Narelle Kennedy1,2, Ann Quinton1,3, Michael John Peek4, Kristy Robledo5, Ron Benzie1,2, Ralph Nanan6. 1. Discipline of Obstetrics, Gynaecology and Neonatology Sydney Medical School Nepean University of Sydney Nepean Hospital Penrith New South Wales 2750 Australia. 2. Christopher Kohlenberg Department of Perinatal Ultrasound Nepean Hospital Penrith New South Wales 2750 Australia. 3. Medical Sonography School of Health, Medical and Applied Science Central Queensland University Sydney New South Wales 2000 Australia. 4. Australian National University Medical School College of Health and Medicine The Australian National University Centenary Hospital for Women and Children Garran Australian Capital Territory 2605 Australia. 5. NHMRC Clinical Trials Centre University of Sydney Sydney New South Wales 2000 Australia. 6. Charles Perkins Centre University of Sydney Nepean Hospital Penrith New South Wales 2750 Australia.
Abstract
INTRODUCTION: Chronic inflammation leads to adipose tissue (AT) fibrosis through excessive accumulation of extracellular matrix proteins. An increasing degree of fibrosis in AT is associated with increasing body mass index (BMI) and insulin resistance. Anecdotally AT has been observed to vary with ease of ultrasound penetration on medical examinations. Ultrasound strain elastography (SE) is a useful tool in assessing fibrosis in liver disease but has not previously been used to assess AT fibrosis. This study assesses the variance in density of the two anatomical layers of subcutaneous AT, superficial subcutaneous adipose tissue (SSAT) and deep subcutaneous adipose tissue (DSAT) in pregnancy using SE. METHOD: Women (n = 210) recruited in early pregnancy. Density of SSAT and DSAT were assessed using SE at five-time points throughout pregnancy and post-partum. Semi-quantitative density measures were achieved using two methods, strain values (SV) of the two layers and ImageJ software to calculate the percentage colour pixels in the elastography image and correlated with the SSAT/DSAT thickness and BMI. RESULTS: Adipose tissue demonstrated a difference in density with the SSAT layer being denser than DSAT. Correlation of tissue density measures with BMI was poor. There was slight change of AT density during pregnancy with a tendency towards harder SSAT and softer DSAT in the third trimester. Post-partum SSAT became softer associated with an increase in SSAT thickness. CONCLUSION: Elastography demonstrated density differences in adipose tissue. SE is a new method of assessing the AT demonstrating density differences in adipose tissue. Information on AT density may determine AT fibrosis and be valuable for metabolic disease risk.
INTRODUCTION: Chronic inflammation leads to adipose tissue (AT) fibrosis through excessive accumulation of extracellular matrix proteins. An increasing degree of fibrosis in AT is associated with increasing body mass index (BMI) and insulin resistance. Anecdotally AT has been observed to vary with ease of ultrasound penetration on medical examinations. Ultrasound strain elastography (SE) is a useful tool in assessing fibrosis in liver disease but has not previously been used to assess AT fibrosis. This study assesses the variance in density of the two anatomical layers of subcutaneous AT, superficial subcutaneous adipose tissue (SSAT) and deep subcutaneous adipose tissue (DSAT) in pregnancy using SE. METHOD: Women (n = 210) recruited in early pregnancy. Density of SSAT and DSAT were assessed using SE at five-time points throughout pregnancy and post-partum. Semi-quantitative density measures were achieved using two methods, strain values (SV) of the two layers and ImageJ software to calculate the percentage colour pixels in the elastography image and correlated with the SSAT/DSAT thickness and BMI. RESULTS: Adipose tissue demonstrated a difference in density with the SSAT layer being denser than DSAT. Correlation of tissue density measures with BMI was poor. There was slight change of AT density during pregnancy with a tendency towards harder SSAT and softer DSAT in the third trimester. Post-partum SSAT became softer associated with an increase in SSAT thickness. CONCLUSION: Elastography demonstrated density differences in adipose tissue. SE is a new method of assessing the AT demonstrating density differences in adipose tissue. Information on AT density may determine AT fibrosis and be valuable for metabolic disease risk.
Authors: Ashwin Suresh; Anthony Liu; Alison Poulton; Ann Quinton; Zara Amer; Max Mongelli; Andrew Martin; Ronald Benzie; Michael Peek; Ralph Nanan Journal: Aust N Z J Obstet Gynaecol Date: 2012-10 Impact factor: 2.100
Authors: D Cosgrove; F Piscaglia; J Bamber; J Bojunga; J-M Correas; O H Gilja; A S Klauser; I Sporea; F Calliada; V Cantisani; M D'Onofrio; E E Drakonaki; M Fink; M Friedrich-Rust; J Fromageau; R F Havre; C Jenssen; R Ohlinger; A Săftoiu; F Schaefer; C F Dietrich Journal: Ultraschall Med Date: 2013-04-19 Impact factor: 6.548
Authors: Sara E Taksali; Sonia Caprio; James Dziura; Sylvie Dufour; Anna M G Calí; T Robin Goodman; Xenophon Papademetris; Tania S Burgert; Bridget M Pierpont; Mary Savoye; Melissa Shaw; Aisha A Seyal; Ram Weiss Journal: Diabetes Date: 2007-10-31 Impact factor: 9.461