ABSTRACT

This study was designed to characterize portal hypertension (PH) by assessing cirrhosis, estimating portal vein (PV) width and spleen size, identifying ascites and deciding abnormal collateral routes in hepatosplenic Schistosoma mansoni patients using brightness mode (B-mode) ultrasound (US). A total of 209 adult patients with hepatosplenic Schistosoma mansoni were prospectively recruited from the Gezira state in central Sudan between February 2016 and May 2019. The sonographic features observed include the overall assessment of liver size, PV diameter, gallbladder (GB) wall thickness, splenic size, the lack of or reduced respiratory variations of the splenic vein (SV), collateral circulation and the presence of ascites. The results revealed that a majority of patients were affected with PH due to schistosomiasis infection (94.7%), liver cirrhosis (3.8%) and viral cirrhosis (1.4%). The measures of PV diameter and the lack of or reduced respiratory variations of SV in patients affected with schistosomiasis were statistically significant when compared with the mean value obtained from the healthy adult participants in the control group (p < 0.05). Furthermore, over half of the examined patients presented with portosystemic collaterals. In conclusion, the US findings were highly specific and sufficient to diagnose PH due to schistosomiasis infection.

摘要

这项研究旨在通过评估肝硬化，估计门静脉（PV）宽度和脾脏大小，确定腹水并使用亮度模式（B型）超声（US）在曼氏血吸虫病患者中确定腹水并确定异常的旁支途径来表征门脉高压（PH） 。在2016年2月至2019年5月之间，从苏丹中部的Gezira州共招募了209名成年肝脾曼氏血吸虫成年患者。观察到的超声特征包括对肝脏大小，PV直径，胆囊（GB）壁厚，脾脏脾脏的总体评估大小，脾静脉（SV）呼吸变化的缺乏或减少，侧支循环和腹水的存在。结果显示，大多数患者因血吸虫病感染而感染了PH（94.7％），肝硬化（3.8％）和病毒性肝硬化（1.4％）。与从对照组健康成年参与者获得的平均值相比，血吸虫病患者的PV直径测量值和SV呼吸变化的缺乏或减少具有统计学意义（p <0.05）。此外，超过一半的接受检查的患者出现了门体侧支。总之，美国的发现具有高度的特异性，足以诊断血吸虫病感染引起的PH。超过一半的接受检查的患者出现了门静脉侧支。总之，美国的发现具有高度的特异性，足以诊断血吸虫病感染引起的PH。超过一半的接受检查的患者出现了门静脉侧支。总之，美国的发现具有高度的特异性，足以诊断血吸虫病感染引起的PH。