Gulizia Rosario, Vercelli Alessandro, Gervasoni Cristina, Uglietti Alessia, Ortu Massimiliano, Ferraioli Giovanna, Galli Massimo, Filice Carlo
Division of Infectious and Tropical Diseases, Foundation IRCCS S Matteo, University of Pavia, Pavia, Italy.
Ultrasound Med Biol. 2008 Jul;34(7):1043-8. doi: 10.1016/j.ultrasmedbio.2007.12.010. Epub 2008 Mar 4.
To assess the comparability of ultrasonographic (US) subcutaneous fat thickness (SFT) measurements in comparison with computed tomography (CT) at reference points (RPs) representative of HIV related adipose redistribution syndrome (HARS) in patients treated with antiretrovirals. US and CT measurements were compared in nine patients with clinical reports of HARS. We obtained the best resolution of facial (at deepest point of Bichat pad), brachial (in the dorsal face of arm) and crural SFT (at mid thigh) by means of minimal transducer pressures avoiding potential biases such as stand off pads pressure on the skin and artefacts due to too abundant quantity of gel. CT scans were obtained in the same RP where US measurements were performed such as identified by means of metallic skin markers. Median US measurement of facial SFT was 8.8 mm (95% CI: 3.1 to 13.4), 3.95 mm (95% CI: 2.62 to 5.84) for brachial SFT and 4 mm (95% CI: 3.4 to 9.4) for crural SFT. Median CT assessments of facial SFT was 8.7 mm (95% CI: 3.5 to 13.5), 4.2 mm (95% CI: 2.6 to 5.88) for brachial SFT and 5 mm (95% CI: 3.9 to 10.3) for crural SFT, with no significant difference at each RP. A linear regression showed good CT/US comparability at each RP, with no significant deviation from linearity (p > 0.10). US shows to be highly comparable with CT, excluding invaliding biases as the transducer pressure on the skin. Given the proven efficacy on the HARS assessments, if well standardized, US could be a reliable method, simpler than CT in the management of body fat changes related to HARS.
为评估超声(US)测量的皮下脂肪厚度(SFT)与计算机断层扫描(CT)在接受抗逆转录病毒治疗的患者中代表HIV相关脂肪重新分布综合征(HARS)的参考点(RP)处的可比性。对9例有HARS临床报告的患者进行了US和CT测量比较。我们通过最小化探头压力获得面部(在鼻唇沟最深点)、肱部(手臂背面)和小腿SFT(大腿中部)的最佳分辨率,避免潜在偏差,如皮肤表面的隔离垫压力以及由于凝胶过多导致的伪像。在与US测量相同的RP处进行CT扫描,通过金属皮肤标记物确定位置。面部SFT的US测量中位数为8.8毫米(95%置信区间:3.1至13.4),肱部SFT为3.95毫米(95%置信区间:2.62至5.84),小腿SFT为4毫米(95%置信区间:3.4至9.4)。面部SFT的CT评估中位数为8.7毫米(95%置信区间:3.5至13.5),肱部SFT为4.2毫米(95%置信区间:2.6至5.88),小腿SFT为5毫米(95%置信区间:3.9至10.3),各RP处无显著差异。线性回归显示各RP处CT/US具有良好的可比性,无显著线性偏差(p>0.10)。US与CT具有高度可比性,排除了皮肤表面探头压力等无效偏差。鉴于其在HARS评估中的已证实疗效,如果标准化良好,US可能是一种可靠的方法,在管理与HARS相关的身体脂肪变化方面比CT更简单。