The research was approved by the Ethics and Research Committee of the Santo Amaro University,
whose number is 1,103,468 dated 06/11/2015 and CAAE: 44933915.3.0000.0081.
A Form of Assent was signed by the children and the Informed Consent Form,
by the parents and/or legal guardians.
Both terms have been read,
explained and signed by both parties.
The children were examined by ultrasonography in dorsal decubitus,
without fasting,
with a linear transducer (6-15MHz) and a convex transducer (1-5MHz),
according to the methodology described by Sakuno et al.
[6].
The device was adjusted with a time gain compensation curve in the neutral position and the general gain was calibrated so that the liquid structures such as gallbladder,
inferior vena cava and aorta were anechoic [6].
All ultrasound measurements were performed without pressure on the transducer and determined in centimeters (cm).
The following ultrasound measurements were evaluated [6]:
1) Subcutaneous cellular tissue (SCCT) - distance from the skin to the linea alba,
measured on the hemisternal line,
1cm above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 2
2) Minimum subcutaneous cellular tissue (minimum SCCT) - measured at the lowest thickness of the SCCT,
in the hemisternal line,
above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 3
3) Maximum subcutaneous cellular tissue (maximum SCCT) - measured at the site of the thicker SCCT,
in the hemisternal line,
above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 4
4) Preperitoneal fat (PPF) - distance from the linea alba to the anterior parietal peritoneum,
measured on the hemisternal line,
1cm above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 2
5) Minimum preperitoneal fat (minimum PPF) - measured at the lowest thickness,
between the linea alba to the anterior parietal peritoneum,
in the hemisternal line,
above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 4
6) Maximum preperitoneal fat (maximum PPF) - measured at the site of greatest thickness,
between the alba line to the anterior parietal peritoneum,
in the hemisternal line,
above the umbilical scar,
using the linear transducer in a longitudinal section; Fig. 3
7) Intraperitoneal fat (IPF) - measured in three ways with convex transducer:
7.1) IPFa - distance between the anterior peritoneum and the anterior wall of the aorta measured in the hemisternal line,
1cm above the umbilical scar,
in a cross section; Fig. 5
7.2) IPFp - distance between the anterior peritoneum and the posterior wall of the aorta measured in the hemisternal line,
1cm above the umbilical scar,
in a cross section; Fig. 5
7.3) IPFo – thickness of minor omentum: distance between the posterior surface of the left lobe of the liver and the anterior wall of the aorta measured at the level of the emergence of the celiac trunk in the midline of the epigastric region,
in a longitudinal section.
Fig. 6