Alveolar Echinococcosis: Spectrum of Findings at Cross-sectional Imaging

Kantarcı, Mecit; Bayraktutan, Ummugulsum; Karabulut, Nevzat; Aydınlı, Bülent; Oğul, Hayri; Yuce, Ihsan; Çalık, Muhammet; Eren, Suat; Atamanalp, Sabri Selçuk; Oto, Aytekin

doi:10.1148/rg.327125708

Cited by 140 publications

(151 citation statements)

References 48 publications

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“…If the lesion is confined, radical surgery offers cure, combined with benzimidazoles. Liver transplantation may be the last option when parasitic liver mass does not respond to chemotherapy and the lesion is unresectable (49).…”

Section: Perfusion Imaging In Cholangiocarcinomamentioning

confidence: 99%

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Perfusion CT imaging of the liver: review of clinical applications

Oğul

Kantarcı²,

Genç³

et al. 2014

Diagn Interv Radiol

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Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemotherapy, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. The advent of multidetector CT has given rise to the acquisition of images with higher quality and accuracy. Multidetector CT has been developed as a noninvasive imaging modality for evaluation of vascular anatomy. It has also made it possible to perform CT angiography of the hepatic vessels. New generation CT systems with multidetector are capable of performing volumetric imaging. These systems provide a single rotational acquisition and almost the whole upper abdomen can be appraised by means of serial rotational acquisitions at a single location in the z-direction. Multidetector CT imaging is used extensively for the preoperative selection of living related liver donors, as well as evaluation of the vascular anatomy of the recipients (1). This imaging technique is also used for the initial evaluation and follow-up of most patients with hepatic metastases, providing valuable information about the number, size, and distribution of hepatic metastases and the presence and extent of extrahepatic disease (1).Perfusion CT imaging permits the qualitative and quantitative assessment of liver perfusion. In perfusion CT, a quantitative tissue perfusion map is obtained from dynamic CT data and displayed using a color scale permitting the quantification of tissue perfusion in absolute units at high spatial resolution (2). Perfusion CT efficiently locates abnormal tissue perfusion which is difficult to detect accurately with conventional CT (3). Functional assessment of the perfusion of normal and pathologic tissues is performed by means of quantitative or semiquantitative parameters, such as blood flow (BF), blood volume (BV), mean transit time (MTT), portal liver perfusion (PLP), arterial liver perfusion (ALP) and hepatic perfusion index (HPI). Perfusion CT measures the temporal changes in tissue density through a series of dynamically acquired CT images after intravenous injection of an iodinated contrast material (4, 5). Perfusion CT may be performed quickly and provide valuable data for diagnosis. However, there are some limitations of this method such as long breath-holding for portal flow measurement, separation of arterial and portal blood flow, additional radiation exposure, limited craniocaudal scan range, and standardization of analytic methods (2). In this a...

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Section: Perfusion Imaging In Cholangiocarcinomamentioning

confidence: 99%

“…It is difficult to evaluate the clear border and microvessel perfusion of the parasitic mass by US. In addition, US is limited to detecting alveolar echinococcus lesions with dense and extensive calcifications (49). On MRI, parasitic liver masses may be confused with metastases and liver malignancies.…”

Section: Perfusion Imaging In Cholangiocarcinomamentioning

confidence: 99%

Perfusion CT imaging of the liver: review of clinical applications

Oğul

Kantarcı²,

Genç³

et al. 2014

Diagn Interv Radiol

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“…In case of pulmonary AE, hemoptysis, chest pain, cough with expectoration, and exertional dyspnea can be also seen. [12] Hydoptysis is very typical for the lung involvement, and immediate examination is required in these patients.. However, pulmonary AE can be usually asymptomatic for about 10 to 15 years, [13] And can be detected incidentally during radiological examination.…”

