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Quantificação da esteatose hepática através de imagens de ecografia e ressonância magnética - estudo comparativo
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Abstract(s)
Introdução: A esteatose hepática é uma condição frequente, caracterizada pela acumulação anormal de gordura nos hepatócitos, associando-se frequentemente a fatores metabólicos como obesidade, dislipidemia e estilo de vida sedentário. O estadio mais grave, a esteatose hepática não alcoólica, pode ter progressão para cirrose e carcinoma hepatocelular. Devido à elevada prevalência e à natureza silenciosa numa fase inicial, torna-se essencial recorrer a métodos de diagnóstico imagiológico fiáveis, não invasivos e reprodutíveis.
Objetivo: O estudo teve como principal objetivo comparar a eficácia da Ecografia e da Ressonância Magnética (RM) na quantificação da esteatose hepática. Foi avaliado o grau de concordância entre ambas as técnicas e a sua relação com parâmetros clínicos, particularmente o Índice de Massa Corporal (IMC) e os valores de colesterol total e triglicerídeos.
Metodologia: Realizou-se um estudo prospetivo, com uma amostra de 33 indivíduos, escolhidos na unidade de imagiologia de uma clínica na cidade de Coimbra. Os indivíduos da amostra foram sujeitos a uma ecografia hepática e RM abdominal no mesmo dia para a quantificação da gordura hepática. Os dados obtidos foram analisados estatisticamente com recurso ao software SPSS (v.29), aplicando métodos descritivos e correlacionais.
Resultados: A uma parte dos participantes apresentou um IMC com valores que excedem o valor normal (11 excesso de peso e 4 obesidade), principalmente no sexo masculino. Observou-se uma correlação positiva entre os valores de IMC e os níveis de esteatose hepática detetados por ambas as técnicas. A RM apresentou maior sensibilidade e consistência na deteção e quantificação da gordura hepática, enquanto a ecografia, apesar de mais acessível e prática, demonstrou limitações na deteção de esteatose ligeira, especialmente em indivíduos com maior perímetro abdominal e gordura visceral. Os níveis de triglicerídeos associaram-se de forma significativa à presença de esteatose hepática, sobretudo no sexo masculino.
Conclusão: A RM confirmou-se como o método mais preciso e reprodutível para a quantificação não invasiva da gordura hepática, sendo útil em contextos clínicos e na investigação. A ecografia, embora limitada na sensibilidade em casos ligeiros, mostrou-se eficaz na avaliação inicial e no acompanhamento de casos moderados a graves, principalmente quando associada a técnicas quantitativas. Assim, a utilização complementar das duas modalidades de imagem, adaptada à realidade clínica, pode alcançar um diagnóstico precoce e evolução da esteatose, ajudando num melhor controlo da doença hepática.
Introduction: Hepatic steatosis is a common condition characterized by the abnormal accumulation of fat in hepatocytes and is often associated with metabolic factors such as obesity, dyslipidemia and a sedentary lifestyle. The most severe stage non-alcoholic hepatic disease can progress to cirrhosis and hepatocellular carcinoma. Due to its high prevalence and silent nature in the early stages, it is essential to use reliable, non-invasive and reproducible imaging diagnostic methods. Objective: The main objective of this study was to compare the effectiveness of ultrasound and magnetic resonance imaging (MRI) in quantifying hepatic steatosis. The degree of agreement between the two techniques and their relationship with clinical parameters, particularly Body Mass Index (BMI) and total cholesterol and triglyceride values were assessed. Methodology: A prospective study was carried out with a sample of 33 individuals chosen from the imaging unit of a clinic in the city of Coimbra. The subjects underwent hepatic ultrasound and abdominal MRI examinations on the same day to quantify liver fat. The data obtained was statistically analyzed using SPSS software (v.29), applying descriptive and correlational methods. Results: Some of the participants had a BMI that exceeded the normal range (11 overweight and 4 obese), mainly males. There was a positive correlation between BMI values and the levels of hepatic steatosis detected by both techniques. MRI showed greater sensitivity and consistency in detecting and quantifying liver fat, while ultrasound, although more accessible and practical, showed limitations in detecting mild steatosis, especially in individuals with greater abdominal fat. Triglyceride levels were significantly associated with the presence of hepatic steatosis especially in males. Conclusion: Magnetic resonance imaging has been confirmed as the most accurate and reproducible method for non-invasive quantification of liver fat and is useful in clinical and research contexts. Ultrasound, although limited in sensitivity in mild cases, proved to be effective in the initial assessment and follow-up of moderate to severe cases, especially when combined with quantitative techniques. Thus, the complementary use of the two imaging modalities, adapted to the clinical reality, can achieve early diagnosis and management of hepatic steatosis, helping with better control of liver disease.
Introduction: Hepatic steatosis is a common condition characterized by the abnormal accumulation of fat in hepatocytes and is often associated with metabolic factors such as obesity, dyslipidemia and a sedentary lifestyle. The most severe stage non-alcoholic hepatic disease can progress to cirrhosis and hepatocellular carcinoma. Due to its high prevalence and silent nature in the early stages, it is essential to use reliable, non-invasive and reproducible imaging diagnostic methods. Objective: The main objective of this study was to compare the effectiveness of ultrasound and magnetic resonance imaging (MRI) in quantifying hepatic steatosis. The degree of agreement between the two techniques and their relationship with clinical parameters, particularly Body Mass Index (BMI) and total cholesterol and triglyceride values were assessed. Methodology: A prospective study was carried out with a sample of 33 individuals chosen from the imaging unit of a clinic in the city of Coimbra. The subjects underwent hepatic ultrasound and abdominal MRI examinations on the same day to quantify liver fat. The data obtained was statistically analyzed using SPSS software (v.29), applying descriptive and correlational methods. Results: Some of the participants had a BMI that exceeded the normal range (11 overweight and 4 obese), mainly males. There was a positive correlation between BMI values and the levels of hepatic steatosis detected by both techniques. MRI showed greater sensitivity and consistency in detecting and quantifying liver fat, while ultrasound, although more accessible and practical, showed limitations in detecting mild steatosis, especially in individuals with greater abdominal fat. Triglyceride levels were significantly associated with the presence of hepatic steatosis especially in males. Conclusion: Magnetic resonance imaging has been confirmed as the most accurate and reproducible method for non-invasive quantification of liver fat and is useful in clinical and research contexts. Ultrasound, although limited in sensitivity in mild cases, proved to be effective in the initial assessment and follow-up of moderate to severe cases, especially when combined with quantitative techniques. Thus, the complementary use of the two imaging modalities, adapted to the clinical reality, can achieve early diagnosis and management of hepatic steatosis, helping with better control of liver disease.
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Keywords
Esteatose Hepática Ecografia Ressonância Magnética e Quantificação Hepática Hepatic Steatosis Ultrasound Magnetic Resonance Imaging and Hepatic Quantification