尽管多学科护理取得了进展，但口腔鳞状细胞癌（OSCC）的肿瘤学结果并没有显著改善：仍然有三分之一的I、II期患者可能出现局部复发。成像在术前分期中扮演重要角色，提供浸润深度（DOI）的测量。然而，局部复发与分期系统中未包括的不良组织病理因素有很强的关联，并且缺乏与其相关的任何成像特征。本研究评估了高频口腔内超声（IOUS）在预测OSCC组织学风险因素方面的可能性。共招募了34名患者。评估了超声测量和病理测量DOI之间的一致性，并将超声边缘外观与Brandwein-Gensler评分和最严重浸润模式（WPOI）进行了比较。发现超声测量和病理测量DOI之间有很好的一致性（平均差异为0.2毫米）。超声浸润前端形态与Brandwein-Gensler评分 ≥ 3（p < 0.0001）和WPOI ≥4（p = 0.0001）之间存在显著关联。IOUS预测Brandwein-Gensler评分 ≥3的敏感性、特异性、阳性预测值和阴性预测值分别为93.33％，89.47％，87.50％和94.44％。本研究证明了IOUS在辅助OSCC患者风险分层中的有希望作用。

Despite advancements in multidisciplinary care, oncologic outcomes of oral cavity squamous cell carcinoma (OSCC) have not substantially improved: still, one-third of patients affected by stage I and II can develop locoregional recurrences. Imaging plays a pivotal role in preoperative staging of OSCC, providing depth of invasion (DOI) measurements. However, locoregional recurrences have a strong association with adverse histopathological factors not included in the staging system, and any imaging features linked to them have been lacking. In this study, the possibility to predict histological risk factors in OSCC with high-frequency intraoral ultrasonography (IOUS) was evaluated. Thirty-four patients were enrolled. The agreement between ultrasonographic and pathological DOI was evaluated, and ultrasonographic margins' appearance was compared to the Brandwein-Gensler score and the worst pattern of invasion (WPOI). Excellent agreement between ultrasonographic and pathological DOI was found (mean difference: 0.2 mm). A significant relationship was found between ultrasonographic morphology of the front of infiltration and both Brandwein-Gensler score ≥ 3 (p < 0.0001) and WPOI ≥4 (p = 0.0001). Sensitivity, specificity, positive predictive value, and negative predictive value for the IOUS to predict a Brandwein-Gensler score ≥3 were 93.33%, 89.47%, 87.50%, and 94.44%, respectively. The present study demonstrated the promising role of IOUS in aiding risk stratification for OSCC patients.