Baumann Victoria J A, Banati Richard, Clarke Jillian L
Discipline of Medical Imaging Science, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia.
Australas J Ultrasound Med. 2024 Oct 20;28(1):e12407. doi: 10.1002/ajum.12407. eCollection 2025 Feb.
In both highly industrialised and developing countries, obesity is reaching epidemic proportions and increasingly becoming a critical indicator of general morbidity, cardiovascular disease (CVD) and renal dysfunction. A promising trend in detection and management of obesity is the measurement of perirenal adipose tissue (PRAT), increasingly recognised as a metabolically active endocrine organ in itself. Its measurement by ultrasound is used increasingly to indicate visceral obesity and its clinical management. This review synthesises current techniques for measuring PRAT and its potential use as an indicator of CVD.
We included clinical studies published between 2010 and 2023, investigating the current practice and use of specific ultrasonographic techniques and assessed the reliability and accuracy of included papers. The risk of bias was assessed using the Downs and Black Checklist, and the methodological quality examined using the Grade of Recommendations, Assessments, Development and Evaluation.
It found, PRAT measures are predictive of CVD risk factors and the accuracy of ultrasound is comparable to CT and MRI, but there is no consistency in ultrasound technique. The lack of any randomised control trials and the use of 20 different non-standardised ultrasound techniques across the 21 studies resulted in inconsistent and imprecise clinical observations and interpretations, which decreased the overall quality of the studies.
This review found the inclusion of ultrasound measures in routine abdominal imaging potentially invaluable but demonstrates the need for standardisation of the perirenal fat ultrasound measuring technique to improve reproducibility and reliability.
在高度工业化国家和发展中国家，肥胖问题都已达到流行程度，并日益成为一般发病率、心血管疾病（CVD）和肾功能障碍的关键指标。肥胖检测与管理方面一个有前景的趋势是测量肾周脂肪组织（PRAT），它日益被公认为自身就是一个具有代谢活性的内分泌器官。超声测量PRAT越来越多地用于指示内脏肥胖及其临床管理。本综述综合了测量PRAT的现有技术及其作为心血管疾病指标的潜在用途。
我们纳入了2010年至2023年间发表的临床研究，这些研究调查了特定超声技术的当前实践和应用，并评估了纳入论文的可靠性和准确性。使用唐斯和布莱克清单评估偏倚风险，并使用推荐分级、评估、制定与评价来检查方法学质量。
研究发现，PRAT测量可预测心血管疾病风险因素，超声的准确性与CT和MRI相当，但超声技术缺乏一致性。21项研究中缺乏任何随机对照试验，且使用了20种不同的非标准化超声技术，导致临床观察和解释不一致且不精确，降低了研究的整体质量。
本综述发现，在常规腹部成像中纳入超声测量可能非常有价值，但表明需要对肾周脂肪超声测量技术进行标准化，以提高可重复性和可靠性。
