Schistosomiasis mansoni in low transmission areas: abdominal ultrasound

Ruiz, Rosana Figueroa; Candia, Paula; Garassini, M; Tombazzi, Claudio; Certad, Gabriela; Bruces, Ana Cecilia; Noya, Óscar; Noya, B Alarcón de

doi:10.1590/s0074-02762002000900029

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…Nos nossos casos, todos os pacientes apresentavam hipersinal nas seqüências ponderadas em T2, levando à suposição que mesmo em pacientes com a forma hepatoesplênica da doença existe ainda um componente inflamatório periportal (23) . O esclarecimento para esta questão poderia ser dado pela correlação entre o aspecto da imagem por RM e os marcadores sorológicos para fibrose e inflamação, como o ácido hialurônico e a proteína C reativa ( , que observaram aumento em 81% dos pacientes, e por Ruiz et al (67) , que encontraram esta alteração em 91,4%.…”

Section: Discussionunclassified

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

et al. 2004

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OBJETIVO: Avaliar, qualitativa e quantitativamente, as alterações morfológicas hepáticas e esplênicas por ressonância magnética (RM) em pacientes portadores de esquistossomose mansônica crônica, e a reprodutibilidade do método na avaliação hepatoesplênica destes pacientes. MATERIAIS E MÉTODOS: Realizou-se estudo prospectivo em 28 pacientes esquistossomóticos submetidos à RM de abdome superior. Os exames foram realizados em equipamento com alto campo (1,5 T), utilizando-se bobina de corpo e bomba injetora para a administração do contraste endovenoso, e interpretados por dois examinadores independentes, que avaliaram a presença de alterações morfológicas hepáticas e esplênicas. A concordância interobservador e intra-observador foram medidas pelo teste kappa e pelo teste do coeficiente de correlação intraclasses. RE-SULTADOS: As variáveis qualitativas e quantitativas apresentaram boa concordância interobservador e intra-observador (κ ≥ κ ≥ κ ≥ κ ≥ κ ≥ 0,65 e r ≥ ≥ ≥ ≥ ≥ 0,66, respectivamente). A maior concordância interobservador foi obtida para o diâmetro ântero-posterior do baço (r = 0,98). Os observadores identificaram redução do lobo hepático direito, aumento do lobo hepático esquerdo e caudado associado a esplenomegalia em quase todos os pacientes, e alargamento de fissuras, heterogeneidade do parênquima hepático, irregularidade de contornos, vasos periféricos hepáticos e fibrose periportal em mais de 82% dos pacientes. CONCLUSÃO: As alterações morfológicas hepáticas caracterizam-se pela redução do lobo direito e aumento dos lobos caudado e esquerdo, e as esplênicas, pela presença de esplenomegalia e nódulos sideróticos. A RM apresenta elevada reprodutibilidade na avaliação dessas alterações em pacientes com esquistossomose mansônica crônica. Unitermos: Hepatopatias parasitárias; Esplenopatias; Esquistossomose mansoni; Ressonância magnética.Liver and spleen magnetic resonance imaging evaluation in patients with chronic Schistosoma mansoni infection. OBJECTIVE: To qualitatively and quantitatively evaluate the morphological changes of the liver and spleen using magnetic resonance imaging (MRI) in patients with chronic infection by Schistosoma mansoni and the reproducibility of MRI findings in the hepatosplenic evaluation of these patients. MATERIALS AND METHODS: We prospectively studied 28 schistosomotic patients submitted to MRI of the upper abdomen. The scans were performed using a high field equipment (1.5 T), a body coil and a power injector for administration of intravenous contrast. The scans were interpreted by two independent examiners who evaluated the presence of morphological changes in the liver and spleen. Interobserver and intraobserver agreement were measured using the kappa and intraclass correlation tests. RESULTS: Qualitative variables presented good interobserver and intraobserver agreement (κ ≥ κ ≥ κ ≥ κ ≥ κ ≥ 0.65 and r ≥ ≥ ≥ ≥ ≥ 0.66, respectively). The best interobserver agreement was for the anteroposterior diameter of the spleen (r = 0.98). The observers identified reduction of the right...

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Section: Discussionunclassified

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

et al. 2004

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“…In addition, although the serological diagnosis of schistosomiasis is generally accurate9, it can also produce false negatives, particularly in patients with longstanding infections while elevated antibody levels can be still detectable many years after treatment 10. Ultrasound is currently the diagnostic tool of choice for detecting pathological conditions associated with urinary schistosomiasis, such as dilatation of the renal pelvis and bladder wall lesions, although its usefulness has been questioned, particularly in low transmission areas, because of its lack of specificity 11. In addition, large variations of sensitivity and specificity estimates have been observed among different endemic zones, age groups and sexes for all the aforementioned diagnostic methods of urinary schistosomiasis in several studies.…”

Section: Introductionmentioning

confidence: 99%

Sensitivities and Specificities of Diagnostic Tests and Infection Prevalence of Schistosoma haematobium Estimated from Data on Adults in Villages Northwest of Accra, Ghana

Koukounari¹,

Webster²,

Donnelly³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. Substantial uncertainties surround the sensitivities and specificities of diagnostic techniques for urinary schistosomiasis. We used latent class (LC) modeling to address this problem. In this study, 220 adults in three villages northwest of Accra, Ghana were examined using five Schistosoma haematobium diagnostic measures: microscopic examination of urine for detection of S. haematobium eggs, dipsticks for detection of hematuria, tests for circulating antigens, antibody tests, and ultrasound scans of the urinary system. Testing of the LC model indicated non-invariance of the performance of the diagnostic tests across different age groups, and measurement invariance held for males and females and for the three villages. We therefore recommend the use of LC models for comparison between and the identification of the most accurate schistosomiasis diagnostic tests. Furthermore, microscopy and hematuria dipsticks were indicated through these models as the most appropriate techniques for detection of S. haematobium infection.

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“…Whilst clinical investigations with ultrasound and/or abdominal palpation methods can better describe morbidity associated with Schistosoma mansoni infection, for example hepatosplenomegaly, liver fibrosis and/or organ texture (Hatz, 2001;King et al, 2003), these require specialist equipment and well trained staff (Nooman et al, 1995;Ruiz et al, 2002). As a consequence, large-scale community screening of morbidity has been limited and broad geographic comparisons are rarely made.…”

Section: Introductionmentioning

confidence: 99%

Morbidity due to Schistosoma mansoni: an epidemiological assessment of distended abdomen syndrome in Ugandan school children with observations before and 1-year after anthelminthic chemotherapy

Balen

Stothard

Kabatereine

et al. 2006

Transactions of the Royal Society of Tropical Medicine and Hygi

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Schistosomiasis mansoni in low transmission areas: abdominal ultrasound

Abstract: In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the

Cited by 16 publications

References 31 publications

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica

Sensitivities and Specificities of Diagnostic Tests and Infection Prevalence of Schistosoma haematobium Estimated from Data on Adults in Villages Northwest of Accra, Ghana

Morbidity due to Schistosoma mansoni: an epidemiological assessment of distended abdomen syndrome in Ugandan school children with observations before and 1-year after anthelminthic chemotherapy

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