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Andrianah GEP, Rakotomena D, Rakotondrainibe A, Rajaonarison Ny Ony LHN, Ranoharison HD, Ratsimba HR, Rajaonera T, Ahmad A. Contribution of Ultrasonography in the Diagnosis of Periportal Fibrosis Caused by Schistosomiasis. J Med Ultrasound 2020; 28:41-43. [PMID: 32368449 PMCID: PMC7194419 DOI: 10.4103/jmu.jmu_16_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 05/22/2019] [Accepted: 08/02/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Periportal fibrosis is one of the major complications of schistosomiasis infection. Specific images of this infection revealed by ultrasonography allow the assessment of the different stages. Our purpose is to describe the ultrasonographic appearances of periportal fibrosis due to schistosomiasis infection. Methods: The study was retrospective descriptive in the Medical Imagery Centre of CHUJRA. Results: A total of 29 patients showed upper and/or lower digestive hemorrhage and a positive result in schistosomiasis serology. The median age was 41.2 years. Male gender dominated with 54.7%. In 78.3% of the cases, the patients were farmers in schistosomiasis-endemic areas. On ultrasonography, 81.3% were found to present Stage III periportal fibrosis, 11.5% presented Stage II, and 7.2% presented Stage I. There was no case of portal thrombosis. Splenomegaly was found in 83.2% of the cases and hepatomegaly in 48.9% of the cases. Porto-systemic shunt was detected in 80.7% of the cases and ascites in 72.3%. Conclusion: Ultrasonography examination represents an important role in the diagnosis of periportal fibrosis, in its staging process, and allows the assessment of porto-systemic, hepatic, and splenic alterations.
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Affiliation(s)
| | - Davidà Rakotomena
- Visceral Service, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
| | - Aurélia Rakotondrainibe
- Intensive Care Unit, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
| | | | - Hasina Dina Ranoharison
- Medical Imaging, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
| | - Hery Rakoto Ratsimba
- Visceral Service, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
| | - Tovo Rajaonera
- Intensive Care Unit, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
| | - Ahmad Ahmad
- Medical Imaging, Center of the University Hospital of Joseph Ravoahangy Andrianavalona Antananarivo, Madagascar
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Clinical and Preclinical Imaging of Hepatosplenic Schistosomiasis. Trends Parasitol 2019; 36:206-226. [PMID: 31864895 DOI: 10.1016/j.pt.2019.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/22/2019] [Accepted: 11/30/2019] [Indexed: 12/12/2022]
Abstract
Schistosomiasis, a neglected tropical disease, is a major cause of chronic morbidity and disability, and premature death. The hepatosplenic form of schistosomiasis is characterized by hepatosplenomegaly, liver fibrosis, portal hypertension, and esophageal varices, whose rupture may cause bleeding and death. We review currently available abdominal imaging modalities and describe their basic principles, strengths, weaknesses, and usefulness in the assessment of hepatosplenic schistosomiasis (HSS). Advanced imaging methods are presented that could be of interest for hepatosplenic schistosomiasis evaluation by yielding morphological, functional, and molecular parameters of disease progression. We also provide a comprehensive view of preclinical imaging studies and current research objectives such as parasite visualization in hosts, follow-up of the host's immune response, and development of noninvasive quantitative methods for liver fibrosis assessment.
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Unexpected hosts: imaging parasitic diseases. Insights Imaging 2016; 8:101-125. [PMID: 27882478 PMCID: PMC5265192 DOI: 10.1007/s13244-016-0525-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/08/2016] [Accepted: 09/28/2016] [Indexed: 12/28/2022] Open
Abstract
Radiologists seldom encounter parasitic diseases in their daily practice in most of Europe, although the incidence of these diseases is increasing due to migration and tourism from/to endemic areas. Moreover, some parasitic diseases are still endemic in certain European regions, and immunocompromised individuals also pose a higher risk of developing these conditions. This article reviews and summarises the imaging findings of some of the most important and frequent human parasitic diseases, including information about the parasite's life cycle, pathophysiology, clinical findings, diagnosis, and treatment. We include malaria, amoebiasis, toxoplasmosis, trypanosomiasis, leishmaniasis, echinococcosis, cysticercosis, clonorchiasis, schistosomiasis, fascioliasis, ascariasis, anisakiasis, dracunculiasis, and strongyloidiasis. The aim of this review is to help radiologists when dealing with these diseases or in cases where they are suspected. Teaching Points • Incidence of parasitic diseases is increasing due to migratory movements and travelling. • Some parasitic diseases are still endemic in certain regions in Europe. • Parasitic diseases can have complex life cycles often involving different hosts. • Prompt diagnosis and treatment is essential for patient management in parasitic diseases. • Radiologists should be able to recognise and suspect the most relevant parasitic diseases.
