• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-23082020-150547
Document
Author
Full name
Nayara Rossi Dias Rosa Assunção
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2020
Supervisor
Committee
Muglia, Valdair Francisco (President)
Macedo, Tulio Augusto Alves
Tucci Junior, Silvio
Title in Portuguese
Avaliação da predição da lateralidade no hiperaldosteronismo primário pela tomografia computadorizada
Keywords in Portuguese
Hiperaldosteronismo primário
Lateralidade
Tomografia computadorizada
Abstract in Portuguese
Introdução: Hiperaldosteronismo primário (HP) é um grupo de desordens em que a produção de aldosterona está inapropriadamente elevada, cursando com supressão de renina plasmática, hipocalemia e hipertensão arterial. O HP pode ser causado por um adenoma produtor de aldosterona ou hiperplasia idiopática bilateral, sendo estes os subtipos mais comuns. Após o diagnóstico clinicolaboratorial do HP, o paciente deverá realizar tomografia computadorizada (TC) e se necessário, cateterismo bilateral seletivo das veias adrenais (CSA) para classificar os subtipos. Objetivo: Avaliar a predição de lateralidade no hiperaldosteronismo primário, através dos resultados da tomografia computadorizada, bem como avaliar a concordância entre observadores com diferentes anos de experiência em diagnóstico por imagem. Materiais e Métodos: Estudo retrospectivo de pacientes com HP confirmados através de critérios clínicos e laboratoriais, que realizaram tomografia computadorizada anterior ao tratamento definitivo, entre os anos de 2007 e 2019. As imagens foram analisadas por dois médicos radiologistas, com concordância inter-observador para caracterização dos achados tomográficos, após utilização do teste de kappa de 0,77. Resultados: Do número total de pacientes avaliados 53, 15 (28,3%) foram excluídos da amostra por motivos que impediam confirmação da lateralidade, com 38 remanescentes (71,6%). Ao analisarmos a concordância entre a TC e a lateralização final, observamos que em 33/38 casos a TC foi concordante com a determinação da lateralização (86,6%), sendo 5 casos discordantes, (13,4%), já o cateterismo venoso, a concordância foi de 8 em 11 casos (72,7%) e 3 foram discordantes (27,3%).Conclusão: Os achados tomográficos das adrenais teve alto índice de concordância com a lateralidade final, demonstrada pela combinação dos padrões de referência, como cateterismo bilateral seletivo das veias adrenais, cirurgia e melhora clínica, afirmando sua importância na predição da lateralidade do hiperaldosteronismo primário.
Title in English
Evaluation of prediction of laterality in primary hyperaldosteronism by computed tomography
Keywords in English
Computed tomography
Laterality
Primary hyperaldosteronism
Abstract in English
Introduction: Primary hyperaldosteronism (PH) is a group of disorders in which the production of aldosterone is inappropriately elevated, leading to suppression of plasma renin, hypokalemia and arterial hypertension. PH can be caused by an aldosterone-producing adenoma or bilateral idiopathic hyperplasia, these being the most common subtypes. After clinical and laboratory diagnosis of PH, the patient must undergo computed tomography (CT) and, if necessary, bilateral selective adrenal vein catheterization (CSA) to classify the subtypes. Objective: To evaluate the prediction of laterality in primary hyperaldosteronism, through the results of computed tomography, as well as to assess the agreement between observers with different years of experience in diagnostic imaging. Materials and Methods: Retrospective study of patients with PH confirmed by clinical and laboratory criteria, who underwent computed tomography prior to definitive treatment, between the years 2007 and 2019. The images were analyzed by two radiologists, with inter-observer agreement for characterization of tomographic findings, after using the 0.77 kappa test. Results: Of the total number of patients evaluated 53, 15 (28.3%) were excluded from the sample for reasons that prevented confirmation of laterality, with 38 remaining (71,6%). When analyzing the agreement between the CT and the final lateralization, we observed that in 33/38 cases, the CT was in agreement with the determination of the lateralization (86.6%), with 5 discordant cases (13.4%), as well as the catheterization the agreement was 8 in 11 cases (72.7%) and 3 were discordant (27.3%). Conclusion: The tomographic findings of the adrenals had a high level of agreement with the final laterality, demonstrated by the combination of reference, such as bilateral selective adrenal vein catheterization, surgery and clinical improvement, affirming its importance in predicting the laterality of primary hyperaldosteronism.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2020-10-19
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2022. All rights reserved.