Dora Intagliata, Massimiliano Priolo, Paola Molinari
{"title":"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。","authors":"Dora Intagliata, Massimiliano Priolo, Paola Molinari","doi":"10.1007/s13555-025-01504-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This observational cohort study included 150 female patients (ages 20-55 years, BMI 18-32 kg/m<sup>2</sup>) 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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"2865-2878"},"PeriodicalIF":4.2000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454704/pdf/","citationCount":"0","resultStr":"{\"title\":\"High-Frequency Ultrasound Imaging for Stage III Cellulite: A Three-Subtype Structural Classification from an Observational Cohort Study.\",\"authors\":\"Dora Intagliata, Massimiliano Priolo, Paola Molinari\",\"doi\":\"10.1007/s13555-025-01504-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This observational cohort study included 150 female patients (ages 20-55 years, BMI 18-32 kg/m<sup>2</sup>) 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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":11186,\"journal\":{\"name\":\"Dermatology and Therapy\",\"volume\":\" \",\"pages\":\"2865-2878\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454704/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dermatology and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13555-025-01504-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatology and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13555-025-01504-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
High-Frequency Ultrasound Imaging for Stage III Cellulite: A Three-Subtype Structural Classification from an Observational Cohort Study.
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.
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.
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