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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-05082019-131934
Document
Author
Full name
Pedro Henrique Tarter Nunes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Júnior, Jorge Elias (President)
Macedo, Tulio Augusto Alves
Muglia, Valdair Francisco
Santos, José Sebastião dos
Title in Portuguese
Ressonância magnética na avaliação da gravidade e prognóstico da colangite aguda
Keywords in Portuguese
Avaliação de gravidade
Colangite aguda
Imagem por Ressonância Magnética
Abstract in Portuguese
A colangite aguda (CA) é uma emergência médica comum, relacionada a inflamação aguda e infecção da via biliar. Geralmente decorre da obstrução mecânica da via biliar requerendo um diagnóstico precoce e tratamento imediato. Embora exista a percepção de que certas alterações ao exame de imagem estejam relacionadas a pior prognóstico, a avaliação da gravidade na colangite bacteriana aguda é baseada em dados clínico-laboratoriais e em disfunção de órgãos alvo. Este estudo procurou identificar os achados de imagem e complicações da colangite aguda através da ressonância magnética e verificar quais características correlacionam-se à morbi-mortalidade da doença. Foram revisados os dados de 226 pacientes com suspeita de colangite aguda dos quais 68 preencheram os critérios de inclusão: presença de bile purulenta na colangiopancreatografia retrógrada e critérios de Tokyo. A principal causa de colangite aguda confirmada foi a presença de estenose biliar e este foi também o achado de imagem que esteve relacionado ao desfecho desfavorável de óbito. Verificou-se ainda que vários achados estiveram individualmente relacionados a alterações clínicas e laboratoriais como idade, hipoalbuminemia, hiperbilirrubinemia e oligúria. A ressonância magnética desempenha papel no diagnóstico etiológico da colangite aguda e pode ter contribuição adicional na avaliação da gravidade da doença nos casos que apresentam estenose da via biliar. No entanto, de maneira geral, os achados na ressonância magnética não substituem a avaliação de gravidade e prognóstico obtidas através dos critérios clínico-laboratoriais
Title in English
Acute cholangitis severity and prognosis assessment by magnetic resonance imaging
Keywords in English
Acute cholangitis
Magnetic Resonance Imaging
Severity assessment
Abstract in English
Acute cholangitis (AC) is a common medical emergency, related to acute inflammation and infection of the biliary tree. It usually results from mechanical obstruction of the biliary tract requiring early diagnosis and immediate treatment. Although there is a perception that certain imaging abnormalities are related to poor prognosis, the assessment of severity of acute bacterial cholangitis is based on clinical-laboratory data and organ dysfunction. This study aimed to identify the imaging findings and complications of acute cholangitis through magnetic resonance imaging and to verify which features correlate with the morbidity and mortality of the disease. Data from 226 patients with suspected acute cholangitis were reviewed, of which 68 met the inclusion criteria: presence of purulent bile during retrograde cholangiopancreatography and Tokyo criteria. The main cause of confirmed acute cholangitis was the presence of bile stenosis and this was also the image finding that was related to the unfavorable outcome of death. It was also found that several findings were individually related to altered clinical and laboratory tests such as age, hypoalbuminemia, hyperbilirubinemia and oliguria. Magnetic resonance imaging plays a role in the diagnosis of acute cholangitis and may have an additional contribution in assessing the severity in cases of biliary stenosis. However, in general, the MRI findings do not replace the assessment of severity and prognosis obtained through clinical-laboratory criteria
 
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Publishing Date
2020-01-15
 
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