautions during the surgery to control bleeding effectively.

3. Adjacent structures:

Identifying nearby structures, such as nerves and blood vessels, is essential for avoiding damage and planning the surgery prior to minimise disruptions to these vital components.

Preoperative imaging is recommended in cases where the lumps and bumps are larger, have regrown, or are situated in deep or complex anatomical locations such as the neck, scalp, back or in areas where access is challenging. The decision to perform preoperative imaging can vary based on several factors, including the specific case and the surgeon’s judgement. However, in most cases, basic cysts and lipomas do not require scans, and a physical assessment alone is enough to proceed with the surgery.