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Differentiating Cirrhosis and Chronic Hepatosplenic Schistosomiasis Using MRI

Alexandre Sérgio de Araújo Bezerra1, Giuseppe D'Ippolito1, Rogério P. Caldana1, Denise D. Leopoldino2, Giovani R. Batista2, Durval R. Borges3, Gaspar de Jesus Lopes Filho4 and Muneeb Ahmed5

1 Department of Diagnostic Imaging, Federal University of São Paulo, Rua Napoleão de Barros 800, São Paulo, SP 04024-002, Brazil.
2 The SARAH Network of Hospitals for Reabilitation, Brasília, Brazil.
3 Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
4 Department of Surgery, Federal University of São Paulo, São Paulo, Brazil.
5 Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA.


Figure 1
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  		Fig. 1A —29-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 2
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  		Fig. 1B —29-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 3
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  		Fig. 1C —29-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 4
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  		Fig. 2A —57-year-old woman with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres (arrow), and splenic siderotic nodules. Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image with fat suppression (1,800/90) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 5
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  		Fig. 2B —57-year-old woman with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres (arrow), and splenic siderotic nodules. Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image with fat suppression (1,800/90) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 6
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  		Fig. 2C —57-year-old woman with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres (arrow), and splenic siderotic nodules. Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image with fat suppression (1,800/90) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 7
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  		Fig. 3A —35-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 8
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  		Fig. 3B —35-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 9
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  		Fig. 3C —35-year-old man with schistosomiasis presenting with irregularity of hepatic contours, widening of ligamentum teres, and splenic siderotic nodules (arrow). Note absence of signal in nodules on T1-weighted turbo field-echo (TFE) in-phase image (TR/TE, 15/4.8) (A), T2-weighted turbo spin-echo image (1,800/160) (B), and contrast-enhanced T1-weighted TFE image (15/4.6) (C).

 

Figure 10
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  		Fig. 4 —Receiver operating characteristic (ROC) curve derived shows sensitivity and false-positive rate (1–specificity) for diagnosis of schistosomiasis. Dotted line represents curve for test that is no better than chance. Continuous line represents data obtained from study data. Area under ROC curve was 0.921.

 

Figure 11
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  		Fig. 5 —Graph shows percentage of cirrhotic patients according to caudate lobe–right lobe ratio.

 

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