RESUMO
The aim of this study was to assess interobserver agreement of ultrasound parameters for portal hypertension in hepatosplenic mansonic schistosomiasis. Spleen size, diameter of the portal, splenic and superior mesenteric veins and presence of thrombosis and cavernous transformation were determined by three radiologists in blinded and independent fashion in 30 patients. Interobserver agreement was measured by the kappa index and intraclass correlation coefficient. Interobserver agreement was considered substantial (ê = 0.714-0.795) for portal vein thrombosis and perfect (ê = 1) for cavernous transformation. Interobserver agreement measured by the intraclass correlation coefficient was excellent for longitudinal diameter of the spleen (r = 0.828-0.869) and splenic index (r = 0.816-0.905) and varied from fair to almost perfect for diameter of the portal (r = 0.622-0.675), splenic (r = 0.573-0.913) and superior mesenteric (r = 0.525-0.607) veins. According to the results, ultrasound is a highly reproducible method for the main morphological parameters of portal hypertension in schistosomiasis patients.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Portal , Hepatopatias Parasitárias , Sistema Porta/ultraestrutura , Esquistossomose mansoni , Esplenopatias , Trombose Venosa , Estudos Transversais , Hipertensão Portal , Variações Dependentes do Observador , Tamanho do Órgão , Estudos Prospectivos , Sistema Porta , Reprodutibilidade dos Testes , Esquistossomose mansoni , Esplenopatias , Ultrassonografia Doppler em Cores , Trombose VenosaRESUMO
More than 22% of undirected percutaneous liver needle biopsies that are performed in search of metastatic neoplasms yield false negative specimens. Failure of sampling is also, met with directed needle biopsy. However, histologic changes are often observed in the liver adjacent to space occupying lesions due to focal obstructor of bile and blood flow. These alterations were defined in 20 liver specimens, with metastatic and primary malignant neoplasms, and revealed a characteristic histologic triad consisting of proliferated and abnormal bile ductules, polymorphonuclear leucocytes in edematous portal tracts, and focal sinusoidal dilatation. The changes had been compared with histologic changes associated with major biliary obstruction with a significant frequency of variable [P <0.05]. Therefore, the observation of the histologic triad described here should lead to a continued search for space occupying tumor in the liver