Almeida AM, Cotrim HP, Barbosa DBV, Athayde LGM, Santos AS, Bitencourt AGV, Freitas LAR, Rios A, Alves E. Fatty liver disease in severe obese patients: Diagnostic value of abdominal ultrasound. World J Gastroenterol 2008; 14(9): 1415-1418 [PMID: 18322958 DOI: 10.3748/wjg.14.1415]
Corresponding Author of This Article
Helma Pinchemel Cotrim, PhD, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Avenida Tancredo Neves, Ed. Salvador Trade Center, Torre Norte-Sala 717, Salvador, Bahia 41830-020, Brazil. helmacotrim@terra.com.br
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Rapid Communication
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World J Gastroenterol. Mar 7, 2008; 14(9): 1415-1418 Published online Mar 7, 2008. doi: 10.3748/wjg.14.1415
Fatty liver disease in severe obese patients: Diagnostic value of abdominal ultrasound
Alessandro de Moura Almeida, Helma Pinchemel Cotrim, Daniel Batista Valente Barbosa, Luciana Gordilho Matteoni de Athayde, Adimeia Souza Santos, Almir Galvão Vieira Bitencourt, Luiz Antonio Rodrigues de Freitas, Adriano Rios, Erivaldo Alves
Alessandro de Moura Almeida, Helma Pinchemel Cotrim, Daniel Batista Valente Barbosa, Luciana Gordilho Matteoni de Athayde, Adimeia Souza Santos, Almir Galvão Vieira Bitencourt, Luiz Antonio Rodrigues de Freitas, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia 41830-020, Brasil
Luiz Antonio Rodrigues de Freitas, Centro de Pesquisa Gonçalo Muniz-Fundação Osvaldo Cruz, Salvador, Bahia 41830-020, Brasil
Adriano Rios, Erivaldo Alves, Núcleo de Cirurgia da Obesidade, Salvador, Bahia 41830-020, Brasil
Author contributions: Almeida AM and Cotrim HP designed research and wrote the paper; Almeida AM, Barbosa DBV, Athayde LGM, Santos AS and Bitencourt AGV performed research; Freitas LAR analyzed all histological samples; Rios A and Alves E performed the preoperative evaluation of patients and the surgeries.
Correspondence to: Helma Pinchemel Cotrim, PhD, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Avenida Tancredo Neves, Ed. Salvador Trade Center, Torre Norte-Sala 717, Salvador, Bahia 41830-020, Brazil. helmacotrim@terra.com.br
Telephone: +55-71-32762373
Fax: +55-71-32762373
Received: August 7, 2007 Revised: January 18, 2008 Published online: March 7, 2008
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.
