Ultra-sonografia do figado e das vias biliares em pacientes com fibrose cistica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

This ultrasonographic study aimed to gain information on the relationship between, liver and gall bladder alterations and functions was carried out to compare the effects of cystic fibrosis (CF) in patients, ages 1-18 years old, representative of A group. The investigation was done through the analysis of ultrasonographic images of the liver and gall bladder of other 38 control individuaIs, representative the B group, the same number of patients affected by cystic fibrosis. Patients of A group were weighed and classified according to the Gomez criteria in eutrofic and undemourished. Analysis of pancreatic function was done by the Van De Kamer method and the patients found to be with esteatorrhoea, sub-group 1, and without esteatorrhoea, sub-group 2. Ultrasonographies were performed with patients while in eight hours to ovemight fasting, laying in supine position. Measurements of the liver were done longitudinally Ín the axiliar anterior line. Characteristics of the organs, such as surface, edge, ecogenecity and the liver texture w,ere also accomplished. Patients with parenchyma aIterations were submitted to percutaneous biopsy. The gaIlbladder was measured and fumished the following information: 1- Larger longitudinal dimension. 2- Larger anteroposterior dimension 3- Whole area. These data were measured in fasting, 30 minutes and 60 minutes after ingestion of food and resulted in a contractility index. Patients of A group received the usual quantity of pancreatic enzyme. Beside the measurements, absence or presence of biliary sludge and stones was also established. Comparisons between continuous variables between subjects and control group was accomplished through the test; comparison between categoricaI variables was determined by the I,,) McNemar test, corrected by the Q-square; comparison between contractility of the gall bladder in both groups was determined by the U test from Mann- Whitney. Significance of t tests, McNemar test, and U test were determined by p<0,05. Regarding the nutritional status, it was observed that 18 patients (47,4%) were considered undemourished. Steatorrhoea was present in 22 patients (57,9%). The ultrasonography of the liver did not disclose differences between groups concerning characteristics of the parenchyma, edge and surface. However, there were differences in liver dimension, with larger sizes in B group. Four patients that showed ecographic alterations in the texture of the hepatic parenchyma and the biopsies of three patients revealed steatosis. Ultrasonography of the gallbladder evidenced only one patient with cholelitiasis and none with biliary sludge. AlI dimensions of the gallbladder in fasting patients were larger in B group when compared with A group. The contractility index 30 and 60 minutes postprandial, the area and the longitudinal length, were also larger in B group when compared with the A group. In A group no differences were observed between subgroups AI and A2. The contractility index of the gall bladder was smaller in the CF than in the control group. Conc1uding, the histological alterations observed in biopsy material were more frequent with patients showing ultrasonographic modification of the hepatic parenchyma. The gall bladder contractility index was also smaller in the CF group than in the control

ASSUNTO(S)

fibrose cistica ultra-sonografia figado

ACESSO AO ARTIGO

Documentos Relacionados