High-Frequency Ultrasound Imaging for Stage III Cellulite: A Three-Subtype Structural Classification from an Observational Cohort Study.

IF 4.2 3区医学 Q1 DERMATOLOGY

Dermatology and Therapy Pub Date : 2025-10-01 Epub Date: 2025-07-25 DOI:10.1007/s13555-025-01504-0

Dora Intagliata, Massimiliano Priolo, Paola Molinari

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引用次数: 0

Abstract

Introduction: Stage III cellulite is traditionally assessed through clinical inspection; however, visual scales often fail to capture the structural complexity of subcutaneous tissue. High-frequency ultrasound (HFUS) provides an objective, non-invasive method for visualizing the architecture of adipose tissue. This study aimed to develop and validate an ultrasound-based subclassification of stage III cellulite to improve diagnostic accuracy and facilitate personalized treatment strategies.

Methods: This observational cohort study included 150 female patients (ages 20-55 years, BMI 18-32 kg/m²) with a clinical diagnosis of stage III cellulite. Two physicians independently performed clinical staging (3A/3B) using the Nürnberger-Müller scale. A single physician conducted HFUS examinations of the subgluteal and trochanteric regions using a 20-MHz probe. Ultrasound features, including fat thickness, echotexture, fibrosis, and edema, served to classify patients into three phenotypes: 3A, 3B, and mixed.

Results: HFUS identified 50 patients in each subtype. The mean superficial fat thickness was 4.8 ± 1.1 mm in 3A, 11.3 ± 2.4 mm in 3B, and 8.6 ± 3.4 mm in mixed subtype. Severe fibrosis occurred in 100.0% of patients with type 3B, was absent in type 3A, and was variable in the mixed type. Edema was mild in all patients with type 3A (100.0%), severe in 44.0% of those with type 3B, and variable in the mixed group. Discrepancies between clinical and ultrasound classifications appeared in 33.3% of cases. Agreement between classifications was moderate (Gwet's AC1 = 0.444; p < 0.001).

Conclusion: HFUS provides a valid and reproducible method for structurally assessing advanced cellulite. It enables the identification of a third, clinically unrecognized mixed phenotype, which has significant therapeutic implications by supporting more accurate treatment selection and improving treatment personalization.

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高频超声成像III期脂肪团：一项观察队列研究的三亚型结构分类。

导语：III期脂肪团通常通过临床检查来评估；然而，视觉尺度往往不能捕捉到皮下组织的结构复杂性。高频超声（HFUS）提供了一种客观的、非侵入性的方法来观察脂肪组织的结构。本研究旨在开发和验证基于超声的III期脂肪团亚分类，以提高诊断准确性和促进个性化治疗策略。方法：本观察性队列研究纳入150例临床诊断为III期脂肪团的女性患者（年龄20-55岁，BMI 18-32 kg/m2）。两名医生使用n rnberger- m ller量表独立进行临床分期（3A/3B）。一名医生使用20 mhz探头对臀下和转子区域进行了高频磁共振检查。超声特征包括脂肪厚度、回声、纤维化和水肿，将患者分为三种表型：3A型、3B型和混合型。结果：HFUS各亚型各50例。3A型平均脂肪厚度4.8±1.1 mm， 3B型平均脂肪厚度11.3±2.4 mm，混合型平均脂肪厚度8.6±3.4 mm。100.0%的3B型患者发生严重纤维化，3A型患者无严重纤维化，混合型患者有不同程度的严重纤维化。所有3A型患者的水肿均为轻度（100.0%），3B型患者的水肿为重度（44.0%），混合组的水肿有所不同。33.3%的病例出现临床与超声分类不一致。分类间一致性中等(Gwet’s AC1 = 0.444；结论：HFUS为晚期脂肪组织的结构评价提供了一种有效的、可重复的方法。它能够识别第三种临床未识别的混合表型，通过支持更准确的治疗选择和改善治疗个性化，具有重要的治疗意义。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.