Nisan 2021
Karaciger fonksiyon testleri bozuklugu göstergesi olarak manyetik rezonans kolanjiyopankreatografide minimal perihepatik sivi varligi
Presence of minimal perihepatic fluid in magnetic resonance cholangiopancreatography as a marker of liver function test impairment
- Ana Sayfa
- Sayılar
- Nisan 2021
- Karaciger fonksiyon testleri bozuklugu göstergesi olarak manyetik rezonans kolanjiyopankreatografide minimal perihepatik sivi varligi...
Medipol Üniversitesi Esenler Saglik Uygulama ve Arastirma Merkezi, 2Fiziksel Tip ve Rehabilitasyon Bölümü, Istanbul
Özet
<span class=fontstyle0>Giris ve Amaç: </span><span class=fontstyle2>Karaciger ve karaciger disi patolojilere bagli görüntülemede perihepatik alanda sivi görülebilmektedir. Belirli bir patolojiye<br>spesifik olmayan bu durum degisik mekanizmalar ile olusabilmektedir. Bu çalismanin amaci manyetik rezonans kolanjiyopankreatografide minimal perihepatik sivi varligi ile karaciger fonksiyon testleri ve manyetik rezonans kolanjiyopankreatografide ortaya koyulabilecek etiyolojik faktörlerden olan biliyer obstrüksiyon ile arasindaki iliskiyi arastirmaktir. </span><span class=fontstyle0>Gereç ve Yöntem: </span><span class=fontstyle2>Hastanemiz Radyoloji bölümünde 2017 yilinda manyetik rezonans kolanjiyopankreatografi yapilan hastalar retrospektif olarak tarandi. Minimal perihepatik sivisi olan 62 hasta çalisma grubuna, perihepatik sivisi olmayan ve rastgele seçilen 62 hasta kontrol grubuna dahil edildi. Hasta ve kontrol grubuna ait karaciger fonksiyon testleri (aspartat aminotransferaz, alanin aminotransferaz, alkalen fosfataz, gama-glutamil transpeptidaz, laktat dehidrogenaz, total/direkt/indirekt bilirübin) karsilastirildi. Perihepatik sivi kalinligi, dagilim paterni, karaciger loblarina göre lokalizasyonu, intrahepatik safra kanallarinda genisleme varligi ve derecesi, koledok tasi, periportal ödem, perisplenik sivi varligi kaydedildi ve perihepatik sivi ile arasindaki iliski degerlendirildi. </span><span class=fontstyle0>Bulgular: </span><span class=fontstyle2>Perihepatik sivisi olan hasta grubunda laktat dehidrogenaz disinda tüm laboratuvar degerleri kontrol grubuna göre anlamli olarak yüksekti (p = 0.131 ve p ? 0.011, sirasiyla) ve perihepatik sivisi olan grupta kontrol grubuna göre daha fazla hastada laboratuvar degerlerinde yükseklik saptandi (p ? 0.037). Intrahepatik safra kanallarinda genisleme ve perisplenik sivi varligi açisindan iki grup arasindaki fark istatistiksel olarak anlamli idi (p = 0.01 ve p < 0.001, sirasiyla). Alkalen fosfataz degerleri ile intrahepatik safra kanallari genisleme derecesi korelasyon göstermekteydi (r = 0.349, p = 0.05). </span><span class=fontstyle0>Sonuç: </span><span class=fontstyle2>Manyetik rezonans kolanjiyopankreatografide karaciger çevresinde minimal düzeyde sivi varligi karaciger fonksiyon testlerinde bozukluga isaret edebilir ve kolestaza neden olabilecek patolojiler açisindan uyarici olmalidir</span>.<br style= font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; >
Abstract
Background and Aims: Perihepatic fluid caused by liver and non-liver pathologies can be observed through imaging. This condition is not specific to a particular pathology and can occur with different mechanisms. This study aimed to investigate the relationship between the presence of minimal perihepatic fluid in magnetic resonance cholangiopancreatography and liver function tests and biliary obstruction, which is oneof the etiological factors that can be detected through magnetic resonance cholangiopancreatography. Materials and Methods: Patients who underwent magnetic resonance cholangiopancreatography in the department of radiology in our hospital in 2017 were retrospectively screened. Sixty-two patients with minimal peripheral fluid were included in the study group, and randomly selected 62 patients without perihepatic fluid were included in the control group. Liver function tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, lactate dehydrogenase, total/direct/indirect bilirubin) of the patient and control groups were compared. Perihepatic fluid thickness, distribution pattern, localization according to liver lobes, presence and degree of intrahepatic bile duct dilatation, and presence of choledocholitiasis, periportal edema, perisplenic fluid were recorded, and the relationship with perihepatic fluid was evaluated. Results: All laboratory values except lactate dehydrogenase were significantly higher in the patient group than in the control group (p = 0.131 and p ? 0.011, respectively). The number of patients with higher laboratory values was higher in the patient group than in the control group (p ? 0.037). The difference between the two groups as regards intrahepatic bile duct dilatation and presence of perisplenic fluid was significant (p = 0.01 and p < 0.001, respectively). Alkaline phosphatase values correlated with the degree of intrahepatic bile duct dilatation (r = 0.349, p = 0.05). Conclusions: The presence of minimal fluid around the liver detected by magnetic resonance cholangiopancreatography may indicate impairment in liver function tests and should alert clinicians of pathologies that can cause cholestasis.
