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Acta Radiol ; 48(2): 125-34, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17354130

RESUMEN

PURPOSE: To evaluate the hepatosplenic manifestations and the portal venous system in patients with chronic infection by Schistosoma mansoni. MATERIAL AND METHODS: A cross-sectional observational study was performed in 28 patients with chronic hepatosplenic schistosomiasis submitted to magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the abdomen. Images were interpreted independently by two radiologists to determine the reproducibility of image interpretation and who evaluated the presence of morphological alterations in the liver and spleen, such as hepatosplenomegaly, hepatic fissure widening, periportal fibrosis, and the presence of siderotic nodules. Interobserver and intra-observer agreement were measured with the kappa and intraclass correlation tests. Evaluation of venous collateral pathways and portal and splenic veins was done in consensus by both examiners. RESULTS: Observers identified enlargement of the left lobe (78.5-92.8%) and caudate-to-right-lobe ratio (78.5-92.8%), irregularity of hepatic contours (89.2-96.4%), fissure widening (89.2-100%), and splenic siderotic nodules (84.2%). Splenomegaly, heterogeneity of hepatic parenchyma, peripheral hepatic vessels, and periportal fibrosis were observed in 100% of patients. MRI findings presented almost perfect interobserver (kappa = 0.65-1) and intra-observer (kappa = 0.73-1 for observer 1, and kappa = 0.65-1 for observer 2) agreement for the variables analyzed. MRA showed the presence of collateral pathways in the majority of patients (71.4%) along with widening of portal and splenic veins. CONCLUSION: Using MRI, hepatosplenic alterations in schistosomiasis are characterized by heterogeneity of hepatic parenchyma, presence of peripheral perihepatic vessels, periportal fibrosis, splenomegaly, siderotic nodules, and the presence of venous collateral pathways.


Asunto(s)
Parasitosis Hepáticas/diagnóstico , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodos , Esquistosomiasis mansoni/diagnóstico , Enfermedades del Bazo/diagnóstico , Enfermedades del Bazo/parasitología , Adulto , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
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