Transient elastography (FibroScan) is not useful in the diagnosis of schistosomal hepatic fibrosis

Shiha, Gamal; Samir, W.; Soliman, Reham; Elbasiony, Mohamed; Ahmed, Nancy Abdel Fattah; Helmy, A. A.

doi:10.21608/mjvh.2016.4568

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…On the other hand, Shiha et al reported that TE would not be useful to diagnose liver fibrosis and esophageal varices in patients with pure schistosomiasis [20]. Nevertheless, these authors, did not applied the Niamey classification, and their paper aimed to compare patients with and without esophageal varices and splenomegaly with TE results.…”

Section: Discussionmentioning

confidence: 99%

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Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

Santos

Batista

Vasconcelos

et al. 2018

Preprint

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Background: ARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. Methodology/Principal findings:This cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years.The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/Significance: pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF. Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

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Section: Discussionmentioning

confidence: 99%

“…These methods have also been considered promising for liver fibrosis assessment in patients with hepatitis B, non-alcoholic fatty liver disease, and post-transplant patients [15,18,19]. In addition, TE was recently evaluated to assess PPF induced by S. mansoni using US grading as gold standard [20,21].…”

Section: Introductionmentioning

confidence: 99%

Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

Santos

Batista

Vasconcelos

et al. 2018

Preprint

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“…Initial studies in patients with schistosomiasis mansoni, conducted by Shiha et al (2016), evaluated the use of ET in 30 patients infected with S. mansoni, and reported that this method was not useful in the diagnosis of PPF or esophageal varices, but that it would be necessary to confirm these…”

Section: )mentioning

confidence: 99%

“…Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni findings in a larger group of patients, as well as to evaluate the applicability of ET in cases of prehepatic portal hypertension, such as portal vein thrombosis and congenital hepatic fibrosis (SHIHA et al, 2016).…”

Section: Global Health Trends and Perspectives In Health Sciencesmentioning

confidence: 99%

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Santos¹,

Pereira²,

Domingues³

et al. 2023

Global Health Trends and Perspectives in Health Sciences

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Schistosomiasis is a neglected tropical disease and an important public health problem, mainly due to its magnitude and transcendence. Although most cases are characterized as a mild infection, due to its morbidity, the untreated disease can cause economic burden and incapacitation. Periportal fibrosis (PPF) is the most common complication of schistosomiasis mansoni chronic infection and a large number of deaths are mainly caused by the rupture of esophageal varices resulting from portal hypertension (non-cirrhotic). Regarding the diagnosis and assessment of PPF and portal hypertension, different methods are applied. Although wedge liver biopsy is considered the gold standard, it is not justified in non-surgical patients, whereas percutaneous liver biopsy, even considered informative, does not have sufficient sensitivity. Thus, imaging techniques such as ultrasonography, computed tomography, magnetic resonance imaging and elastography have been applied, not only to support the diagnosis of schistosomiasis, but also to assess signs of portal hypertension. In the present chapter, an evaluation of the non-invasive imaging methods currently available for the evaluation of PPF and portal hypertension in schistosomiasis was carried out. The objectivity of elastography compared to ultrasonography is emphasized, because even though ultrasound is more frequently performed, it still has the limitation of being operator-dependent. Transient elastography (TE) has been applied more and it has shown good results in differentiating clinical forms and PPF stages, in addition to presenting potential in predicting esophageal varices. On the other hand, point shear wave elastography (pSWE) has shown more promising results in the analysis of spleen stiffness, when compared to liver stiffness. Therefore, there is a need for further studies applying liver and spleen elastography in the evaluation of PPF and portal hypertension in these patients.

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Liver stiffness is able to differentiate hepatosplenic Schistosomiasis mansoni from liver cirrhosis and spleen stiffness may be a predictor of variceal bleeding in hepatosplenic schistosomiasis

Silva

Nardelli

Barbosa

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Ultrasonography is limited for differentiating portal hypertension due to liver cirrhosis from that secondary to hepatosplenic schistosomiasis (HSS). We aimed to investigate the role of transient elastography (TE) in differentiating HSS mansoni from cirrhosis and the factors associated with liver and spleen stiffness (LS and SS) in HSS. Method A cross-sectional study was conducted including patients with HSS mansoni (n=29) and liver cirrhosis due to non-alcoholic steatohepatitis (n=23). All patients underwent TE and those with HSS were assessed by the Niamey protocol. Results HSS subjects presented lower median LS (9.6 vs 21.3 Kpa, p<0.001) and liver controlled attenuation parameter (229 vs 274 dB/m, p=0.010) than cirrhosis subjects, in addition to higher SS (73.5 vs 42.2 Kpa, p=0.002). The area under the receiver operating characteristic curve for detecting cirrhosis by LS was 0.947 (95% CI 0.89 to 1.00, p<0.001), with an optimal cut-off of 11.75 Kpa. In HSS subjects, higher SS was associated with the presence of the following: diabetes mellitus (p=0.036), metabolic syndrome (p=0.043), esophageal varices (p=0.001), portal vein thrombosis (p=0.047) and previous variceal bleeding (p=0.011). In HSS patients without portal vein thrombosis, variceal bleeding was associated with higher SS (p=0.018). Niamey categories were not associated with LS (p=0.676) or SS (p=0.504). Conclusion TE can play a role in differentiating HSS from cirrhosis, especially by LS. SS may be further investigated for predicting complications in HSS.

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Transient elastography (FibroScan) is not useful in the diagnosis of schistosomal hepatic fibrosis

Cited by 3 publications

References 8 publications

Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Liver stiffness is able to differentiate hepatosplenic Schistosomiasis mansoni from liver cirrhosis and spleen stiffness may be a predictor of variceal bleeding in hepatosplenic schistosomiasis

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