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2-D Shear Wave Elastography for the Evaluation of Liver Fibrosis in Hepatosplenic Schistosomiasis: Reliability of a Single Measurement and Inter-Hepatic Lobe Variability

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  • 1 Gastroenterology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil;
  • 2 Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil;
  • 3 Infectious Diseases Clinics, University Hospital Clementino Fraga Filho/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
  • 4 Department of Immunology, Institute of Microbiology Paulo de Goes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
  • 5 Gastroenterology Department, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil;
  • 6 D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil;
  • 7 Internal Medicine Department, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

ABSTRACT

Data on liver and spleen stiffness by 2-D shear wave elastography (2-D SWE) in hepatosplenic schistosomiasis (HES) remain scarce. We aimed to assess the correlation between single to multiple measurements of liver and spleen stiffness and to evaluate inter-hepatic lobe variability of liver stiffness measurement (LSM) using 2-D SWE in HES patients. Liver and spleen elastography were performed in HES patients in this cross-sectional study. A total of four stiffness measurements were performed in the right lobe (RL), left lobe (LL), and spleen. The correlation between the first measurement and the median of four measurements was assessed. Liver stiffness measurement of both hepatic lobes was compared. Twenty-six HES patients were included. Liver stiffness measurement was higher in the left than in the right hepatic lobe (17.9 kPa [11.3–92.0] versus 14.9 kPa [5.6–44.4]; P = 0.019). The first measurement was similar to the median of the four measurements for the RL (14.6 [5.6–60.8] versus 14.9 kPa [5.6–44.4]; P = 0.87), LL (17.4 [8.0–128.1] versus 17.9 kPa [11.3–92.0]; P = 0.54), and spleen (50.5 [10.0–157.0] versus 55.7 kPa [19.1–119.4]; P = 0.48). An excellent correlation between the first measurement and the median of four measurements for the RL (r = 0.93; P < 0.001), LL (r = 0.88; P < 0.001), and spleen (r = 0.89; P < 0.001) was observed. In HES, LSM of the LL seems to be higher than that of the right hepatic lobe. Considering the excellent correlation between the first measurement and the median of four measurements in both hepatic lobes and spleen, a single measurement would be sufficient to evaluate liver and splenic stiffness in patients with HES.

Author Notes

Address correspondence to Zulane S. T. Veiga, Gastroenterology Department, Bonsucesso Federal Hospital, Avenida Londres, 616-Rio de Janeiro, Rio de Janeiro 21041-030, Brazil. E-mail: zulane@yahoo.com.br

Financial supports: C. A. V.-N., and R. M. P. received research grants from Fundação Carlos Chagas de Amparo à Pesquisa (FAPERJ) (Grant numbers E-26/110.259/2014 and E-26/203.061/2016) and the Brazilian National Research Council (CNPq) (Grant number PQ 2015).

Authors’ addresses: Zulane S. T. Veiga, Flávia F. Fernandes¸and Gustavo H. Pereira, Gastroenterology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil, E-mails: zulane@yahoo.com.br, ffernandes.flavia@gmail.com, and ffernandes.flavia@gmail.com or ghspereira@gmail.com. Hugo Perazzo, Laboratory of clinical research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil, E-mail: perazzohugo@gmail.com. Marta G. Cavalcanti, Infectious Diseases Clinics, University Hospital Clementino Fraga Filho/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, E-mail: cavalcanti.marta66@gmail.com. José M. Peralta, Department of Immunology, Institute of Microbiology Paulo de Goes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, E-mail: peraltajm@globo.com. Renata M. Perez, Gastroenterology Department, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil, and Internal Medicine Department, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil, E-mail: renatamperez@gmail.com. Cristiane A. Villela-Nogueira, Internal Medicine Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil, E-mail: crisvillelanog@gmail.com.

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