Elastografía en tiempo real (Supersonic), experiencia de un centro en Bogotá

Palabras clave: 2D-SWE, elastografía en tiempo real, Supersonic, fibrosis hepática, evaluación no invasiva de la fibrosis hepática

Resumen

Introducción: la elastografía en tiempo real, 2D-SWE (Supersonic), es una prueba no invasiva que se utiliza para determinar la elasticidad del hígado y, de esa forma, calcular el grado de fibrosis hepática. En Colombia, la prueba se introdujo en 2016 y no existen hasta el momento estudios del comportamiento de la prueba en todos los pacientes hepáticos, solo se han publicado en pacientes sanos y cirróticos.

Objetivo: analizar la experiencia de la aplicación de la elastografía en tiempo real, en sujetos atendidos en el centro de enfermedades hepáticas y digestivas de Bogotá, Colombia.

Materiales y métodos: estudio descriptivo retrospectivo de una cohorte de sujetos atendidos entre marzo de 2016 y julio de 2017. Se realizó una historia clínica completa y una prueba de elastografía en tiempo real (Supersonic).

Resultados: se incluyeron 654 sujetos, con una mediana de edad de 55 años (rango intercuartílico [RIC]: 45-64). La mediana de valores de fibrosis expresada en kilopascales (kPs) fue de 8,3, con un promedio de 5 mediciones. Se observó una diferencia significativa en el grado de fibrosis entre los grupos de edad y en relación con el diagnóstico final, donde se evidenció una mayor fibrosis en el grupo de enfermedades colestásicas (autoinmune, colangitis biliar primaria [CBP] y superposición autoinmune-CBP). La tasa global de fracaso fue menor al 1 %.

Conclusiones: es la primera descripción del comportamiento de la prueba a nivel nacional. Los valores de rigidez hepática observados en los diferentes estadios demuestran la utilidad de la prueba para la determinación de la fibrosis hepática en pacientes con diferentes patologías.

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Biografía del autor/a

Jhon Edison Prieto Ortiz, Centro de Enfermedades Hepáticas y Digestivas (CEHYD)

Médico Internista-Gastroenterólogo Hepatólogo, Bogotá, Colombia

Nathaly Garzón-Orjuela, Universidad Nacional de Colombia

MD, MSc en Epidemiología Clínica. Investigadora asociada al grupo equidad en salud. Bogotá, Colombia.

Santiago Sánchez Pardo, Clínica Infantil Santa Maria del Lago

Médico Internista

Robin Germán Prieto Ortíz, Centro de Enfermedades Hepáticas y Digestivas CEHYD SAS

Especialista en Cirugía General, especialista en gastroenterología y endoscopia digestiva. Bogotá, Colombia

Andrés Felipe Ochoa Díaz, Universidad Industrial de Santander

Médico y cirujano, Estudiante posgrado Medicina Interna. Bucaramanga, Colombia

Pedro Hernán Soto-Ospina, Clínica del Country

Médico radiólogo, Bogotá, Colombia

Javier Eslava-Schmalbach, Universidad Nacional de Colombia

MD, MSc, PhD en Salud Pública, Vicedecano de investigación y extensión de la facultad de medicina. Bogotá, Colombia

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Figura 1. Estadios de fibrosis obtenidos con el Supersonic
Publicado
2021-03-08
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Prieto Ortiz, J. E., Garzón-Orjuela, N., Sánchez Pardo, S., Prieto Ortíz, R. G., Ochoa Díaz, A. F., Soto-Ospina, P. H., & Eslava-Schmalbach, J. H. (2021). Elastografía en tiempo real (Supersonic), experiencia de un centro en Bogotá. Revista Colombiana De Gastroenterología, 36(1), 58-64. https://doi.org/10.22516/25007440.594
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