Title:	Fatty liver disease in severe obese patients: diagnostic value of abdominal ultrasound
Authors:	Almeida, Alessandro de Moura Cotrim, Helma Pinchemel Barbosa, Daniel Batista Valente Athayde, Luciana Gordilho Matteoni de Santos, Adimeia Souza Bitencourt, Almir Galvão Vieira Freitas, Luiz Antonio Rodrigues de Rios, Adriano Alves, Erivaldo
Affilliation:	Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil. Núcleo de Cirurgia da Obesidade. Salvador, BA, Brasil. Núcleo de Cirurgia da Obesidade. Salvador, BA, Brasil.
Abstract:	AIM: To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive series of obese patients, who underwent bariatric surgery from October 2004 to May 2005, was selected. Ultrasonography was performed in all patients as part of routine preoperative time and an intraoperative wedge biopsy was obtained at the beginning of the bariatric surgery. The US and histological findings of steatosis were compared, considering histology as the gold standard. RESULTS: The study included 105 patients. The mean age was 37.2+/-10.6 years and 75.2% were female. The histological prevalence of steatosis was 89.5%. The sensitivity and specificity of US in the diagnosis of hepatic steatosis were, respectively, 64.9% (95% CI: 54.9-74.3) and 90.9% (95% CI: 57.1-99.5). The positive predictive value and negative predictive value were, respectively, 98.4% (95% CI: 90.2-99.9) and 23.3% (95% CI: 12.3-39.0). The presence of steatosis on US was associated to advanced grades of steatosis on histology (P=0.016). CONCLUSION: Preoperative abdominal US in our series has not shown to be an accurate method for the diagnosis of hepatic steatosis in severe obese patients. Until another non-invasive method demonstrates better sensitivity and specificity values, histological evaluation may be recommended to these patients undergoing bariatric surgery.
Keywords:	Bariatric surgery Obesity Hepatic steatosis Abdominal ultrasound diagnosis Fatty liver
DeCS:	Fígado Gorduroso/complicações Fígado Gorduroso/ultrassonografia Obesidade Mórbida/complicações Obesidade Mórbida/complicações Adulto Cirurgia Bariátrica Biópsia Feminino Humanos Fígado/patologia Fígado/ultrassonografia Masculino Meia-Idade Obesidade Mórbida/cirurgia Reprodutibilidade dos Testes Prevalência Sensibilidade e Especificidade Índice de Gravidade de Doença
Issue Date:	2008
Publisher:	Baishideng Publishing Group Co. Limited
Citation:	ALMEIDA, Alessandro de Moura et al. Fatty liver disease in severe obese patients: diagnostic value of abdominal ultrasound. World Journal of Gastroenterology, v. 14, n. 9, p. 1415-1418, 2008.
DOI:	10.3748/wjg.14.1415
ISSN:	1007-9327
Copyright:	open access
Appears in Collections:	BA - IGM - Artigos de Periódicos

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