title: Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs.
abstract: BACKGROUND
  There is no study relating magnetic resonance imaging (MRI) to ultrasound (US) findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US.
  
  
  METHODS
  Fifty-four patients (mean age 41.6±13.5years) from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma).
  
  
  RESULTS
  Forty-seven (87%) of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%), MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1%) of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis.
  
  
  CONCLUSIONS
  Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI) is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.
authors: Programa de Pós-Graduação em Ciências da Saúde Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. lucristina@medicina.ufmg.br
authors: Luciana Cristina Dos Santos
authors: LC
authors: Silva
authors: Luciene Mota
authors: LM
authors: Andrade
authors: Ivie Braga
authors: IB
authors: de Paula
authors: Leonardo Campos
authors: LC
authors: de Queiroz
authors: Carlos Maurício Figueiredo
authors: CM
authors: Antunes
authors: José Roberto
authors: JR
authors: Lambertucci
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008109:Liver Diseases, Parasitic / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012555:Schistosomiasis mansoni / Q000000981:diagnostic imaging* / Q000473:pathology*; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult