Alferso C Abrahams1, Amélie Dendooven2,3, Jan Willem van der Veer4, Rens Wientjes5, Raechel J Toorop6, Ronald L A W Bleys7, Antoni P A Hendrickx8, Maarten S van Leeuwen9, Quido G de Lussanet10, Marianne C Verhaar4, Gerard Stapper9, Tri Q Nguyen2. 1. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands A.C.Abrahams@umcutrecht.nl. 2. Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of Pathology, University Hospital of Antwerp, Edegem, Belgium. 4. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands. 5. Department of Medical Technology and Clinical Physics, University Medical Center Utrecht, Utrecht, the Netherlands. 6. Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands. 7. Department of Anatomy, University Medical Center Utrecht, Utrecht, the Netherlands. 8. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 9. Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands. 10. Department of Radiology, IJsselmeer Hospital, Lelystad, the Netherlands.
Abstract
Background:Long-term treatment with peritoneal dialysis (PD) results in peritoneal fibrosis. Peritoneal biopsies have been used to determine the severity of fibrosis. Ultrasonography (US) of the abdominal wall has been used to measure peritoneal thickness non-invasively. However, direct comparison of both methods in the same patient has never been done. Furthermore, the validity of US to measure peritoneal thickness has not been investigated. Methods: We performed 3 studies: 1) a human biopsy study to compare US measurement of peritoneal thickness with histological examination; 2) a human cadaver study to investigate the effect of removing the peritoneum on US results; and 3) a phantom study in which we used US to measure the thickness of membrane-like structures with a known thickness to investigate the influence of different US settings. Results: The median thickness in biopsies of the peritoneum was 113 μm (interquartile range [IQR] 72 -129 μm), while this was 370 μm (IQR 324 - 458 μm) when measured by US (p < 0.0001). The mean difference between the 2 measures was -257 μm (limits of agreement -4.6 and -511 μm). In the cadaver study, removal of the peritoneum did not have an effect on the presence or thickness of the hyperechoic line reported to represent the peritoneum. In the phantom study, results were highly dependent on frequency of the transducer, scan depth, and gain settings.Conclusions:Ultrasonography results differ markedly from histological measurement using peritoneal biopsies. However, the hyperechoic line generated by US represents the interface between 2 neighboring tissues and not a separate morphological structure. Moreover, its thickness is greatly influenced by user-defined US settings.
Background:Long-term treatment with peritoneal dialysis (PD) results in peritoneal fibrosis. Peritoneal biopsies have been used to determine the severity of fibrosis. Ultrasonography (US) of the abdominal wall has been used to measure peritoneal thickness non-invasively. However, direct comparison of both methods in the same patient has never been done. Furthermore, the validity of US to measure peritoneal thickness has not been investigated. Methods: We performed 3 studies: 1) a human biopsy study to compare US measurement of peritoneal thickness with histological examination; 2) a human cadaver study to investigate the effect of removing the peritoneum on US results; and 3) a phantom study in which we used US to measure the thickness of membrane-like structures with a known thickness to investigate the influence of different US settings. Results: The median thickness in biopsies of the peritoneum was 113 μm (interquartile range [IQR] 72 -129 μm), while this was 370 μm (IQR 324 - 458 μm) when measured by US (p < 0.0001). The mean difference between the 2 measures was -257 μm (limits of agreement -4.6 and -511 μm). In the cadaver study, removal of the peritoneum did not have an effect on the presence or thickness of the hyperechoic line reported to represent the peritoneum. In the phantom study, results were highly dependent on frequency of the transducer, scan depth, and gain settings.Conclusions:Ultrasonography results differ markedly from histological measurement using peritoneal biopsies. However, the hyperechoic line generated by US represents the interface between 2 neighboring tissues and not a separate morphological structure. Moreover, its thickness is greatly influenced by user-defined US settings.
Authors: Soo Jin Park; Eun Ji Lee; Aeran Seol; Sunwoo Park; Jiyeon Ham; Ga Won Yim; Seung-Hyuk Shim; Whasun Lim; Suk-Joon Chang; Gwonhwa Song; Ji Won Park; Hee Seung Kim Journal: J Gynecol Oncol Date: 2022-05-24 Impact factor: 4.756
Authors: Joost C de Vries; Maaike K van Gelder; Anneke S Monninkhof; Sabbir Ahmed; Diënty H M Hazenbrink; Tri Q Nguyen; Gèrard A P de Kort; Evert-Jan P A Vonken; Koen R D Vaessen; Jaap A Joles; Marianne C Verhaar; Karin G F Gerritsen Journal: Toxins (Basel) Date: 2022-09-14 Impact factor: 5.075