Transient elastography evaluation of hepatic and spleen stiffness in patients with hepatosplenic schistosomiasis.
BACKGROUND
Hepatosplenic schistosomiasis (HES) has not been evaluated by transient elastography so far and its correlation with ultrasound variables remains to be defined.


OBJECTIVE
The aim of this study was to describe the parameters of liver and spleen stiffness in HES assessed by transient elastography in comparison with cirrhotics and controls evaluating its correlation with ultrasonographic data.


METHODS
HES, hepatitis C virus-cirrhotic, and control patients were included in this sectional study. Liver and spleen stiffness were compared among the three groups. The ultrasonographic parameters were compared with transient elastography in HES patients.


RESULTS
Thirty HES, 30 hepatitis C virus-cirrhotic patients, and 17 controls were included. Those with HES presented liver stiffness that was significantly higher than the controls and lower than the cirrhotics: 9.7 (3.6-75.0) versus 3.7 (2.8-5.4) versus 27.0 (14.7-61.5) kPa (P<0.001). Spleen stiffness values were comparable between hepatosplenic and cirrhotics: 66.4 (25.7-75.0) versus 69.1 (18.0-75.0) kPa (P=0.78) and were significantly higher than the controls 16.5 kPa (6.3-34.3) (P<0.001). In patients with HES, high spleen stiffness was associated with right liver lobe diameter (P=0.015), splenic artery resistance index (P=0.002), portal vein diameter (P=0.021), portal vein area (P=0.008), portal vein congestion index (P=0.035), splenic vein diameter (P=0.013), and spleen diameter (P=0.021).


CONCLUSIONS
Liver stiffness may be a useful tool to differentiate portal hypertension related to cirrhosis from that of HES. High spleen stiffness is a potential surrogate marker of portal hypertension in this population.
aDepartment of Gastroenterology and Hepatology, Bonsucesso Federal Hospital bDepartment of Internal Medicine, School of Medicine cInfectious and Parasitic Disease Service, Clementino Fraga Filho University Hospital dDepartment of Immunology, Paulo de Góes Microbiology Institute eDepartment of Radiology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro fDepartment of Gastroenterology, University of the State of Rio de Janeiro gD'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
Zulane S T
ZST
Veiga
Cristiane A
CA
Villela-Nogueira
Flávia F
FF
Fernandes
Marta G
MG
Cavalcanti
Fátima A
FA
Figueiredo
João L
JL
Pereira
Gustavo H
GH
Pereira
Henrique S
HS
Moraes Coelho
José M
JM
Peralta
Carlos E
CE
Marques
Renata M
RM
Perez
Homero S
HS
Fogaça
D000328:Adult; D000368:Aged; D001938:Brazil; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000821:virology; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000469:parasitology / Q000821:virology; D008099:Liver / Q000000981:diagnostic imaging* / Q000469:parasitology / Q000821:virology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012552:Schistosomiasis / Q000000981:diagnostic imaging* / Q000469:parasitology; D013154:Spleen / Q000000981:diagnostic imaging* / Q000469:parasitology / Q000821:virology; D018615:Ultrasonography, Doppler, Color