Differentiating Cirrhosis and Chronic Hepatosplenic Schistosomiasis Using MRI

Bezerra, Alexandre Sérgio de Araújo; D'Ippólito, Giuseppe; Caldana, Rogério Pedreschi; Leopoldino, Denise de Deus; Batista, Giovani Rodrigues; Borges, Durval Rosa; Filho, Gaspar de Jesus Lopes; Ahmed, Muneeb

doi:10.2214/ajr.07.2639

Cited by 21 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MRI identified schistosomal fibrosis as hyperintense periportal bands on T2-weighted images and hypointense on T1-weighted images with enhancement after contrast, in accordance with previous reports and studies (Patel et al 1993, Willemsen et al 1995, Lambertucci et al 2002, Bezerra et al 2004, 2007, 2008.…”

Section: Discussionsupporting

confidence: 90%

“…MRI has been described in hepatosplenic schistosomiasis mansoni (Patel et al 1993, Willemsen et al 1995, Lambertucci et al 2002, Bezerra et al 2004, 2007, 2008, Silva et al 2006), but there is no standardisation of the method in the evaluation of liver periportal fibrosis. The aim of this paper was to analyse MRI using an adaptation of the WHO patterns for US assessment of schistosomiasisrelated morbidity.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Silva

Andrade

Queiroz

et al. 2010

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

For the last two decades, ultrasound (US) has been considered a surrogate for the gold standard in the evaluation of liver fibrosis in schistosomiasis. The use of magnetic resonance imaging (MRI) is not yet standardised for diagnosing and grading liver schistosomal fibrosis. The aim of this paper was to analyse MRI using an adaptation of World Health Organization (WHO) patterns for US assessment of schistosomiasis-related morbidity. US and MRI were independently performed in 60 patients (42.1 ± 13.4 years old), including 37 men and 23 women with schistosomiasis. Liver involvement appraised by US and MRI was classified according to the WHO protocol from patterns A-F. Agreement between image methods was evaluated by kappa index (k). The correlation between US and MRI was poor using WHO patterns [k = 0.14; confidence interval (CI) 0.02; 0.26]. Even after grouping image patterns as "A-D", "Dc-E" and "Ec-F", the correlation between US and MRI remained weak (k = 0.39; CI 0.21; 0.58). The magnetic resonance adaptation used in our study did not confirm US classification of WHO patterns for liver fibrosis

show abstract

Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Silva

Andrade

Queiroz

et al. 2010

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

show abstract

“…Advanced-stage hepatosplenic schistosomiasis results in marked morphologic changes in the liver, typical periportal fibrosis, and signs of portal hypertension. Severe splenomegaly with siderotic nodules is common, and observation of these features may aid in diagnosis (5). Isolated intestinal schistosomiasis may be indistinguishable from other forms of proctocolitis (6).…”

Section: Schistosomiasismentioning

confidence: 99%

“…At contact with a human host, the infective larvae penetrate the skin (3), migrate to the lungs (4), and ascend the bronchial tree to the esophagus, at which point they are swallowed. In the small intestine, the larvae mature into worms (5). A unique pattern of continuous autoinfection may become established (6).…”

Section: Strongyloidiasismentioning

confidence: 99%

Helminthic Diseases in the Abdomen: An Epidemiologic and Radiologic Overview

Ortega¹,

Ogawa²,

Rocha³

et al. 2010

RadioGraphics

View full text Add to dashboard Cite

Helminthic diseases have a worldwide distribution. They affect billions of people in endemic areas and can result in serious clinical complications. Some parasites have a human gastrointestinal life cycle with resultant abdominal manifestations. However, the symptoms of helminthic diseases are usually nonspecific. Radiologic imaging, along with the identification of risk factors, may help narrow the differential diagnosis. To avoid diagnostic delays, radiologists should be familiar with the geographic distribution, transmission cycle, and characteristic and atypical manifestations of common helminthic diseases at abdominal imaging with radiography, computed tomography, magnetic resonance imaging, and ultrasonography. Awareness of the clinical, epidemiologic, and pathogenic characteristics of these diseases also may be helpful for narrowing the diagnosis when imaging features are nonspecific.

