The prevalence of childhood obesity is increasing rapidly. Visceral fat plays an important role in the pathogenesis of metabolic and cardiovascular diseases. Currently, computed tomography (CT) is broadly seen as the most accurate method of determining the amount of visceral fat. The main objective was to examine whether measures of abdominal visceral fat can be determined by ultrasound in children and whether CT can be replaced by ultrasound for this purpose. To assess whether preperitoneal fat thickness and area are good approximations of visceral fat at the umbilical level, we first retrospectively examined 47 CT scans of nonobese children (body mass index <30 kg/m2; median age 7.9 y [95% range 1.2 to 16.2]). Correlation coefficients between visceral and preperitoneal fat thickness and area were 0.58 (p < 0.001) and 0.76 (p < 0.001), respectively. Then, to assess how preperitoneal and subcutaneous fat thicknesses and areas measured by ultrasound compare with these parameters in CT, we examined 34 nonobese children (median age 9.5 [95% range 0.3 to 17.0]) by ultrasound and CT. Ultrasound measurements of preperitoneal and subcutaneous fat were correlated with CT measurements, with correlation coefficients ranging from 0.75-0.97 (all p < 0.001). Systematic differences of up to 24.0 cm2for preperitoneal fat area (95% confidence interval -29.9 to 77.9 cm2) were observed when analyzing the results described by the Bland-Altman method. Our findings suggest that preperitoneal fat can be used as an approximation for visceral fat in children and that measuring abdominal fat with ultrasound in children is a valid method for epidemiological and clinical studies. However, the exact agreement between the ultrasound and CT scan was limited, which indicates that ultrasound should be used carefully for obtaining exact fat distribution measurements in individual children. (E-mail:

Adolescent, Child, Intra-abdominal fat, Ultrasonography, Validation study,
Ultrasound in Medicine & Biology
Erasmus MC: University Medical Center Rotterdam

Mook-Kanamori, D.O, Holzhauer, S, Hollestein, L.M, Durmus, B, Manniesing, R, Koek, M, … Leguin, M. (2009). Abdominal Fat in Children Measured by Ultrasound and Computed Tomography. Ultrasound in Medicine & Biology, 35(12), 1938–1946. doi:10.1016/j.ultrasmedbio.2009.07.002