Volume de fluxo sanguíneo na artéria mesentérica superior aferido pela ultrassonografia com doppler em crianças e adolescentes

Abstract

OBJECTIVE To measure superior mesenteric artery blood flow (SMABF) in healthy children and adolescents in age groups of greater Crohn's disease (CD) incidence. To assess the interobserver variability. MATERIAL AND METHODS The superior mesenteric artery blood flow was prospectively measured using pulsed Doppler ultrasound in 60 volunteers without any chronic diseases. Participants were divided into two groups: children (5-9 years) and adolescents (10-17 years). All were classified according to weight and blood pressure. Each volunteer was examined by two experienced radiologists. Each examiner made three measurements to decrease the chance of random errors. The Student t test was used to evaluate the difference between examiners, and Bland-Altman plots, to evaluate agreement. SMABF was compared with anthropometric data and hemodynamic parameters, and their correlation was determined using the Spearman coefficient. Multiple linear regression was used to control for confounding factors and to evaluate factors independently associated with SMABF. The difference between groups was significant at p<0. 05.RESULTS The average age of participants was 12. 2 years; 21 (35%) were in the 5-9 group, and 10 (65%), in the 10-17 group. SMABF was significantly lower in the group of children (mean=556 ml/min; SD=122 ml/min) than among adolescents (mean=775 ml/min; SD=311 ml/min) (p<0. 001). Participants with normal weight had a lower SMABF value than obese individuals. No significant differences were found between overweight and obese patients or patients with normal weight. Waist circumference and systolic blood pressure also were significantly associated with the SMABF. However, after multivariate analysis, only the body surface was significantly associated with SMABF, and the greater the body surface, the greater the SMABF. CONCLUSIONS: The SMABF is directly associated with the body surface. Studies are needed with CD activity and remission, considering the SMABF according to body surface in normal subjects for this parameter can be used as a marker of activity. Pulsed Doppler ultrasound was a feasible and accurate method for the pediatric population.

Objetivo: Avaliar o volume de fluxo na artéria mesentérica superior (VFAMS) através da ultrassonografia com Doppler pulsátil em crianças e adolescentes sadios na faixa etária de maior incidência de doença de Crohn. Avaliar a concordância interobservador do método. Materiais e métodos: O estudo foi aprovado pelo comitê de ética médica e foi colhido o termo de consentimento informado. Estudou-se prospectivamente o volume de fluxo da artéria mesentérica superior em 60 voluntários sadios, dividido em 2 grupos de acordo com a faixa etária: crianças (5-9 anos) e adolescentes (10-17 anos). Todos foram classificados segundo o estado nutricional e pressórico. Todos os voluntários foram examinados por 2 radiologistas independentes com longa experiência e foram realizadas três medidas. Resultados: Os 60 indivíduos tinham idade média de 12,2 anos, sendo 21 entre 5 e 9 anos (35%) e 39 entre 10 e 17 anos (65%). O VAMS foi significativamente menor nas crianças (média=556 ml/min; DP=122ml/min) do que nos adolescentes (média=775ml/min, DP=311 ml/min), com p<0,001. Os eutróficos também apresentaram o VFAMS menor do que os obesos. Os indivíduos com sobrepeso não apresentaram diferença significativa, tanto em relação aos eutróficos quanto aos obesos. Apenas a superfície corporal ficou associada significativamente com o VFAMS. Dessa forma, quanto maior a superfície corporal, maior será o VFAMS. Conclusões: O VFAMS determinado pela US com Doppler a cores é diretamente proporcional à superfície corporal.