Quantifying fibrosis in venous disease: mechanical properties of lipodermatosclerotic and healthy tissue.
OBJECTIVE
To quantify the mechanical properties of medioposterior bulk calf tissue in patients with lipodermatosclerotic venous-insufficient tissue and individuals with apparently healthy tissue using a novel ultrasound indentometry method, and to identify parameters with the potential for quantifying fibrosis in subsequent studies.


METHODS
2-group, quasi-experimental design


METHODS
Soft Tissue Mechanics Laboratory, University of Pittsburgh, Pittsburgh, PA PARTICIPANTS: 9 healthy and 9 venous-insufficient individuals aged 35 to 85 years


METHODS
Ultrasound indentometry and computed tomography (CT) of calf tissue


METHODS
Between group differences and associations among quasi-linear viscoelastic (QLV) tissue parameters and CT descriptors


RESULTS
Established the accuracy, validity, and reliability of the QLV model and ultrasound indentometry method. Demonstrated a range of significant differences between the groups (P <.020 to P <.004) for selected QLV parameters. Also found significant correlations between CT measures of fibrosis and dermal thickness and QLV elastic measures (P <.034 to P <.005).


CONCLUSIONS
Attempts to quantify fibrosis in lipodermatosclerosis have included histologic exams, palpation/pitting, durometer readings, and imaging techniques, but these efforts have failed to produce a clinically practical, noninvasive method. A novel ultrasound indentometry method was used to acquire in vivo data from which tissue parameters were derived. These data support the further development of ultrasound indentometry as a method to quantify fibrosis in venous disease.
Geyer
Mary Jo
MJ
Lymphedema and Wound Care Clinical Support Services and Research, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Brienza
David M
DM
Chib
Vikram
V
Wang
Jue
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D004548:Elasticity; D005260:Female; D005355:Fibrosis; D006801:Humans; D007866:Leg / Q000098:blood supply; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D011237:Predictive Value of Tests; D012594:Scleroderma, Localized / Q000150:complications*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods / Q000592:standards; D014689:Venous Insufficiency / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology