Alfidja A T, Badiane M, Mbaye A, Dial Y, Richter J, Ba Diop S
Service de Radiologie Générale CHU de Fann, BP 5035 Dakar, Sénégal.
J Radiol. 2004 Jun;85(6 Pt 1):763-7. doi: 10.1016/s0221-0363(04)97679-2.
To assess with ultrasound periportal fibrosis due to chronic Schistosoma mansoni infection in children living in an endemic region. Materials and methods. A total of 441 children underwent two stool examinations and abdominal sonography. Liver echotexture was assessed by two observers and compared to pre-defined image patterns and a fibrosis score was assigned ranging from 0 to 8. Ultrasound features were correlated to age, sex, and parasitologic findings.
Prevalence of Schistosoma mansoni infestation was 63%. Two cases of advanced fibrosis (E pattern or fibrosis score of 6) were observed. Fibrosis correlated with age. No correlation existed between fibrosis and intensity of egg-output. A correlation between the two examinors was noted in 84% of examinations with a kappa coefficient of 0.7.
Although severe periportal fibrosis is a rare finding in this endemic region, follow-up sonography must be performed because it is the only non invasive and reliable tool for detection of periportal fibrosis.
评估生活在血吸虫病流行地区的儿童因慢性曼氏血吸虫感染所致的门静脉周围纤维化情况。材料与方法。共有441名儿童接受了两次粪便检查及腹部超声检查。两名观察者对肝脏回声质地进行评估,并与预先定义的图像模式进行比较,同时给出0至8分的纤维化评分。超声特征与年龄、性别及寄生虫学检查结果相关。
曼氏血吸虫感染率为63%。观察到2例晚期纤维化(E型或纤维化评分为6分)。纤维化与年龄相关。纤维化与虫卵排出强度之间无相关性。在84%的检查中,两名检查者之间存在相关性,kappa系数为0.7。
尽管在该流行地区严重的门静脉周围纤维化较为罕见,但必须进行超声随访检查,因为这是检测门静脉周围纤维化的唯一非侵入性且可靠的工具。