Section: Discussionmentioning

confidence: 99%

Treatment approach for pulmonary alveolar echinococcosis

Aydın¹,

Altuntas²,

Oğul³

et al. 2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada kliniğimizde tedavi edilen pulmoner alveolar ekinokok olguları sunuldu. Ça lış ma pla nı: Bu tek merkezli, retrospektif çalışmaya Ocak 2008 -Mayıs 2015 tarihleri arasında pulmoner alveoler ekinokok tanısı konmuş 12 hasta (6 erkek, 6 kadın; ort. yaş 49.2 yıl; dağılım 25-68 yıl) dahil edildi. Hastaların yaşı ve cinsiyeti, kistin yeri, sayısı ve büyüklüğü ve akciğerler dışında diğer organlara yayılımına ilişkin veriler kaydedildi. Bul gu lar: Hastaların sekizinde iki taraflı yaygın metastatik lezyonlar, diğerlerinde soliter veya birkaç pulmoner lezyon vardı. Bir hastada sağ alt lobta endobronşiyal lezyon, birinde sağ akciğerde kistik lezyon ve sol akciğerde üç lezyon, birinde komşuluk yoluyla akciğer invazyonu ve birinde sağ alt lobta endobronşiyal lezyon izlendi. Sağ akciğerde soliter pulmoner nodülü olan hastaya ilk olarak kama rezeksiyon ve ardından karaciğer nakli yapıldı. Komşuluk yoluyla akciğer invazyonu olan hastaya eş zamanlı olarak karaciğer nakli, akciğer kama rezeksiyonu ve diyafragma rezeksiyonu/rekonstrüksiyonu uygulandı. Sağ akciğerde bir, sol akciğerde üç adet kistik lezyonu olan hastaya bir ay arayla iki taraflı torakoskopik kama rezeksiyonu uygulandı ve karaciğer rezeksiyonu planlandı. Ameliyat edilen hastaların hiçbirinde nüks gözlenmedi. So nuç: Dikkatlice seçilmiş pulmoner alveoler ekinokok hastalarında cerrahi tedavi uygulanabilir. Cerrahi kararı lezyonun yaygınlığına, karaciğer fonksiyonlarına ve hastanın genel durumuna göre değerlendirilmelidir.Anah tarsöz cük ler: Alveoler ekinokok; akciğer; tedavi; cerrahi. ABSTRACTBackground:In this study, we present cases with pulmonary alveolar echinococcosis who were treated in our clinic. Methods: This single-center, retrospective study included 12 patients (6 males, 6 females; mean age 49.2 years; range 25 to 68 years) diagnosed with pulmonary alveolar echinococcosis between January 2008 and May 2015. Data including age and gender of the patients, the location, number, and size of the cyst, and spread to other organs outside the lungs were recorded. Results:Of the patients, eight had bilateral diffuse metastatic lesions, while the others had solitary or a few pulmonary lesions. One patient had an endobronchial lesion in the right lower lobe, one had a cystic lesion in the right lung and three lesions in the left lung, one had pulmonary invasion through neighborhood, and one had an endobronchial lesion in the right lower lobe. Initially, wedge resection was applied to the patient who had a solitary pulmonary nodule in the right lung and, then, liver transplantation was performed. Liver transplantation, wedge resection of the lung, and diaphragm resection/reconstruction were simultaneously applied in the patient who had pulmonary invasion through neighborhood. Bilateral thoracoscopic wedge resection with one-month interval was applied in the patient with cystic lesions, one in the right and three in the left lung, and liver resection was planned. Recurrence was not observed in any patients operated. Conclusion:Surgical treatment ca...

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“…Metastasis to the lung occurs relatively frequently and is observed in 7-20% of patients [6][7][8]. The clinical symptoms of pulmonary AE are hemoptysis, chest pain, cough with expectoration, and exertional dyspnea.…”

Section: Discussionmentioning

confidence: 99%

“…Brain metastasis is considered as a sign of the terminal phase of AE and has been reported in only 1-3% of patients with the disease [7]. Increased intracranial pressure, epilepsy, skull deformity, and cranial nerve palsies have been reported [8].…”

Section: Discussionmentioning

confidence: 99%