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
Artigo
em Inglês
| 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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Esplenopatias
/
Esquistossomose mansoni
/
Cirrose Hepática
/
Hepatopatias Parasitárias
Tipo de estudo:
Guia de Prática Clínica
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Mem. Inst. Oswaldo Cruz
Assunto da revista:
Medicina Tropical
/
Parasitologia
Ano de publicação:
2010
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Fundação Gonçalo Moniz-Fiocruz/BR
/
Hospital das Clínicas/BR
/
Serviço de Cirurgia de Fígado e Vias Biliares/BR
/
Universidade Federal de Minas Gerais/BR
Similares
MEDLINE
...
LILACS
LIS