Diffusion-weighted MRI and FLAIR sequence for differentiation of hydatid cysts and simple cysts in the liver

Yalçınöz, Kürşad; İkizceli, Türkan; Kahveci, Servet; Karahan, Okan

doi:10.1016/j.ejro.2021.100355

Cited by 2 publications

(1 citation statement)

References 43 publications

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“…Of particular importance is the differential diagnosis with alveolar echinococcosis caused by Echinococcus multilocularis, especially in co-endemic areas, as cystic echinococcosis and alveolar echinococcosis are two very different diseases and dramatic consequences may derive from their inaccurate differentiation [15]. Several studies published in the last decade have explored the usefulness of advanced imaging techniques, including ultrasound elastography, CT, and DW-MRI, for the differential diagnosis of cystic echinococcosis and other lesions; however, results were variable and overall disappointing when coming to clinical usefulness [16][17][18][19][20][21][22][23]. FDG-PET/CT, which has a defined role in alveolar echinococcosis, has been also applied to cystic echinococcosis, with potential usefulness to evaluate the presence of inflammatory complications [24][25][26], but not for evaluation of CE cysts in terms of viability [27].…”

Section: Updates On Imaging Techniques For the Etiological Diagnosis ...mentioning

confidence: 99%

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

Siles‐Lucas

Uchiumi

Tamarozzi

2023

Current Opinion in Infectious Diseases

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Purpose of review In 2010, the WHO-Informal Working Group on Echinococcosis (IWGE) published an Expert Consensus on the diagnosis and treatment of echinococcal infections. We provide an update on the diagnosis of cystic echinococcosis through a scoping review of the literature published after the release of the WHO-IWGE document. Recent findings Ultrasound accurately and reliably depicts the pathognomonic signs of cystic echinococcosis (CE) stages compared with other imaging techniques. Among these, T2-wighted MRI is to be preferred to computed tomography, which has poor performance for the etiological diagnosis of CE. A negative serology cannot exclude the diagnosis of CE, while a positive serology, applied after the visualization of a CE-compatible lesion, may confirm a CE diagnosis. Serology alone must not be used to define ‘CE’ nor as ‘screening’ tool for infection. Other imaging and laboratory techniques did not show clinically applicable performances. Summary In the absence of a focal lesion compatible with a CE cyst, no diagnosis of CE should be attempted. There is urgent need to achieve univocal CE case definitions and consensus diagnostic algorithm, as well as standardization of diagnostic methods and issue of a Target Product Profile of CE diagnostics, as advocated by the WHO in the 2021–2030 roadmap for neglected tropical diseases (NTDs).

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Section: Updates On Imaging Techniques For the Etiological Diagnosis ...mentioning

confidence: 99%

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

Siles‐Lucas

Uchiumi

Tamarozzi

2023

Current Opinion in Infectious Diseases

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The Role of Diffusion-Weighted MRI in Correlation with Contrast-Enhanced MRI and Histopathology in the Evaluation of Focal Liver Lesions

Varigonda,

Yarlagadda,

Chetana Naga Sai

et al. 2024

Cureus

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Introduction: Accurate diagnosis of focal liver lesions is of utmost importance for the initiation of appropriate treatment. This study aims to assess the effectiveness of diffusion-weighted imaging (DWI) in diagnosing focal liver lesions, specifically focusing on differentiating between benign and malignant lesions, distinguishing metastases from primary liver tumors, and identifying various types of both benign and malignant lesions.. Methods: The study design is that of a prospective observational study done on 28 cases with focal liver lesions detected on ultrasound. DWI was done followed by contrast-enhanced MRI (CE-MRI). Identification of the lesion on DWI and apparent diffusion coefficient (ADC) map was made by using the CE-MRI images as a guide. The signal intensity of the lesion on DWI is determined as either diffusion restriction or no restriction. ADC measurements were made quantitatively over various regions of interest (ROIs) of the focal liver lesion. All the lesions were confirmed by histopathological examination (HPE) except few benign lesions like simple cysts and few hemangiomas, which were followed up by ultrasonography after six months. Results: Our study included 28 patients with 44 focal liver lesions. Out of 28 patients in this study group (n=28), there were a total of 17 male and 11 female patients. The mean age of the sample population was 50.89±13.40 years. The lesions were more commonly seen is the age group of 41-60 years (57.14%). Out of 44 lesions (n), 24 (54.5%) lesions were benign , 20 (45.45%) were malignant. There were 17 hemangiomas (38.6%), 2 hematomas (4.5%), 2 simple cysts (4.5%), 1 hydatid cyst (2.27%), 2 hepatic adenomas (4.5%), 16 hepatocellular carcinoma (HCC) (36.36%), 3 cholangiocarcinoma (6.8%), and 1 hepatoblastoma (2.27%). DWI has 85% sensitivity and 84.7% specificity for the differentiation of benign from malignant lesions. The mean ADC value of benign lesions was 1.83x10 -3 mm 2 /s and the mean ADC of malignant liver lesions was 0.96x10 -3 mm 2 /s. In the present study, the average cut off of mean ADC to differentiate benign and malignant bone lesions is 1.3x10 -3 mm 2 /s, with statistically significant p value of 0.001, sensitivity of 95% and specificity of 83.3%. Conclusion: DWI is a valuable imaging technique in the evaluation of focal liver lesions. The ability to differentiate between benign and malignant liver lesions without the need for contrast is a significant benefit, particularly in challenging cases involving uncooperative patients or when contrast administration is contraindicated.

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Diffusion-weighted MRI and FLAIR sequence for differentiation of hydatid cysts and simple cysts in the liver

Abstract: Highlights DWI signal characteristics are useful in differentiating between hydatid cysts and simple cysts. ADC values (b600 and b1000) can distinguish hydatid cyst and simple cyst. FLAIR sequence contributes to the differentiation of type 2 hydatid and simple cysts.

Cited by 2 publications

References 43 publications

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

The Role of Diffusion-Weighted MRI in Correlation with Contrast-Enhanced MRI and Histopathology in the Evaluation of Focal Liver Lesions

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