show abstract

“…Compared to DUS, MRI is a much more comprehensive imaging method to evaluate the abdomen, and the portal system and liver, in particular. The usefulness of MRI to evaluate chronic hepatosplenic schistosomiasis (5) and portal vein disease (6) has been demonstrated. MRI displays well the tridimensional anatomy of the liver and portal venous system; and can provide portal venous flow evaluation by phase-contrast techniques.…”

Section: Editorialmentioning

confidence: 99%

Imagem e avaliação do fluxo da veia porta: comparação entre ultrassom Doppler e RM

Semelka¹,

Elias

2010

Radiol Bras

View full text Add to dashboard Cite

VIIRadiol Bras. 2010 Nov/Dez;43(6):VII-VIII EditorialThe diagnosis of diffuse liver disease, including characterization and quantification, has gained particular importance in recent years, reflecting in large measure advances in imaging techniques. During the same time period concern has escalated about the use of CT due to the harmful effects of radiation. The net result is that the non-invasive techniques of sonography and magnetic resonance imaging (MRI) have achieved considerable interest.Both methods are non-invasive, innocuous and safe, but with important and noticeable differences. While sonography is a well established and widely used method, reflecting its low cost and portability, it suffers with high operator dependence variations, low sensitivity and even lower specificity. On the other hand, MRI is a comprehensive method with multiple types of data acquisition, and unmatched ability to differentiate normal from diseased tissues. The drawbacks of MRI are less availability, no portability, and higher cost.Despite these limitations and others discussed below, both methods are progressively replacing more invasive diagnostic techniques. Portal system morphology and hemodynamics constitute suitable application areas for both Doppler sonography (DUS) and MR techniques. Clinical indications for hepatic venous pressure gradient measurements performed by angiography are: prediction of clinical events, sequential assessment of clinical evolution, assessment of pharmacologic therapy, and assessment of pre- operative risk in cirrhotic patients (1) . Because of the invasiveness of the procedure and that it is unlikely to achieve more widespread use, this direct measurement technique is likely to be confined to basic research studies and not develop substantially into clinical utilization.In this issue of Radiologia Brasileira Leão et al.( 2) have written an interesting article testing interobserver reproducibility of DUS and MRI for the evaluation of portal blood flow in schistosomal patients (2) . An intriguing finding is the poor intermethod agreement between these two methods. It is always refreshing when authors in the scientific literature provide sobering prudent observations, rather than the usual over enthusiastic description.The sonography evaluation of the portal system is probably adequate for the majority of patients. One major exception being the overly obese patients, as there is often the lack of appropriate sonographic window, and often, as a result, or due to coexistent fatty liver, which complicates visualization because of heterogeneous echotexture. With this caveat in mind, DUS can adequately diagnose hepatic schistosomiasis, characterize the portal vein flow, and display portal hypertension related findings, i.e., splenomegaly, ascites and varices. However, the challenge to identify patients at risk for upper gastrointestinal tract bleeding remains, and this has been the subject of other studies (3,4) . Compared to DUS, MRI is a much more comprehensive imaging method to evaluate the abdomen...

show abstract

Differentiating Cirrhosis and Chronic Hepatosplenic Schistosomiasis Using MRI

Abstract: The presence of peripheral periportal fibrosis, heterogeneity of hepatic parenchyma, and splenic siderotic nodules, and the splenic index and caudate lobe-right lobe ratio are useful features for differentiating alcoholic or virus-induced cirrhosis from chronic schistosomiasis using MRI.

Cited by 21 publications

References 34 publications

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Helminthic Diseases in the Abdomen: An Epidemiologic and Radiologic Overview

Imagem e avaliação do fluxo da veia porta: comparação entre ultrassom Doppler e RM

Contact Info

Product

Resources

About