Aspectos Doppler e elastográficos renal e esplênico na Leishmaniose visceral canina
Data
2020-05-06
Autores
Dadalto, Carmel Rezende [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O diagnóstico da Leishmaniose visceral é complexo, devido à infinidade de sinais clínicos inespecíficos e por vezes os cães apresentam-se assintomáticos por longos períodos de incubação, contribuindo para a disseminação da doença. Com a finalidade de auxiliar o diagnóstico, o presente estudo tem por objetivo descrever alterações ultrassonográficas ao modo B, Doppler e elastográficos em rim e baço de cães soropositivos para LV. Foram avaliados ao exame ultrassonográfico rins de 33 animais naturalmente infectados por LV, sendo as alterações mais relevantes observadas: o aumento da ecogenicidade cortical (75,75%) e a perda da definição corticomedular (27,27%). O índice de resistividade apresentou-se elevado 0,70 e 0,71, para o rim esquerdo e direito, respectivamente. A dimetilarginina simétrica se mostrou elevada em apenas 12 animais. O escore elastográfico observado com maior frequência foi o dois, referente a tecidos de elasticidade intermediária, tendendo a macio. Também foram avaliados 36 baços de animais soropositivos, o sinal mais frequente foi a heterogeneidade do parênquima (77,77%) com áreas micronodulares hipoecogênicas (60,7%) e esplenomegalia (55,5%). O escore elastográfico esplênico mais observado foi o três, referente a tecidos de elasticidade intermediária tendendo a rígido. As alterações renais e esplênicas descritas no estudo devem ser inclusas como diagnóstico diferencial em cães provenientes de áreas endêmicas.
The diagnosis of visceral Leishmaniasis is complex, due to the infinity of nonspecific clinical signs and dogs are often asymptomatic for long incubation periods, which may contribute to the spread of the disease. In order to help early diagnosis, the present study aims to describe sonographic mode B, Doppler and elastographic changes in kidney and spleen of VL seropositive dogs. Kidneys of 33 animals naturally infected with VL were evaluated by ultrasound examination. The most relevant changes were the increase in cortical echogenicity (75.75%) and the loss of corticomedullary definition (27.27%). The resistivity index remained high 0.70 and 0.71 for the left and right kidney respectively. Symmetric dimethylarginine was elevated in only 12 animals. The most frequently observed elastographic score was two, referring to tissues of intermediate elasticity. Thirty-six spleens from seropositive animals were also evaluated, the most frequent sign being parenchymal heterogeneity (77.77%) with hypoechogenic micronodular areas (60.7%), followed by splenomegaly (55.5%), and these changes could appear concomitant or not. The most observed splenic elastographic score was three (47.22%), referring to intermediate elasticity tissues tending to rigid. The renal and splenic changes described in the study should be included as differential diagnosis in dogs from endemic areas.
The diagnosis of visceral Leishmaniasis is complex, due to the infinity of nonspecific clinical signs and dogs are often asymptomatic for long incubation periods, which may contribute to the spread of the disease. In order to help early diagnosis, the present study aims to describe sonographic mode B, Doppler and elastographic changes in kidney and spleen of VL seropositive dogs. Kidneys of 33 animals naturally infected with VL were evaluated by ultrasound examination. The most relevant changes were the increase in cortical echogenicity (75.75%) and the loss of corticomedullary definition (27.27%). The resistivity index remained high 0.70 and 0.71 for the left and right kidney respectively. Symmetric dimethylarginine was elevated in only 12 animals. The most frequently observed elastographic score was two, referring to tissues of intermediate elasticity. Thirty-six spleens from seropositive animals were also evaluated, the most frequent sign being parenchymal heterogeneity (77.77%) with hypoechogenic micronodular areas (60.7%), followed by splenomegaly (55.5%), and these changes could appear concomitant or not. The most observed splenic elastographic score was three (47.22%), referring to intermediate elasticity tissues tending to rigid. The renal and splenic changes described in the study should be included as differential diagnosis in dogs from endemic areas.
Descrição
Palavras-chave
Diagnóstico por imagem, Doença renal, Leishmania, Saúde pública, Zoonose, Imaging diagnosis, Kidney disease, Public health, Zoonosis