Navegando por Palavras-chave "hepatosplenic schistosomiasis"

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    Differentiating cirrhosis and chronic hepatospienic schistosorniasis using MRI
    (Amer Roentgen Ray Soc, 2008-03-01) Bezerra, Alexandre Sergio de Araujo [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Caldana, Rogerio Pedreschi [UNIFESP]; Leopoldino, Denise D.; Batista, Giovani Rodrigues [UNIFESP]; Borges, Durval Rosa [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Ahmed, Muneeb; Universidade Federal de São Paulo (UNIFESP); SARAH Network Hosp Reabilitat; Beth Israel Deaconess Med Ctr
    OBJECTIVE. the objective of our study was to identify which imaging features may be used to differentiate between cirrhosis and chronic hepatosplenic schistosomiasis and to assess image interpretation agreement for MRI findings.MATERIALS and METHODS. Retrospective review of 27 patients with alcoholic or virus-induced cirrhosis and 24 patients with chronic hepatosplenic schistosorniasis who underwent MRI (1.5 T) of the abdomen was performed. Images were interpreted independently by two radiologists evaluating the following MRI features: hepatic fissure widening, irregularity of hepatic contours, periportal fibrosis, hepatic parenchyma heterogeneity, and splenic siderotic nodules. Left, right, and caudate hepatic lobe measurements were obtained, and the splenic index was measured. the Fisher's exact test, chi-square test, and Student's t test were used to compare both groups, and regression analysis was performed. Observer agreement was measured using kappa and intraclass correlation tests.RESULTS. Periportal fibrosis, heterogeneity of hepatic parenchyma, and splenic siderotic nodules were more frequent in the group with schistosomiasis (p < 0.05), with periportal fibrosis showing the largest difference in presence and distribution (peripheral greater than central). the transverse diameter of the right hepatic lobe, caudate lobe-right lobe ratio, and splenic index were larger in patients with chronic schistosomiasis (P < 0.001). At multiple regression analysis, splenic siderotic nodules, splenic index, and caudate lobe-right lobe ratio were predictive of schistosomiasis. Observer agreement was substantial or almost perfect for almost all variables analyzed (K or r = 0.81-1.00).CONCLUSION. the presence of peripheral periportall 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.
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    Endoscopic, ultrasonographic, and US-Doppler parameters as indicators of variceal bleeding in patients with schistosomiasis
    (Kluwer Academic/plenum Publ, 2000-05-01) Martins, R. D.; Szejnfeld, J.; Lima, F. G.; Ferrari, A. P.; Universidade Federal de São Paulo (UNIFESP)
    Bleeding from esophagogastric varices is a potentially deadly complication in patients with hepatosplenic schistosomiasis. the aim of this study is to establish indicators of variceal bleeding. We studied 40 patients with compensated hepatosplenic schistosomiasis and varices, analyzing four endoscopic (variceal size, red color signs, fundic var-ices, and congestive gastropathy), nine ultrasonographic (right and left hepatic lobe size, periportal and gallbladder wall thickness, portal and splenic veins diameter, spleen longitudinal axis and volume, and presence of collateral circulation), and five US-Doppler parameters (portal and splenic veins velocity and flaw and portal vein congestion index). Patients were divided in two groups according to previous history of variceal bleeding. the group with bleeding episodes was again divided in two groups: with and without treatment, namely endoscopic sclerotherapy. All endoscopic parameters and two ultrasonographic (periportal thickness and portal vein diameter) were statistically different between the groups with and without previous bleeding. the likelihood index, adopted to determine the best parameters related to previous bleeding showed that the most important combinations are: gastropathy and red signs followed by portal vein diameter and variceal size. in conclusion, although aware of the limits of the statistical analysis due to the small number of patients, our results demonstrated that endoscopic and US parameters (isolated or combined) can identify patients with a high risk of variceal bleeding, allowing physicians to optimize prophylactic therapy.