Avaliação ultrassonográfica do baço por elastografia em pacientes com Esquistossomose mansoni

• Autor(a) principal: Czapkowski, Adriano [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=8595778; https://repositorio.unifesp.br/handle/11600/59377
• topic: Schistosomiasis Mansoni; Ultrasound Imaging; Elasticity Imaging Techniques; Portal Hypertension; Spleen; Esquistossomose Mansoni; Imagem Por Ultrassom; Técnicas De Imagem Por Elasticidade; Hipertensão Portal; Baço

Objectives: To compare spleen stiffness (SS) by Point Shear Wave Speed Measurement (pSWE) elastography (VTTQ) in patients with splenic hepatic Schistosomiasis Mansoni (SM) in relation to asymptomatic studies and correlated with splenic parenchymal stiffness with indicators of portal hypertension for conventional ultrasound (US) and Doppler velocimetry. Methods: From June 2016 to May 2018, we evaluated patients with hepatosplenic SM and asymptomatic volunteers (AV), correlating the SS of these two groups using the elastography technique that assesses tissue elasticity through point measurement of shear wave velocity (Point Shear Wave Speed Measurement (pSWE) with Acoustic Radiation Force Impulse (ARFI). We correlate the stiffness of the splenic tissue with the degree of hepatic fibrosis classified by Niamey's criteria and the main ultrasound indicators of portal hypertension, as portal and splenic vein diameter, portal vein flow velocity, as well as splenomegaly and siderotic nodules in the spleen. Results: This study included 68 patients. The mean of SS patients was 50.4 ± 10.9 years (age range 31-76 years) and the age of asymptomatic volunteers was 37.6 ± 12.5 years; (age range 24-68 years). Mean spleen stiffness measurements using ARFI elastography were 2.1 m/s in AV patients and 3.5 m/s in SM patients (p <0.0001). There was a correlation between SS and portal vein diameter (r = 0.661), SS and splenic vein diameter (r = 0.722) and SS and splenic index (r = 0.807). Conclusion: Spleen stiffness assessed with ARFI elastography was higher in SM patients compared with AV and can be used as a noninvasive indicator of hypertension portal.