Imaging techniques and histology in the evaluation of liver fibrosis in hepatosplenic schistosomiasis mansoni in Brazil: a comparative study
Mem. Inst. Oswaldo Cruz
;
105(4): 414-421, July 2010. ilus, tab
Article
in English
| LILACS
| ID: lil-554806
ABSTRACT
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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Splenic Diseases
/
Schistosomiasis mansoni
/
Liver Cirrhosis
/
Liver Diseases, Parasitic
Type of study:
Practice guideline
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2010
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Gonçalo Moniz-Fiocruz/BR
/
Hospital das Clínicas/BR
/
Serviço de Cirurgia de Fígado e Vias Biliares/BR
/
Universidade Federal de Minas Gerais/BR
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