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Ultrasonography of gallbladder abnormalities due to schistosomiasis. Parasitol Res 2016; 115:2917-24. [PMID: 27169865 DOI: 10.1007/s00436-016-5116-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/04/2016] [Indexed: 12/19/2022]
Abstract
After malaria, schistosomiasis remains the most important tropical parasitic disease in large parts of the world. Schistosomiasis has recently re-emerged in Southern Europe. Intestinal schistosomiasis is caused by most Schistosoma (S.) spp. pathogenic to humans and leads to chronic inflammation and fibrosis of the colon as well as to liver fibrosis. Gallbladder abnormalities usually occur in patients with advanced hepatic portal fibrosis due to Schistosoma mansoni infection. Occasionally, gallbladder abnormalities have been seen also in children and occurring without associated overt liver abnormalities.The specific S. mansoni-induced gallbladder abnormalities detectable by ultrasound include typical hyperechogenic wall thickening with external gallbladder wall protuberances. The luminal wall surface is smooth. The condition is usually clinically silent although some cases of symptomatic cholecystitis have been described. The ultrasonographic Murphy response is negative. Gallbladder contractility is impaired but sludge and calculi occur rarely. Contrary to other trematodes such as liver flukes, S. mansoni does not obstruct the biliary tract. Advanced gallbladder fibrosis is unlikely to reverse after therapy.
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Sah VK, Wang L, Min X, Rizal R, Feng Z, Ke Z, Deng M, Li L, Li H. Human schistosomiasis: A diagnostic imaging focused review of a neglected disease. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jrid.2015.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Olveda DU, Olveda RM, McManus DP, Cai P, Chau TNP, Lam AK, Li Y, Harn DA, Vinluan ML, Ross AGP. The chronic enteropathogenic disease schistosomiasis. Int J Infect Dis 2014; 28:193-203. [PMID: 25250908 DOI: 10.1016/j.ijid.2014.07.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/26/2014] [Accepted: 07/16/2014] [Indexed: 02/08/2023] Open
Abstract
Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. The disease afflicts approximately 240 million individuals globally, causing approximately 70 million disability-adjusted life years lost. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver, or in the case of Schistosoma haematobium, the bladder. Various methods are utilized to diagnose and evaluate liver fibrosis due to schistosomiasis. Liver biopsy is still considered the gold standard, but it is invasive. Diagnostic imaging has proven to be an invaluable method in assessing hepatic morbidity in the hospital setting, but has practical limitations in the field. The potential of non-invasive biological markers, serum antibodies, cytokines, and circulating host microRNAs to diagnose hepatic fibrosis is presently undergoing evaluation. This review provides an update on the recent advances made with respect to gastrointestinal disease associated with chronic schistosomiasis.
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Affiliation(s)
- David U Olveda
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Donald P McManus
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Pengfei Cai
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Thao N P Chau
- Department of Public Health, Flinders University, Adelaide, Australia
| | - Alfred K Lam
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Yuesheng Li
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald A Harn
- Department of Infectious Diseases, University of Georgia, Georgia, USA
| | - Marilyn L Vinluan
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Allen G P Ross
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia.
