Transient elastography evaluation of hepatic and spleen stiffness in patients with hepatosplenic schistosomiasis

Veiga, Zulane; Villela-Nogueira, Cristiane Alves; Fernandes, Flávia; Cavalcanti, Marta Guimarães; Figueiredo, Fábio P.; Pereira, João Luiz; Coelho, Henrique Sérgio Moraes; Peralta, José Mauro; Marques, Carlos E.; Perez, Renata M.; Fogaça, Homero Soares

doi:10.1097/meg.0000000000000853

Cited by 25 publications

(32 citation statements)

References 20 publications

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“…A study conducted by Veiga et al . [ 19 ] using transient elastography compared hepatosplenic schistosomiasis and HCV-cirrhotic patients; spleen stiffness values were comparable between schistosomiasis and cirrhotics. These discrepancies may be a result of different sample sizes, racial differences, and differing imaging principles among TE and ARFI technologies.…”

Section: Discussionmentioning

confidence: 99%

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

Gohary

Elyamany

Abdalla

et al. 2020

ceh

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Section: Discussionmentioning

confidence: 99%

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

Gohary

Elyamany

Abdalla

et al. 2020

ceh

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“…US scan has become the most consolidated tool for evaluation of PPF in endemic areas because it shows practical usefulness, satisfactory interobserver agreement, and enables data comparison on international scale [6][7][8]21]. Despite the widespread use of US for diagnosing and monitoring changes caused by PPF, its use has some limitations, since it is a subjective method and requires physician expertise to apply the WHO Niamey-Belo Horizonte protocol.…”

Section: Discussionmentioning

confidence: 99%

“…This method was chosen since it is more easily applied than Niamey US protocol, and, could enhance the diagnosis of those patients with advanced PPF, who need greater care and supervision. Moreover, it would provide a foundation for further studies to assess the presence and severity of portal hypertension and prediction of esophageal varices using pSWE and TE [21,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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

Santos

Batista

Vasconcelos

et al. 2018

Preprint

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Background: ARFI 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 findings:This 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/Significance: pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF. Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

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“…The common adverse complications of portal hypertension include esophageal and gastric variceal bleeding, hepatic encephalopathy, hepatorenal syndrome and others; these are the main indications of surgery for treating portal hypertension[ 39 ]. Among these complications, esophageal and gastric variceal bleeding were the most dangerous[ 40 , 41 ]. When this occurs, patients will be at risk due to acute upper gastrointestinal bleeding[ 42 - 44 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension

Zhang¹,

Mao²,

Zhang³

et al. 2017

WJG

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AIMTo explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension, and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.METHODSAll 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore, 67 patients were followed-up at 20 mo after treatment, and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1st week, 3rd month and 9th month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group, while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile, in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension, Cox’s proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic (ROC) curves.RESULTSThe liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline, while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore, liver and spleen shear wave velocity was higher in the unfavorable prognosis group, compared with the favorable prognosis group; the differences were statistically significant (P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3rd month after treatment [relative risk (RR) = 3.481]. At the 9th month after treatment, the prognosis was affected by liver hardness (RR = 5.241) and spleen hardness (RR = 7.829). The differences between these two groups were statistically significant (P < 0.05). The ROC analysis revealed that the area under the curve (AUC) of spleen hardness at the 3rd month after treatment was 0.644, while the AUCs of liver and spleen hardness at the 9th month were 0.579 and 0.776, respectively. These might predict the prognosis of patients with portal hypertension.CONCLUSIONSpleen hardness at the 3rd month and liver and spleen shear wave velocity at the 9th month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.

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Transient elastography evaluation of hepatic and spleen stiffness in patients with hepatosplenic schistosomiasis

Abstract: Liver stiffness may be a useful tool to differentiate portal hypertension related to cirrhosis from that of HES. High spleen stiffness is a potential surrogate marker of portal hypertension in this population.

Cited by 25 publications

References 20 publications

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

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

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

Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension

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