Differentiating cirrhosis and chronic hepatospienic schistosorniasis using MRI

Differentiating cirrhosis and chronic hepatospienic schistosorniasis using MRI

Author Bezerra, Alexandre Sergio de Araujo Autor UNIFESP Google Scholar
D'Ippolito, Giuseppe Autor UNIFESP Google Scholar
Caldana, Rogerio Pedreschi Autor UNIFESP Google Scholar
Leopoldino, Denise D. Google Scholar
Batista, Giovani Rodrigues Autor UNIFESP Google Scholar
Borges, Durval Rosa Autor UNIFESP Google Scholar
Lopes Filho, Gaspar de Jesus Autor UNIFESP Google Scholar
Ahmed, Muneeb Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
SARAH Network Hosp Reabilitat
Beth Israel Deaconess Med Ctr
Abstract 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.
Keywords cirrhosis
hepatosplenic schistosomiasis
liver disease
MRI
schistosomiasis
Language English
Date 2008-03-01
Published in American Journal of Roentgenology. Reston: Amer Roentgen Ray Soc, v. 190, n. 3, p. W201-W207, 2008.
ISSN 0361-803X (Sherpa/Romeo, impact factor)
Publisher Amer Roentgen Ray Soc
Extent W201-W207
Origin http://dx.doi.org/10.2214/AJR.07.2639
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000253421600029
URI http://repositorio.unifesp.br/handle/11600/30474

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