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Lambertucci JR. Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools. Rev Soc Bras Med Trop 2014; 47:130-6. [PMID: 24861284 DOI: 10.1590/0037-8682-0186-2013] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/22/2014] [Indexed: 12/19/2022] Open
Abstract
Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fibrosis 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 fibrosis was made by abdominal palpation and the finding 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 fibrosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) findings 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 fibrosis/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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Affiliation(s)
- José Roberto Lambertucci
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BRAZIL
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Drummond SC, Pereira PN, Otoni A, Chaves BA, Antunes CM, Lambertucci JR. Thrombocytopenia as a surrogate marker of hepatosplenic schistosomiasis in endemic areas for Schistosomiasis mansoni. Rev Soc Bras Med Trop 2014; 47:218-22. [DOI: 10.1590/0037-8682-0020-2014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/11/2014] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Alba Otoni
- Universidade Federal de Minas Gerais, BRAZIL
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Olveda DU, Olveda RM, Lam AK, Chau TNP, Li Y, Gisparil AD, Ross AGP. Utility of Diagnostic Imaging in the Diagnosis and Management of Schistosomiasis. ACTA ACUST UNITED AC 2014; 3. [PMID: 25110719 PMCID: PMC4124748 DOI: 10.4172/2327-5073.1000142] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Diagnosis of schistosomiasis is made by demonstration of the parasite ova in stools, urine,and biopsy specimens from affected organs, or presence of antibodies to the different stages of the parasite or antigens circulating in body fluids by serologic techniques. DNA of schistosomes can now also be detected in serum and stool specimens by molecular technique.However, these tests are unable to determine the severity of target organ pathology and resultant complications. Accurate assessment of schistosome-induced morbidities is now made with the use of imaging techniques like ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). US has made major contributions in the diagnosis of hepatosplenic and urinary form of disease. This imaging method provides real time results, is portable (can be carried to the bed side and the field) and is lower in cost than other imaging techniques. Typical findings in hepatosplenic schistosomiasis by US include: hyperechoic fibrotic bands along the portal vessels (Symmer’s fibrosis), reduction in the size of the right lobe, hypertrophy of the left lobe, splenomegaly, and ascites. More advanced ultrasound equipment like the colour Doppler ultrasound can characterize portal vein perfusion, a procedure that is critical for the prediction of disease prognosis and for treatment options for complicated portal hypertension. Although CT and MRI are more expensive, are hospital based, and require highly additional specially-trained personnel, they provide more accurate description of the pathology, not only in hepatosplenic and urinary forms of schistosomiasis, but also in the diagnosis of ectopic forms of the disease,particularly involving thebrain and spinal cord. MRI demonstrates better tissue differentiation and lack of exposure to ionizing radiation compared with CT.
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Affiliation(s)
- David U Olveda
- Griffith Health Institute, Griffith University, Gold Coast Campus, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Philippines
| | - Alfred K Lam
- Griffith Health Institute, Griffith University, Gold Coast Campus, Australia
| | - Thao N P Chau
- Discipline of Public Health, Flinders University, Australia
| | - Yuesheng Li
- QIMR Berghofer Medical Research Institute, Australia
| | | | - Allen G P Ross
- Griffith Health Institute, Griffith University, Gold Coast Campus, Australia
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Silva LCDS, Andrade LM, Paula IBD, Queiroz LCD, Antunes CMF, Lambertucci JR. Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs. Rev Soc Bras Med Trop 2012; 45:500-4. [DOI: 10.1590/s0037-86822012005000008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 09/30/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: There is no study relating magnetic resonance imaging (MRI) to ultrasound (US) findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years) from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma). RESULTS: Forty-seven (87%) of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%), MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1%) of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI) is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.
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Pinto-Silva RA, Queiroz LCD, Azeredo LM, Silva LCDS, Lambertucci JR. Ultrasound in schistosomiasis mansoni. Mem Inst Oswaldo Cruz 2011; 105:479-84. [PMID: 20721494 DOI: 10.1590/s0074-02762010000400021] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 10/15/2009] [Indexed: 12/20/2022] Open
Abstract
We reviewed ultrasound features in patients with schistosomiasis mansoni. The alterations that we observed in acute and hepatosplenic schistosomiasis are described. The advantages and disadvantages of using ultrasound patterns in the evaluation of liver fibrosis are discussed. Other diseases that are important in the differential diagnosis of schistosomal liver fibrosis are presented. Ultrasound is an effective and flexible diagnostic tool in the evaluation of a variety of diseases. It presents no harmful effects to patients, allowing non-invasive studies in hospitalized patients and in other facilities.
