Navegando por Palavras-chave "Volume Fracionado Dos Membros"

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    Uso de técnicas ultrassonográficas para estimativa do trofismo muscular dos membros inferiores de fetos com disrafismo espinhal aberto lombossacral
    (Universidade Federal de São Paulo (UNIFESP), 2021) Milani, Herbene Jose Figuinha [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo
    Objective: to evaluate the use of ultrasound techniques of fractional thigh volume (TVOL) and circumference and area of the leg to estimate the muscle trophism of lower limbs in fetuses with lumbosacral spinal dysraphism, comparing these techniques between normal fetuses and fetuses with spine bifida (SB); and correlating these techniques with the subjective evaluation of the lower limbs (muscle echogenicity and movement patterns) in fetuses with SB. Patients and Method: an observational crosssectional study was carried out between 2016 and 2019. Pregnant women with 26 weeks were included, dividing them into 2 groups: fetuses with lumbosacral SB; and normal fetuses. Initially, fetal biometry and morphology were evaluated. In fetuses with SB, the type and anatomical level of the lesion was described, and a subjective evaluation of the lower limbs was performed (describing muscle echogenicity and movement patterns). For the evaluation of the thigh, TVOL was used. To assess the leg, the measurement of the area and circumference of the upper, middle and lower third of the leg was standardized, and the reproducibility of this method was studied. Results: Thirty-one fetuses with SB and 51 normal fetuses were evaluated in the study. In the SB group, the injury level was L3 / L4 in 80.64% of the cases. There was no significant difference for TVOL between fetuses with SB and normal fetuses (p = 0.623). The measurements of the area and circumference of the legs (in the upper, middle and lower thirds) were statistically lower in the SB group than in the normal group (p = 0.002 for the upper third area; p <0.001 for the other parameters). When subjective ultrasound assessment demonstrated hypotrophy of the lower limbs, the measurements of the area and circumference of the leg (in the upper, middle and lower thirds) were statistically lower when compared to the measurements of the fetuses classified as normal (p <0.001), except for TVOL (p = 0.148). Fetuses with open SB with abnormal lower limb movements had lower measurements for TVOL and area and circumference of the leg (in all segments) than fetuses with a normal movements (p <0.001). The technique of area and circumference of the leg proved to be highly reproducible (ICC > 0.95). Conclusions: There was no significant difference for TVOL between fetuses with lumbosacral SB and normal fetuses. Measurements of the area and circumference of the leg (in the upper, middle and lower thirds) were statistically lower in fetuses with lumbosacral SB compared to normal fetuses. In the group of fetuses with SB, a high correlation was observed between subjective findings of lower limb hypotrophy and lower measurements of the area and circumference of the leg (in the upper, middle and lower thirds), and this correlation was not observed for TVOL. In fetuses with SB, there was a high correlation between changes in the movement patterns of the lowers limbs and lower measurements for TVOL and area and circumference of the leg. The technique of evaluating the leg by area and circumference proved to be highly reproducible.