Dopplerfluxometria da veia hepática em pacientes com esteatose não alcoólica

Borges, Valéria Ferreira de Almeida e; Diniz, Angélica Lemos Debs; Cotrim, Helma Pinchemel; Rocha, Haroldo Luís Oliva Gomes; Salomão, Frederico Chaves

doi:10.1590/s0100-39842011000100005

Cited by 8 publications

(16 citation statements)

References 14 publications

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“…Os grupos experimental e controle apresentaram esteatose hepática, sendo classificada em moderada (de 33 a 66%) em ambos 32 e sem diferença significante entre eles. A esteatose hepática é uma condição onde há acúmulo de gordura no fígado, intimamente relacionada com a obesidade central, resistência à insulina, hipertrigliceridemia e hiperglicemia de jejum.…”

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Ganho de peso e alterações metabólicas em camundongos submetidos à dieta hiperlipídica

et al. 2018

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Section: Discussionunclassified

Ganho de peso e alterações metabólicas em camundongos submetidos à dieta hiperlipídica

et al. 2018

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“…These changes may lead to changes in intra-and extra-hepatic vascular impedance, which theoretically can be detected by the Doppler examination of the portal vein, hepatic vein and hepatic artery. A large number of Doppler ultrasound parameters have been studied in order to identify hemodynamic changes in the liver, but there is no consensus on which option is best in identifying the grade of liver fibrosis (6,8,15) . The numerous hemodynamic changes present in livers with established cirrhosis is unquestionable.…”

Section: Discussionmentioning

confidence: 99%

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Rocha

Diniz²,

Borges

et al. 2012

Arq. Gastroenterol.

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-Context -Hepatitis C is an important cause of chronic liver disease worldwide. The grading of hepatic fibrosis in chronic hepatitis C is important for better clinical management. However, until now, liver biopsy is the only test accepted for this purpose, despite their contraindications and complications. New methods for non-invasive assessment of hepatic fibrosis are under investigation. One proposal is the Doppler ultrasound, as a non-invasive, widely available and inexpensive. Objective -To compare Doppler parameters of portal vein in patients with chronic hepatitis C with a healthy control group and to correlate these parameters with fibrosis degree obtained by liver biopsy. Methods -Fifty patients with chronic hepatitis C submitted to liver biopsy and 44 healthy controls had Doppler of the portal vein performed, with the calculation of the portal venous index. We conducted a comparison between the averages of the two groups of portal venous index. For the correlation between portal venous index and fibrosis was employed the Spearman test. Results -There was a difference between the average portal venous index between controls (0.33 ± 0.07) and patients (0.23 ± 0.09) with P<0.001. No difference was observed between the portal venous index in patients with chronic hepatitis C who have significant fibrosis or not. The correlation between the portal venous index and fibrosis degree was reverse and moderate (r =-0.448 P<0.001). The area under the ROC curve was 78.4% (95% CI: 68.8% to 88%). The cutoff for the portal venous index was 0.28 with sensitivity of 73.5% and specificity of 71.1%. Conclusion -The portal venous index was useful in distinguishing healthy patients from patients with CHC. However, there was no significant difference in the quantification of degree of fibrosis.

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“…Several studies have been undertaken by Brazilian authors approaching the importance of imaging methods in the evaluation of liver diseases (24)(25)(26)(27)(28) , with CT diagnosis of HS being traditionally made according the criteria applied to the non-contrast-enhanced phase (10,11,16) . However, in a scenario of increased preoccupation with the harmful effects of ionizing radiation, and considering the opportunity to obtain the diagnosis of HS by means of the portal contrast-enhanced phase and the fact that such phase is the most useful in most abdominal CT indications (9,14,15) , the possibility of confirming the value of contrast-enhanced CT in the screening for HS becomes particularly interesting.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

et al. 2013

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Objective: To evaluate the diagnostic capacity of abdominal computed tomography in the assessment of hepatic steatosis using the portal phase with a simplified calculation method as compared with the non-contrast-enhanced phase. Materials and Methods: In the present study, 150 patients were retrospectively evaluated by means of non-contrast-enhanced and contrast-enhanced computed tomography. One hundred patients had hepatic steatosis and 50 were control subjects. For the diagnosis of hepatic steatosis in the portal phase, the authors considered a result of < 104 HU calculated by the formula [L -0.3 × (0.75 × P + 0.25 × A)] / 0.7, where L, P and A represent the attenuation of the liver, of the main portal vein and abdominal aorta, respectively. Sensitivity, specificity, positive and negative predictive values were calculated, using non-contrast-enhanced computed tomography as the reference standard. Results: The simplified calculation method with portal phase for the diagnosis of hepatic steatosis showed 100% sensitivity, 36% specificity, negative predictive value of 100% and positive predictive value of 75.8%. The rate of false positive results was 64%. False negative results were not observed. Conclusion: The portal phase presents an excellent sensitivity in the diagnosis of hepatic steatosis, as compared with the non-contrast-enhanced phase of abdominal computed tomography. However, the method has low specificity. Keywords: Fatty liver; Steatosis; Liver disease; Tomography; Multidetector computed tomography; Contrast media.Objetivo: Comparar a capacidade diagnóstica para esteatose hepática utilizando-se a fase portal com método simplificado de cálculo com a fase sem contraste na tomografia computadorizada de abdome. Materiais e Métodos: Foi realizado estudo retrospectivo em 150 pacientes submetidos a tomografia computadorizada de abdome sem e com contraste intravenoso, 100 deles com esteatose hepática e 50 controles. Para diagnóstico de esteatose hepática na fase portal considerou-se um resultado < 104 UH aplicando-se a fórmula [L -0,3 × (0,75 × P + 0,25 × A)] / 0,7, onde L, P e A representam a atenuação hepática, da veia porta e da aorta, respectivamente. Foram calculados sensibilidade, especificidade, valores preditivos positivos e negativos, utilizando-se a tomografia computadorizada sem contraste intravenoso como padrão de referência. Resultados: O método simplificado de cálculo para o diagnóstico de esteatose hepática na fase portal mostrou sensibilidade de 100%, especificidade de 36%, valor preditivo negativo de 100% e valor preditivo positivo de 75,8%. A taxa de falso-positivos foi 64%. Não foram encontrados falso-negativos. Conclusão: A utilização da fase portal apresenta elevada sensibilidade para o diagnóstico de esteatose hepática, quando comparada à fase sem contraste da tomografia computadorizada de abdome. Por outro lado, o método apresenta baixa especificidade. Unitermos: Fígado gorduroso; Esteatose hepática; Hepatopatias; Tomografia; Tomografia computadorizada multidetectores; Meios de contrast...

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Dopplerfluxometria da veia hepática em pacientes com esteatose não alcoólica

Cited by 8 publications

References 14 publications

Ganho de peso e alterações metabólicas em camundongos submetidos à dieta hiperlipídica

Ganho de peso e alterações metabólicas em camundongos submetidos à dieta hiperlipídica

Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography

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