Maria José Noruegas

Publications (2)3.35 Total impact

• Article: Effectiveness and safety of ultrasound-guided percutaneous liver biopsy in children.

  Hugo Matos, Maria José Noruegas, Isabel Gonçalves, Conceição Sanches
  [show abstract] [hide abstract]
  ABSTRACT: Percutaneous liver biopsy (PLB) is an important procedure in the diagnosis and follow-up of paediatric liver disease. Its purpose is to obtain tissue for histopathological observation, in our case, with ultrasound (US) guidance. To evaluate the effectiveness and safety of US-guided PLB in children. A retrospective study over a period of 12 years, from January 1999 until December 2010, with a selection of US-guided PLB performed in children with focal liver lesions or diffuse hepatic disease and liver transplant (LT). A 16-gauge automatic needle was used and a maximum of three fragments of liver were collected. Contraindications were: bile duct dilatation (>3 mm) INR > 1.5 (reference range, 0.9 -- 1.2) and platelet count <50,000 (reference range, 150,000 -- 450,000). Analysis focused on complications and final diagnosis. A total of 513 biopsies were performed, 379 (73.9%) in children who had undergone orthotopic LT, 117 (22.8%) in children with liver disease of unknown cause and 17 (3.3%) in children with focal hepatic lesions. Histological diagnosis was obtained in 509 of 513 (99.3%) biopsies performed. Minor complications were registered in 38 patients (7.4%) and major complications occurred in 5 patients (1%). None needed a surgical intervention. US-guided PLB in children is a safe and efficient method to achieve a specific diagnosis in liver disease.
  Pediatric Radiology 08/2012; 42(11):1322-5. · 1.67 Impact Factor
• Article: Acoustic radiation force impulse-imaging in the assessment of liver fibrosis in children.

  Maria José Noruegas, Hugo Matos, Isabel Gonçalves, Maria Augusta Cipriano, Conceição Sanches
  [show abstract] [hide abstract]
  ABSTRACT: Acoustic radiation force impulse-imaging (ARFI) uses sound waves to interrogate the mechanical stiffness of a tissue. To determine the usefulness of ARFI for estimating liver fibrosis in children. A prospective masked study of children with chronic liver disease (CLD) and/or before liver transplant (LT) comparing ARFI with histopathological analysis. Children with no history of liver disease served as a control group. ARFI was performed with Virtual Touch software using ACUSON S2000. Share wave velocities (SWV) of several regions within the liver were measured. Fifty-two children were studied (mean age 8 years; range 1-16 years). The abnormal group included 10 children (31%) with CLD and 22 (69%) planned for LT. There were 20 normal controls. Mean SWV was 1.42 m/s in the abnormal group and 1.11 m/s [corrected] in the controls. For diagnosis of fibrosis stage ≥ F1, ≥F2 and F4, the areas under the receiver-operator characteristics curves were 0.834, 0.818 and 0.983, respectively. SWV is related to the degree of liver fibrosis in children, and may be a non-invasive alternative to biopsy.
  Pediatric Radiology 02/2012; 42(2):201-4. · 1.67 Impact Factor