Navegando por Palavras-chave "Técnicas De Imagem Por Elasticidade"

Agora exibindo 1 - 2 de 2
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Avaliação ultrassonográfica do baço por elastografia em pacientes com Esquistossomose mansoni
    (Universidade Federal de São Paulo (UNIFESP), 2019-09-26) Czapkowski, Adriano [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; http://lattes.cnpq.br/1047430444405235; http://lattes.cnpq.br/4029665568653148; http://lattes.cnpq.br/3704426844004248; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To compare spleen stiffness (SS) by Point Shear Wave Speed Measurement (pSWE) elastography (VTTQ) in patients with splenic hepatic Schistosomiasis Mansoni (SM) in relation to asymptomatic studies and correlated with splenic parenchymal stiffness with indicators of portal hypertension for conventional ultrasound (US) and Doppler velocimetry. Methods: From June 2016 to May 2018, we evaluated patients with hepatosplenic SM and asymptomatic volunteers (AV), correlating the SS of these two groups using the elastography technique that assesses tissue elasticity through point measurement of shear wave velocity (Point Shear Wave Speed Measurement (pSWE) with Acoustic Radiation Force Impulse (ARFI). We correlate the stiffness of the splenic tissue with the degree of hepatic fibrosis classified by Niamey's criteria and the main ultrasound indicators of portal hypertension, as portal and splenic vein diameter, portal vein flow velocity, as well as splenomegaly and siderotic nodules in the spleen. Results: This study included 68 patients. The mean of SS patients was 50.4 ± 10.9 years (age range 31-76 years) and the age of asymptomatic volunteers was 37.6 ± 12.5 years; (age range 24-68 years). Mean spleen stiffness measurements using ARFI elastography were 2.1 m/s in AV patients and 3.5 m/s in SM patients (p <0.0001). There was a correlation between SS and portal vein diameter (r = 0.661), SS and splenic vein diameter (r = 0.722) and SS and splenic index (r = 0.807). Conclusion: Spleen stiffness assessed with ARFI elastography was higher in SM patients compared with AV and can be used as a noninvasive indicator of hypertension portal.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Fibrose hepática e comprometimento neurológico em pacientes com Ataxia-telangiectasia: relação com resistência à insulina e inflamação
    (Universidade Federal de São Paulo (UNIFESP), 2021) Barreto, Talita Lemos Neves [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Universidade Federal de São Paulo
    Background: Ataxia-telangiectasia (A-T) is a DNA repair disorder characterized by alterations in several organs and systems. Advances in clinical protocols have resulted in increased survival of A-T patients, however disease progression is evident, mainly through metabolic and liver changes. Objective: Identify the frequency of significant liver fibrosis in A-T patients and verify the association with metabolic alterations and degree of ataxia. To assess the correlation between neurological features, nutritional status, and metabolic changes in A-T patients. Methods: Cross-sectional study that included 25 A-T patients aged between 5 and 31 years. Anthropometric data, liver, inflammatory, lipid metabolism and glucose biomarkers (oral glucose tolerance test with insulin curve - OGTT) were collected. The Cooperative Ataxia Rating Scale (ICARS) and Assessment and Rating of Ataxia (SARA) were applied to assess the degree of ataxia. The following were calculated: Homeostasis Model Assessment - Insulin Resistance (HOMA-IR), Homeostasis Model Assessment - Adiponectin (HOMA-AD), Matsuda index, aspartate aminotransferase (AST): platelet ratio index (APRI), nonalcoholic fatty liver disease fibrosis score (NFS) and BARD score. Liver ultrasonography and transient liver elastography (EHT) by FibroScan® were performed. Patients who presented values ≥7 kPa or changes in the APRI index and one of the scores (NFS or BARD) simultaneously were considered as suggestive of significant liver fibrosis. Results: The following were observed: dyslipidemia in 16/25 (64%), diabetes in 4/22 (18%), insulin resistance in 5/17 (29%), liver steatosis in 13/20 (65%) and suggestive of significant liver fibrosis in 5/25 (20%). Patients in the group with suggestive of significant liver fibrosis were older (p<0.001), they were lower values of platelet (p=0.027), albumin (p=0.019), HDL-c (p=0.013), and Matsuda index (p=0.044); and high values of LDL-c (p=0.049), AST (p=0.001), alanine aminotransferase (p=0.002), gamma glutamyl transferase (p=0.001), ferritin (p=0.001), blood glucose in 120 minutes in the OGTT (p=0.049), HOMA-AD (p=0.016), and degree of ataxia (p=0.009). Significant correlations were found between the scores on the ICARS scale and age (rho = 0.748; p <0.001), GGT (rho = 0.743; p <0.001), insulin levels (rho = 0.520; p = 0.016) and the Homeostasis Model Assessment for Insulin Resistance index (HOMA-IR) (rho = 0.585; p = 0.005) as well as the scores on the SARA scale and age (rho = 0.704; p <0.001), GGT (rho = 0.701; p <0.001), insulin levels (rho = 0.706; p <0.001) and HOMA-IR index (rho = 0.764; p <0.001). Conclusion: It was found suggestive of significant liver fibrosis in 20% of A-T patients, which was associated with the degree of ataxia and higher values of liver biomarkers, LDL-c, ferritin, HOMA-AD compared to A-T patients without liver fibrosis. The relevant correlation between severity of ataxia and disease progression with metabolic changes such as liver function impairment and insulin resistance reinforce the importance to monitoring metabolic changes and evaluate nutritional status in these patients.