• Nenhum resultado encontrado

Arq. Gastroenterol. vol.53 número3


Academic year: 2018

Share "Arq. Gastroenterol. vol.53 número3"

Mostrar mais ( páginas)






212 Arq Gastroenterol v. 53 no. 3 - jul./set. 2016

DOI: 10.1590/S0004-28032016000300017

We have read the article by Guerra et al. with interest in a recent issue of the Arquivos de Gastroenterologia(2).

They concluded that acoustic radiation force impulse (ARFI) was useful tools to stage the severity of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC). We would like to thank the authors for their invaluable contribution. However, we would like to report few concerns regarding this study from a methodological point of view.

First, it would have been relevant, if the sample size of CHC patients had been larger.

Second, it would also have been better, if separate comparison of subgroups (CHC and NAFLD) had been made while evaluating patient group according to ibrosis score by ARFI technique. Additionally, it is stated in the present study that the measurements of Acoustic Radiation Force Impulse (ARFI) were performed in the right liver lobe through the inter-costal space in the left lateral decubitus position(2).

In contrast to this study, Uslu et al demonstrated that subcostal approach to the liver parenchyma was signiicantly superior to intercostal approach for the








, Ergenekon



and Huseyin Onur



Received 24/4/2016 Accepted 4/5/2016

Declared conflict of interest of all authors: none Disclosure of funding: no funding received

1 Canakkale Military Hospital Department of Radiology, Canakkale, Turkey; 2 Van Military Hospital Department of Infectious Diseases, Istanbul, Turkey; 3 GATA Haydarpasa

Training Hospital Department of Radiology, Istanbul, Turkey.

Correspondence: Dr. Coskun Ozturker. Department of Radiology, Canakkale Military Hospital, 17000, Cevatpasa/Canakkale, Turkey. E-mail: drozturker@gmail.com

evaluation of stiffness(5). If the ARFI measurements

had been performed through the subcostal space, the pressure would have been transmitted better to liver parenchyma, and this would have given better results than intercostal approach in terms of determining the elasticity of the liver.

Third, the length of the biopsy material was not mentioned in present study. Bedossa et al. demonstrated 40 mm long biopsy was considered an optimal specimen for accurate evaluation of liver ibrosis in the same study(3). Additionally, the number of the pieces of the

portal tracts was at least seven in present study. According to American Association of Study of Liver Disease guidelines, an adequate number of portal tracts has been proposed to be greater than 11(3). It would have been better, if the authors had been

mentioned these constitute limitations in the study. Last, Trovato et al. demonstrated that ARFI of the spleen is correlated with fibrosis staging, and could be a possible additional tool for the diagnosis of liver ibrosis(4). It would have been useful, if the

authors had evaluated their patients according to spleen measurements of these techniques.


1. Bedossa P, Dargere D, Paradis V. Sampling variability of liver ibrosis in chronic hepatitis C. Hepatology. 2003;38:1449-57.

2. Guerra JA, Trippia M, Pissaia A, Teixeira BC, Ivantes CA. Acoustic radiation force impulse is equivalent to liver biopsy to evaluate liver ibrosis in patients with chronic hepatitis C and nonalcoholic fatty liver disease. Arq Gastroenterol. 2015;52:234-8.

3. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology. 2009;49:1017-44.

Ozturker C, Karagoz E, Sildiroglu HO. O exame de sonoelastograia (ARFI) é uma ferramenta valiosa para avaliação da ibrose na doença hepática gordurosa não alcoólica e na hepatite C? Arq Gastroenterol. 2016,53(3):212.

4. Trovato FM, Atzori S, Musumeci G, et al. Liver and spleen transient elastography and Acoustic Radiation Force Impulse Measurements. Performance and comparison of measurements in the same area concurrently assessed for liver fibrosis by biopsy. Adv Med Sci. 2015;60:300-6.


Documentos relacionados

5.5.3 Produção de etanol em mosto contendo alta concentração de açúcar Como visto anteriormente, antes de proceder com as fermentações sem e com esterilização do mosto e com e

Key words: Viral hepatitis, alcohol induced liver disease, autoimmune hepatitis, cryptogenic liver cirrhosis, non- alcoholic fatty liver

A clave é, claro, satírica. E ridendo castigat mores, o que significa também que uma crónica humorística – ou um sketch – pode ser um lugar politizado. Esta Boca do Inferno,

These results show that ursodeoxycholic acid is able to reduce serum levels of hepatic enzymes in patients with nonalcoholic fatty liver disease, but this effect is not related

Transient elastometry (TE) is increasingly becoming standard method to longitudinally assess liver fibrosis in patients with chronic liver disease, with good concordance with

Prevalence of mixed infection by different hepatitis C virus genotypes in patients with hepatitis C virus-related chronic liver disease. Evaluation and comparison of different

CONCLUSIONS: In this study, we found lower serum 25(OH)D levels in patients with non-alcoholic fatty liver disease than in subjects without non-alcoholic fatty liver disease..

Cryptogenic cirrhosis (CC) is observed in 15-30% of patients with advanced liver disease, and certain studies have suggested that nonalcoholic fatty liver disease (NAFLD) may be a

Accuracy of transient elastography-FibroScan s , acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with

Serum retinol bin- ding protein 4 and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. Diabetes Res

No artigo “ Dietary intake of patients with Nonalcoholic Fatty Liver Disease: Comparison between the presence and absence of Nonalcoholic Steatohepatitis and Metabolic Syndrome ”,

Aim of the present study was to evaluate the prevalence of GD and associated factors in a large series of patients with histologically proven NAFLD and to define whether the presence

studied 101 patients with chronic hepatitis C, excluding patients with risk factors for nonalcoholic fatty liver disease, and they observed hepatic steatosis in 41% of the

Change in platelet count in patients with hypersplenism subjected to liver transplantation.. Arq

This study aims assess the sensitivity and speciicity of ARFI compared to liver biopsy to quantify hepatic ibrosis in patients with hepatitis C virus (HCV) and nonalcoholic

(11) demonstrated in a prospective study with 766 patients that the higher caffeine consumption is associated with lower degrees of ibrosis in patients with chronic liver

This study aimed to evaluate the association between vitamin D serum levels and inlammatory activity and degree of liver ibrosis in patients with chronic hepatitis C virus

Transient elastometry (TE) is increasingly becoming standard method to longitudinally assess liver fibrosis in patients with chronic liver disease, with good

Transient elastometry (TE) is increasingly becoming standard method to longitudinally assess liver fibrosis in patients with chronic liver disease, with good

CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, au- toimmune hepatitis, aminotransferase elevations, nonalcoholic fatty

Este estudo tem o intuito de refletir sobre a experiência do resgate da leitura e da escrita através do uso e da produção do jornal na sala de aula, enquanto ferramenta pedagógica

Cardiovascular Risk Factors and the Metabolic Syndrome in Pediatric Nonalcoholic Fatty Liver Disease.. Glicose em

Conclusions: Probiotic therapy has contributed to the reduction of ALT serum levels in pediatric patients with nonalcoholic fatty liver disease, which is in line with results found