Correlação interobservador das alterações morfológicas das vias biliares em pacientes com esquistossomose mansoni pela colangiorressonância magnética

• Autor(a) principal: Sales, Danilo Moulin [UNIFESP]
• Data de Publicação: 2009
• Outros Autores: Santos, José Eduardo Mourão dos [UNIFESP], Shigueoka, David Carlos [UNIFESP], Leão, Alberto Ribeiro de Souza [UNIFESP], Colleoni Neto, Ramiro [UNIFESP], Borges, Durval Rosa [UNIFESP], D'Ippolito, Giuseppe [UNIFESP], Szejnfeld, Jacob [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-39842009000500004; http://repositorio.unifesp.br/handle/11600/5308
• topic: Schistosomiasis mansoni; Magnetic resonance imaging; Cholangiography; Biliary ducts; Esquistossomose mansoni; Imagem por ressonância magnética; Colangiografia; Ductos biliares

OBJECTIVE: To describe changes of the biliary tree demonstrated by magnetic resonance cholangiography (MRC) in patients with the hepatosplenic presentation of schistosomiasis mansoni, and evaluating the interobserver agreement in the detection of schistosomal cholangiopathy. MATERIALS AND METHODS: Prospective, cross-sectional study involving 24 patients with hepatosplenic schistosomiasis and 6 healthy patients (control group) submitted to biliary tree evaluation by MRC. The following changes of the biliary tree were considered: distortion, thinning, stenosis, dilation and irregularity. The interobserver agreement in the detection of biliary tree changes was calculated with the McNemar's test and the kappa index of agreement (κ). RESULTS: The interobserver agreement in the detection of distortion and thinning of the biliary tree was almost perfect (κ = 0.867; confidence interval [CI] 95% [0.512-1.0] and κ = 0.865; CI 95% [0.51-1.0], respectively). There was a substantial agreement for stenosis (κ = 0.78; CI 95% [0.424-1.0]), moderate agreement for dilation (κ = 0.595; CI 95% [0.247-0.942]) and mild agreement for thinning (κ = 0.229; CI 95% [0.095-0.552]). CONCLUSION: In a decreasing order of frequency, the changes of the biliary tree were observed: distortion, thinning, stenosis, dilation and irregularity. The interobserver agreement for signs of schistosomal cholangiopathy was almost perfect for distortion and thinning, and substantial for stenosis.