Chronic hepatosplenic schistosomiasis mansoni: magnetic resonance imaging and magnetic resonance angiography findings

Bezerra, A. S. A.; D'Ippólito, Giuseppe; Caldana, Rogério Pedreschi; Cecin, Alexandre Oliveira; Ahmed, Muna; Szejnfeld, Jacob

doi:10.1080/02841850601105833

Cited by 31 publications

(38 citation statements)

References 29 publications

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“…MRI identified schistosomal fibrosis as hyperintense periportal bands on T2-weighted images and hypointense on T1-weighted images with enhancement after contrast, in accordance with previous reports and studies (Patel et al 1993, Willemsen et al 1995, Lambertucci et al 2002, Bezerra et al 2004, 2007, 2008.…”

Section: Discussionsupporting

confidence: 79%

“…MRI has been described in hepatosplenic schistosomiasis mansoni (Patel et al 1993, Willemsen et al 1995, Lambertucci et al 2002, Bezerra et al 2004, 2007, 2008, Silva et al 2006), but there is no standardisation of the method in the evaluation of liver periportal fibrosis. The aim of this paper was to analyse MRI using an adaptation of the WHO patterns for US assessment of schistosomiasisrelated morbidity.…”

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confidence: 99%

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Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Silva

Andrade

Queiroz

et al. 2010

Mem. Inst. Oswaldo Cruz

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For the last two decades, ultrasound (US) has been considered a surrogate for the gold standard in the evaluation of liver fibrosis in schistosomiasis. The use of magnetic resonance imaging (MRI) is not yet standardised for diagnosing and grading liver schistosomal fibrosis. The aim of this paper was to analyse MRI using an adaptation of World Health Organization (WHO) patterns for US assessment of schistosomiasis-related morbidity. US and MRI were independently performed in 60 patients (42.1 ± 13.4 years old), including 37 men and 23 women with schistosomiasis. Liver involvement appraised by US and MRI was classified according to the WHO protocol from patterns A-F. Agreement between image methods was evaluated by kappa index (k). The correlation between US and MRI was poor using WHO patterns [k = 0.14; confidence interval (CI) 0.02; 0.26]. Even after grouping image patterns as "A-D", "Dc-E" and "Ec-F", the correlation between US and MRI remained weak (k = 0.39; CI 0.21; 0.58). The magnetic resonance adaptation used in our study did not confirm US classification of WHO patterns for liver fibrosis

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Section: Discussionsupporting

confidence: 79%

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confidence: 99%

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Silva

Andrade

Queiroz

et al. 2010

Mem. Inst. Oswaldo Cruz

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“…It uses strong magnetic fi elds and non-ionizing radiation in the radio frequency range, in contrast to CT scans and traditional X-rays, which both use ionizing radiation. Contrast agents may be injected intravenously to enhance the appearance of blood vessels, tumors or infl ammation [36][37][38][39][40][41][42][43] . …”

Section: Magnetic Resonance Imaging In Hepatosplenic Schistosomiasismentioning

confidence: 99%

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Lambertucci

2014

Rev. Soc. Bras. Med. Trop.

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Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fi brosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fi brosis was made by abdominal palpation and the fi nding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US) has become the best imaging technique to evaluate liver fi brosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) fi ndings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count), biomarkers for liver fi brosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

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“…In schistosomiasis, MR alterations have already been described in case reports and in series of cases (Patel et al 1993, Willemsen et al 1995, Lambertucci et al 2002, 2004, Silva et al 2006, Bezerra et al 2007, Silva 2007. However, to our knowledge, no study has compared US and MR to liver histology in patients with hepatosplenic schistosomiasis.…”

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confidence: 99%

Imaging techniques and histology in the evaluation of liver fibrosis in hepatosplenic schistosomiasis mansoni in Brazil: a comparative study

Voieta

Queiroz

Andrade

et al. 2010

Mem. Inst. Oswaldo Cruz

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Few publications have compared ultrasound (US) to histology in diagnosing schistosomiasis-induced liver fibrosis (LF); none has used magnetic resonance (MR). The aim of this study was to evaluate schistosomal LF using these three methods. Fourteen patients with hepatosplenic schistosomiasis admitted to hospital for surgical treatment of variceal bleeding were investigated. They were submitted to upper digestive endoscopy, US, MR and wedge liver biopsy. The World Health Organization protocol for US in schistosomiasis was used. Hepatic fibrosis was classified as absent, slight, moderate or intense. Histology and MR confirmed Symmers' fibrosis in all cases. US failed to detect it in one patient. Moderate agreement was found comparing US to MR; poor agreement was found when US or MR were compared to histology. Re-classifying LF as only slight or intense created moderate agreement between imaging techniques and histology. Histomorphometry did not separate slight from intense LF. Two patients with advanced hepatosplenic schistosomiasis presented slight LF. Our data suggest that the presence of the characteristic periportal fibrosis, diagnosed by US, MR or histology, associated with a sign of portal hypertension, defines the severity of the disease. We conclude that imaging techniques are reliable to define the presence of LF but fail in grading its intensity

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Chronic hepatosplenic schistosomiasis mansoni: magnetic resonance imaging and magnetic resonance angiography findings

Abstract: Using MRI, hepatosplenic alterations in schistosomiasis are characterized by heterogeneity of hepatic parenchyma, presence of peripheral perihepatic vessels, periportal fibrosis, splenomegaly, siderotic nodules, and the presence of venous collateral pathways.

Cited by 31 publications

References 29 publications

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Imaging techniques and histology in the evaluation of liver fibrosis in hepatosplenic schistosomiasis mansoni in Brazil: a comparative study

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