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Affiliation(s)
- Rogério Augusto Pinto-Silva
- Serviço de Radiologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
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Silva LCS, Andrade LM, Queiroz LCD, Voieta I, Azeredo LM, Antunes CMF, Lambertucci JR. Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity. Mem Inst Oswaldo Cruz 2010; 105:467-70. [DOI: 10.1590/s0074-02762010000400019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2009] [Accepted: 09/04/2009] [Indexed: 01/15/2023] Open
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Voieta I, Queiroz LCD, Andrade LM, Silva LCS, Fontes VF, Barbosa Jr A, Resende V, Petroianu A, Andrade Z, Antunes CM, Lambertucci JR. Imaging techniques and histology in the evaluation of liver fibrosis in hepatosplenic schistosomiasis mansoni in Brazil: a comparative study. Mem Inst Oswaldo Cruz 2010; 105:414-21. [DOI: 10.1590/s0074-02762010000400011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 12/18/2009] [Indexed: 12/28/2022] Open
Affiliation(s)
| | | | - Luciene M Andrade
- Universidade Federal de Minas Gerais, Brasil; Laboratórios Hermes Pardini, Brasil
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Marinho CC, Bretas T, Voieta I, Queiroz LCD, Ruiz-Guevara R, Teixeira AL, Antunes CM, Prata A, Lambertucci JR. Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil. Mem Inst Oswaldo Cruz 2010; 105:471-8. [DOI: 10.1590/s0074-02762010000400020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 09/04/2009] [Indexed: 12/27/2022] Open
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Lambertucci JR, Voieta I, Andrade LM. Intrahepatic venous shunt and splenic artery aneurysm in hepatosplenic schistosomiasis. Rev Soc Bras Med Trop 2010; 43:215-6. [DOI: 10.1590/s0037-86822010000200024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Prata A, Ruiz-Guevara R, Antunes CMDF, Marinho CC, Queiroz LC, Voieta I, Lambertucci JR. Comparison between clinical and ultrasonographic findings in cases of periportal fibrosis in an endemic area for schistosomiasis mansoni in Brazil. Rev Soc Bras Med Trop 2010; 43:129-34. [DOI: 10.1590/s0037-86822010000200005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 03/05/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Abdominal palpation and ultrasound findings among patients from an endemic area for schistosomiasis in Brazil who had been followed up for 27 years were compared. METHODS: In 2004, 411 patients from Brejo do Espírito Santo, in the State of Bahia, were selected for the present investigation after giving their written informed consent. Based on clinical data, they were divided into three groups: 41 patients with evidence of liver fibrosis in 2004 (Group 1); 102 patients with evidence of liver fibrosis in the past (1976-1989) but not in 2004 (Group 2); and 268 patients without evidence of liver fibrosis at any time during the 27-year follow-up (Group 3). All of the patients underwent abdominal ultrasound in which the examiner did not know the result from the clinical examination. The data were stored in a database. RESULTS: The prevalence of periportal fibrosis on ultrasound was 82.9%, 56.9% and 13.4% in Groups 1, 2 and 3, respectively. In the presence of hard, nodular liver or prominent left lobe and a hard palpable spleen, ultrasound revealed periportal fibrosis in 70.9%. However, periportal fibrosis was diagnosed using ultrasound in 25.4% of the patients in the absence of clinical evidence of liver involvement. Thus, ultrasound diagnosed periportal fibrosis 3.1 times more frequently than clinical examination did. CONCLUSIONS: Although clinical examination is important in evaluating morbidity due to Manson's schistosomiasis in endemic areas, ultrasound is more accurate in diagnosing liver involvement and periportal fibrosis.
