Avaliação do volume de fluxo portal em pacientes esquistossomóticos: Estudo comparativo entre Ressonância Magnética e Ultra-som Doppler

Autor: Leão, Alberto Ribeiro de Souza [UNIFESP]
Jazyk: portugalština
Rok vydání: 2008
Předmět:
Zdroj: Repositório Institucional da UNIFESPUniversidade Federal de São PauloUNIFESP.
Druh dokumentu: masterThesis
Popis: Made available in DSpace on 2015-12-06T23:45:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2008
Objetivo: Avaliar a concordancia entre o Ultra-som Doppler (USD) e a Ressonancia Magnetica (RM) e a reprodutibilidade inter-observador do USD e RM, na quantificacao do volume de fluxo portal em individuos esquistossomoticos. Metodos: Foi realizado estudo transversal, observacional e auto-pareado, avaliando 21 pacientes portadores de esquistossomose hepato- esplenica, submetidos a mensuracao do fluxo portal atraves da RM (utilizando-se a tecnica Phase-contrast) e USD, por 4 observadores, de forma independente, sendo calculada a concordancia entre os metodos e os observadores, atraves do coeficiente de correlacao intraclasse, teste T-pareado e grau de linearidade de Pearson. Resultados: Observou-se uma baixa concordancia entre os metodos [coeficiente de correlacao intra-classe de 34,5% (IC a 95%)]. A reprodutibilidade inter-observador, na avaliacao pela Ressonancia Magnetica [coeficiente de correlacao intra-classe u 99,2% % (IC a 95%) / coeficiente de Correlacao de Pearson - 99,2% / media do fluxo portal = 0,806] e pelo USD [coeficiente de correlacao intra-classe - 80,6 a 93,0 % (IC a 95%) / coeficiente de Correlacao de Pearson - 81,6 a 92,7% / media do fluxo portal = 0,954; 0,758 e 0,749], foram excelentes. Conclusao: Ha uma baixa concordancia entre o USD e RM na mensuracao do volume de fluxo na veia porta. A RM e o USD sao metodos reprodutiveis na quantificacao do fluxo portal em pacientes portadores de hipertensao porta de origem esquistossomotica, apresentando boa concordancia inter-observador
Purpose: to evaluate the agreement between Doppler Ultrasound (DUS) and Magnetic Resonance Imaging (MRI) and also de reproducibility of both methods in measuring portal volume blood flow in patients with schistosomiasis. Methods: this was a prospective, observational, transversal, auto controlled research design. Twenty-one patients with hepatosplenic schistosomiasis mansoni referred for measurement of portal blood flow by MRI, using phase-contrast technique and Doppler ultra-sonography. The patients were studied independently by four observers and the agreement between both methods and observers was determined using the paired-sample T test, intraclass correlation and Pearson´s correlation coefficient. Results: there was poor agreement between MRI and DUS values (intraclass correlation coefficient 34,5% [CI at 95%]). Nevertheless, inter-observer reproducibility of MRI (intraclass correlation coefficient – 99,2% % [CI at 95%] / Pearson’s correlation coefficient - 99,2% / portal blood flow = 0,806) and DUS measurements (intraclass correlation coefficient - 80,6 to 93,0 % [CI at 95%]/ Pearson’s correlation coefficient - 81,6 to 92,7% / portal blood flow = 0,954; 0,758 and 0,749) were excellent. Conclusion: there is poor agreement between DUS and phase-Contrast MRI technique in measuring portal blood flow volume. Nevertheless, MRI and DUS are reproducible methods for measuring portal blood flow in patients with portal hypertension due to hepatoesplenic schistosomiasis, presenting excellent inter-observer agreement.
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