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Title
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Direct comparison of the thickness of the parietal peritoneum using peritoneal biopsy and ultrasonography of the abdominal wall in patients treated with peritoneal dialysis
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Author
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Abstract
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| 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 mu m (interquartile range [IQR] 72 -129 mu m), while this was 370 mu m (IQR 324 - 458 mu m) when measured by US (p < 0.0001). The mean difference between the 2 measures was -257 mu m (limits of agreement -4.6 and -511 mu m). 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 userdefined US settings. |
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Language
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English
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Source (journal)
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Peritoneal dialysis international. - New York
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Publication
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New York
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2019
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ISSN
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0896-8608
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DOI
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10.3747/PDI.2018.00108
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Volume/pages
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39
:5
(2019)
, p. 455-464
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ISI
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000484823800008
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Pubmed ID
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31337699
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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