Correlation between clinical evaluation of liver size versus ultrasonography evaluation according to body mass index (BMI) and biotypes.

BACKGROUND: Body weight may influence liver size. AIM: To determine the correlation between clinical and ultrasound evaluation of the liver size according to body mass index (BMI). MATERIAL AND METHODS: A cross-sectional study of 81 subjects aged 25 ± 6 years (43 females). Two percussion measurements were taken and ultrasonography was performed on the same site demarcated by percussion. RESULTS: Mean BMI was 23 ± 4 kg/m². Nineteen individuals (23.5%) had a BMI ≥ 25 kg/m². There was a significant difference between the values of liver size obtained by clinical and ultrasound methods. The correlation coefficient between the liver size obtained by clinical and ultrasound methods was 0.419 (p < 0.01). No significant differences in liver size were observed, between subjects with a BMI below or over 25 kg/m². In all subjects, regardless of BMI, there was a statistically significant difference between the mean sizes obtained by both methods. The correlation coefficients between both methods in subjects with a BMI ≤ 25 Kg/m² and their counterparts with higher BMI were 0.47 and 0.03, respectively. CONCLUSIONS: There are significant differences in liver size obtained by clinical examination and ultrasound. Only in subjects with BMI ≤ 25 kg/m², the correlation between the two techniques is significant.

Hepatimetria: correlação entre o método clínico e ultra-sonográfico / Liver size: correlation between clinical method and ultrasonography

Introdução: O método clínico é amplamente utilizado para avaliação da hepatimetria, utilizando-se a associaçãodas técnicas de percussão e palpação. Alterações encontradas no exame físico determinam investigações posteriores com exames complementares. Objetivo: Avaliar a correlação da hepatimetria obtida pela semiotécnica de percussão e palpação, com a hepatimetria obtida através da ultra-sonografia. Métodos: Foi realizado um estudo transversal, onde a amostra foi formada por quarenta acadêmicos do Curso de Medicina da Unisul – Tubarão - SC. Os participantes foram submetidos ao exame clínico e ultra-sonográficoabdominal. Resultados: Dos 40 participantes, 20 de cada gênero,a idade média foi de 22,98 (± 2,75) anos. A média final da hepatimetria clínica foi de 9,14 (± 1,99) cm. A diferença das medidas entre os examinadores não foi estatisticamente significativa (p=0,28). A média dahepatimetria obtida através do ultra-som foi de 10,33 (± 2,89) cm. Não foram estatisticamente significativas asdiferenças da hepatimetria entre os gêneros (p=0,11) e entre os biótipos (p=0,082). Para os indivíduos com pesoabaixo de 70Kg o coeficiente de correlação de Pearson foi de 0,75 (IC 95%: 0,23 a 0,78). Para os indivíduoscom peso superior a 70 Kg o coeficiente de correlação de Pearson foi de 0,45 (IC 95%: -0,27 a 0,66). Conclusão: A hepatimetria obtida pelo método clínicoapresenta boa correlação com o método ultrasonográfico, embora subestime o tamanho real do fígado em adultos jovens. A influência das habilidades doexaminador mostram-se nítidas, assim como as características dos pacientes.

Introduction: The clinical method widely is used for evaluation of the liver size.Objectives: To evaluate the correlation of the liver size gotten for the technique semiologic of percussion and palpation, with the liver size obtained byultrasonography. Methods: A transversal study was carried through between-observator, sample was formed by fortyacademics of the Course of Medicine of the Unisul – Tubarão - SC. The participants had been submitted tothe clinical examination and the abdominal ultrasonography. Results: 20 participants had been of each gender,average age were of 22,98 (± 2,75) years. The final average of the clinical liver size was of 9,14 (± 1,99) cm.The difference of the measures between the examiners was not statistically significant (p=0,28). The average ofthe liver size obtained by trasonography was of 10,33 (± 2,89) cm had not been statistically significant the differences of the liver size between genders (p=0,11) and the biotypes (p=0,082). For people which weightbelow of 70Kg we find the following correlation: r = 0,75 (IC 95%: 0,23 0,78). For people which weight above70 kg we find the following correlation r = 0,45 (IC 95%: -0,27 0,66).Conclusion: The liver size obtained by the clinical method presents good correlation with the ultrasonography method, even so underestimate the realsize of the liver in young adults. The influence of the abilities of the examiner reveals clear, as well as thecharacteristics of the patients.