Avaliação da reprodutibilidade da tomografia computadorizada no estadiamento da pancreatite aguda

• Autor(a) principal: Freire Filho, Edison de Oliveira [UNIFESP]
• Data de Publicação: 2007
• Outros Autores: Shigueoka, David Carlos [UNIFESP], Bekhor, Daniel [UNIFESP], Vieira, Renata La Rocca [UNIFESP], Yamada, André Fukunishi [UNIFESP], Freire, Maxime Figueiredo de Oliveira [UNIFESP], Ajzen, Sergio Aron [UNIFESP], D'Ippolito, Giuseppe [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-39842007000600006; http://repositorio.unifesp.br/handle/11600/4023
• topic: Pancreatitis; X-ray computed tomography; Disease severity index; Prognosis; Contrast media; Necrosis; Pancreatite; Tomografia computadorizada por raios-x; Índice de gravidade de doença; Prognóstico; Meios de contraste; Necrose

OBJECTIVE: To evaluate the reproducibility of unenhanced and contrast-enhanced computed tomography in the assessment of patients with acute pancreatitis. MATERIALS AND METHODS: Fifty-one unenhanced and contrast-enhanced abdominal computed tomography studies of patients with acute pancreatitis were blindly reviewed by two radiologists (observers 1 and 2). The morphological index was separately calculated for unenhanced and contrast-enhanced computed tomography and the disease severity index was established. Intraobserver and interobserver reproducibility of computed tomography was measured by means of the kappa index (kappa). RESULTS: Interobserver agreement was kappa = 0.666, 0.705, 0.648, 0.547 and 0.631, respectively for unenhanced and contrast-enhanced morphological index, presence of pancreatic necrosis, pancreatic necrosis extension, and disease severity index. Intraobserver agreement (observers 1 and 2, respectively) was kappa = 0.796 and 0.732 for unenhanced morphological index; kappa = 0.725 and 0.802 for contrast-enhanced morphological index; kappa = 0.674 and 0.849 for presence of pancreatic necrosis; kappa = 0.606 and 0.770 for pancreatic necrosis extension; and kappa = 0.801 and 0.687 for disease severity index at computed tomography. CONCLUSION: Computed tomography for determination of morphological index and disease severity index in the staging of acute pancreatitis is a quite reproducible method. The absence of contrast-enhancement does not affect the computed tomography morphological index reproducibility.