Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

Abstract

BackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18–92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/significancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

Anatomical MRI and [18F]FDG PET/CT imaging of Schistosoma mansoni in a NMRI mouse model

“…Direct detection methods like Kato-Katz or Telemann stool microscopy or indirect detection of anti-bodies against schistosome antigens in the blood serum 29 are not suitable for drawing conclusions about parasite associated organ damage. In human infection there is no gold standard for the evaluation of portal fibrosis 30 . Wedge or percutaneous liver biopsies are invasive methods that are unsuitable for long-term or follow-up assessment.…”

Comparison of hepatic and splenic stiffness in chronic hepatitis C infection with and without schistosomal infection; correlation with hepatic histopathological changes

“…Furthermore, a cross-sectional study comprising 358 patients with schistosomiasis was conducted by Carvalho et al . [ 14 ] using point shear-wave elastography (pSWE). Patients were classified into two groups: 86 patients with mild PPT and 272 patients with significant PPT.…”

Parasites of the liver – epidemiology, diagnosis and clinical management in the European context

“…123,124 The role of elastosonography in HSS is still a matter of debate. 125 Liver biopsy is not recommended.…”