Portal Doppler ultrasound evaluation in myelitis by Schistosoma mansoni

Abstract

The mechanism for development of schistosomal myelitis has not yet been completely understood. Few publications have tried to establish a link between the general clinical presentation of the illness and its neurological manifestations. Objective: To evaluated the portal blood flow in patients with schistosomal myelitis and controls. Method: Fortythree individuals were evaluated using portal Doppler ultrasound. Group I consisted of 13 patients with the spinal form of schistosomiasis. Group II included 10 patients with intestinal and hepatointestinal forms of schistosomiasis, but no neurological symptoms; while group III involved 20 healthy controls. Results: Portal venous speed and portal venous flow were significantly elevated in group I (p<0.001) compared with the others. Conclusion: Doppler ultrasound demonstrated a situation of high flow within the portal venous system of patients with schistosomal myelitis. Key words: schistosomiasis mansoni, neuroschistosomiasis, myelitis, portal system. Avaliação pela ultrassonografia com Doppler portal na mielite pelo Schistosoma mansoni RESUMOA fisiopatogênese da mielopatia esquistossomótica não é completamente entendida, sendo escassas as publicações que tentam inferir a relação entre a forma clínica da esquistossomose e suas manifestações neurológicas. Objetivo: Avaliar o fluxo sanguíneo do sistema porta em pacientes com mielite esquistossomótica, contribuindo no entendimento dos mecanismos que favorecem a chegada dos parasitas e/ou seus derivados ao sistema nervoso. Método: Foram avaliados 43 indivíduos pela Dopplerfluxometria portal. O grupo I constou de 13 pacientes com esquistossomose medular, sendo o grupo II composto por 10 portadores de formas intestinal e hepatointestinal (sem doença neurológica), e o grupo III, por 20 controles sadios. Resultados: A velocidade venosa portal e o fluxo venoso portal foram significativamente elevados (p-valor<0,001) no grupo I. Conclusão: A Dopplerfluxometria demonstrou a presença de estados hiperdinâmicos do leito vascular porta em pacientes com mielite pelo Schistosoma mansoni. Palavras-chave: esquistossomose mansoni, neuroesquistossomose, mielite, sistema porta.

The role of ultrasound in the diagnosis of a rare case of chronic Shistosoma haematobium in the United Kingdom

“…29 Appropriate use vastly improves the correlation of ultrasound and cystoscopy results. 30,31 Despite this, no studies specifically consider the use of THI, CI or adaptive image processing (AIP) 32 in the investigation of schisto. haem.…”

“…30 On reflection, the high velocity scale setting (21 cm s −1 ) and the disproportionately large colour-box (Figure 2) used in this examination may have reduced the potential to detect any low-flow velocities. 31,35…”