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Lambertucci JR, Voieta I, Andrade LM. Gamna-Gandy bodies in hepatosplenic schistosomiasis mansoni. Rev Soc Bras Med Trop 2009; 41:320-1. [PMID: 18719819 DOI: 10.1590/s0037-86822008000300021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Differentiating Cirrhosis and Chronic Hepatosplenic Schistosomiasis Using MRI. AJR Am J Roentgenol 2008; 190:W201-7. [DOI: 10.2214/ajr.07.2639] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Scortegagna Junior E, Leão ARDS, Santos JEM, Sales DM, Shigueoka DC, Aguiar LAKD, Brant PE, Colleoni Neto R, Borges DR, D'Ippolito G. Avaliação da concordância entre ressonância magnética de ultra-sonografia na classificação de fibrose periportal em esquitossomóticos, segundo a classificação de Niamey. Radiol Bras 2007. [DOI: 10.1590/s0100-39842007000500005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a reprodutibilidade da ressonância magnética e a concordância entre a ultra-sonografia e a ressonância magnética na classificação da fibrose periportal em pacientes esquistossomóticos, segundo os critérios qualitativos de Niamey. MATERIAIS E MÉTODOS: Foi realizado estudo prospectivo e duplo-cego, entre fevereiro de 2005 e junho de 2006, em 20 pacientes (10 homens e 10 mulheres, idades entre 24 e 60 anos, média de 42,75 anos) com diagnóstico de esquistossomose mansônica. As imagens de ultra-sonografia e de ressonância magnética foram avaliadas por dois examinadores experientes de forma independente. Foi medida a concordância interobservador para a ressonância magnética e entre a ressonância magnética e a ultra-sonografia. RESULTADOS: A ressonância magnética apresentou resultados concordantes entre os observadores em 14 pacientes (70%). Quando comparamos a ressonância magnética com a ultra-sonografia, obtivemos concordância em apenas seis pacientes pelo observador 1 (30%) e em oito pacientes pelo observador 2 (40%). CONCLUSÃO: A ressonância magnética tem boa reprodutibilidade na avaliação de fibrose periportal em pacientes com esquistossomose avançada, porém sua concordância com a ultra-sonografia é fraca.
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Silva LCS, Pereira ACF, Queiroz LC, Andrade LM, Antunes CMF, Lambertucci JR. Disagreement between ultrasound and magnetic resonance imaging in the identification of schistosomal periportal fibrosis. Mem Inst Oswaldo Cruz 2006; 101 Suppl 1:279-82. [PMID: 17308782 DOI: 10.1590/s0074-02762006000900043] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 06/26/2006] [Indexed: 11/21/2022] Open
Abstract
Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease, and it has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis. We describe the case of a man in whom US showed solid evidence of schistosomal periportal fibrosis and magnetic resonance imaging revealed that periportal signal alteration corresponded to adipose tissue which entered the liver together with the portal vein.
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Affiliation(s)
- Luciana C S Silva
- Serviço de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, 30130-100 Belo Horizonte, MG, Brazil.
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Drummond SC, Silva LCDS, Amaral RSD, Sousa-Pereira SR, Antunes CM, Lambertucci JR. Morbidity of schistosomiasis mansoni in the state of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 2006; 101 Suppl 1:37-44. [PMID: 17308746 DOI: 10.1590/s0074-02762006000900007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 06/26/2006] [Indexed: 11/22/2022] Open
Abstract
From 2002 to 2005, a program of active search for patients with hepatosplenic schistosomiasis and schistosomal myeloradiculopathy has been implemented in the state of Minas Gerais by the local Health Department. The state was divided in 28 regional health centers and the local representatives have been trained to identify and direct patients with hepatosplenic schistosomiasis and neuroschistosomiasis to a reference center in Belo Horizonte, the capital of the state of Minas Gerais. Seventy five patients with hepatosplenic schistosomiasis and 54 with schistosomal myeloradiculopathy have been referred and examined in the reference center in a period of time of 3 years. Schistosomal myeloradiculopathy should be emphasized because the number of cases reported is increasing rapidly and when timely diagnosed and treated, they respond promptly to treatment. Left untreated, they die or become invalid for life. In our view, the time has come for more active investigation of the different aspects of morbidity caused by schistosomiasis mansoni in Brazil.
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