Imaging diagnostic criteria of hepatic echinococcosis in China

Liu, Wenya; Jiang, Yi; Wang, Jian; Zhang, Tieliang; Xiong, Xingxing; Li, Li; Zhang, Dongliang

doi:10.1016/j.jrid.2020.04.005

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…Therefore, solely relying on ultrasound, CT imaging, and clinical presentations is insu cient for distinguishing CE from AE. MRI and MRCP should be considered as more compelling imaging evidence for differentiation [17,18], particularly for less experienced clinical and radiology practitioners, signi cantly enhancing their ability to distinguish between AE and CE.…”

Section: Discussionmentioning

confidence: 99%

Case report ： A case misdiagnosed as cystic echinococcosis in alveolar echinococcosis

Zhao,

Cai,

Wang

et al. 2024

Preprint

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Background Echinococcosis is one of the most common parasitic diseases among humans and animals worldwide, with the most prominent in the northwest region of China. According to different types of infected larvae, it can be divided into cystic echinococcosis and alveolar echinococcosis. Both types of infected organs are most common in the liver. Here we report a 49 years old female patient with hepatic cystic echinococcosis who was initially misdiagnosed as hepatic cystic echinococcosis (CE1) due to her imaging findings being very similar to those of cystic echinococcosis. After further examination and literature review, we were ultimately diagnosed with hepatic alveolar echinococcosis (P4), which was confirmed by surgery and postoperative pathology. In the article, we use MRI and MRCP as recommendations for distinguishing the two, which can efficiently help us distinguish them and avoid misdiagnosis. Presentation: We report a 49 year old female patient residing in an area with a high incidence of hydatid disease. She was admitted with the chief complaint of "persistent swelling and pain in the upper right abdomen for more than half a month". Prior to admission, the abdominal CT result diagnosed her with hepatic cystic echinococcosis CE1 type, which was a huge liver mass of 13.5cm * 13cm * 14cm. After admission, a comprehensive MRI and MRCP imaging examination was performed, and the results were different from CT. The diagnosis was P4 stage cystic cystic echinococcosis in the right lobe of the liver. Through literature review and general practice discussions, we ultimately diagnosed with P4 type of cystic cystic echinococcosis in the right lobe of the liver, and actively prepared for surgery. Due to the large size of the patient's liver lesion, the risk of surgery was assessed to be high. We first performed percutaneous liver puncture under ultrasound to drain the cystic fluid of the lesion. After the lesion collapsed, we finally performed a right hemihepatectomy. The surgery went smoothly and the patient recovered well, and was discharged as scheduled. After intraoperative and postoperative pathological diagnosis, it was confirmed that our diagnosis and treatment were correct and misdiagnosis was avoided. Conclusion when faced with difficult to distinguish AE and CE, MRI and MRCP may be the best choices to solve the problem, as they can effectively avoid misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Case report ： A case misdiagnosed as cystic echinococcosis in alveolar echinococcosis

Zhao,

Cai,

Wang

et al. 2024

Preprint

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“…CE1, CE2, CE3a and CE3b feature unique ultrasonic characteristics, including the double cystic wall or snowflake sign for CE1, rosette-like or honeycomb-like sign for CE2, water-lily sign for CE3a, complex mass sign for CE3b and so on, easy to diagnose by US. However, the sonographic features of CE4 and CE5 in US are difficult to differentiate from AE [ 18 ]. At these stages, CE4 appears as a coarse variable (hyper or hypo)-echogenic echotexture without daughter vesicles, showing the ball of wool sign.…”

Section: Discussionmentioning

confidence: 99%

Can contrast-enhanced ultrasound differentiate the type of hepatic echinococcosis: cystic echinococcosis or alveolar echinococcosis?

et al. 2023

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Background Hepatic echinococcosis (HE) is a zoonotic disease caused by Echinococcus, and Echinococcus granulosus and E. multilocularis are the most common, causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Contrast-enhanced ultrasound (CEUS) is an imaging technique which has been recommended for identifying focal lesions in the liver. However, the effect of CEUS on the differentiation of hepatic echinococcosis type remains unclear. Methods Twenty-five patients with 46 HE lesions confirmed by histopathology in our hospital from December 2019 to May 2022 were reviewed by conventional ultrasound (US) and CEUS examinations, respectively. After US was completed, the CEUS study was performed. A bolus injection of 1.0–1.2 ml of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue®) was administered. The images and clips of the lesions by US and CEUS were reviewed retrospectively. The lesions detected using US were evaluated including the location, size, morphology, margin, internal echogenicity and the internal Doppler signal. The lesions detected using CEUS were evaluated including the enhancement degree, enhancement pattern and enhancing boundary in different phases. The diagnoses of lesions by US or CEUS were respectively recorded. By taking the histopathology as the gold standard, the paired Chi-square test was performed with statistical software (IBM SPSS; IBM Corp., Armonk, NY, USA), and the results of differentiation of HE type by US and CEUS were statistically analyzed. Results A total of 46 lesions were involved in 25 patients, including 10 males (40.0%) and 15 females (60.0%) aged 15–55 (42.9 ± 10.3) years. By histopathology, 24 lesions of nine patients were diagnosed as CE and 22 lesions of 16 patients were diagnosed as AE. Among the 46 HE lesions, compared with histopathological examination, the accuracy rate was 65.2% and 91.3% in US and CEUS findings, respectively. Among the 24 CE lesions, 13 lesions were correctly differentiated by US, and 23 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, $${\chi }^{2}$$ χ 2 = 8.10, df = 23, P < 0.005). Among the total 46 HE lesions, 30 lesions were correctly differentiated by US, and 42 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, $${\chi }^{2}$$ χ 2 = 10.08, df = 45, P < 0.005). Conclusions CEUS is a more effective technique than US for differentiating the type of HE between CE and AE. It could be a reliable tool in the differentiation of HE.

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“…The patients with echinococcosis were confirmed by postoperative pathology, clinical ultrasound, and enzyme-linked immunosorbent assay (ELISA)/indirect hemagglutination assay (IHA) based on previous literature [ 19 ]. A total of 94 serum samples of echinococcosis patients, 59 cured patients who had taken albendazole and fully recovered confirmed by ultrasound and Em18 protein-based ELISA [ 20 ], and 65 serum samples from healthy volunteers were collected.…”

Section: Methodsmentioning

confidence: 99%

Proteomic profiling of serum extracellular vesicles identifies diagnostic markers for echinococcosis

Guo

Wang²,

Zhang³

et al. 2022

PLoS Negl Trop Dis

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Echinococcosis is a parasitic disease caused by the metacestodes of Echinococcus spp. The disease has a long latent period and is largely underdiagnosed, partially because of the lack of effective early diagnostic approaches. Using liquid chromatography-mass spectrometry, we profiled the serum-derived extracellular vesicles (EVs) of E. multilocularis-infected mice and identified three parasite-origin proteins, thioredoxin peroxidase 1 (TPx-1), transitional endoplasmic reticulum ATPase (TER ATPase), and 14-3-3, being continuously released by the parasites into the sera during the infection via EVs. Using ELISA, both TPx-1 and TER ATPase were shown to have a good performance in diagnosis of experimental murine echinococcosis as early as 10 days post infection and of human echinococcosis compared with that of control. Moreover, TER ATPase and TPx-1 were further demonstrated to be suitable for evaluation of the prognosis of patients with treatment. The present study discovers the potential of TER ATPase and TPx-1 as promising diagnostic candidates for echinococcosis.

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Imaging diagnostic criteria of hepatic echinococcosis in China

Cited by 7 publications

References 27 publications

Case report ： A case misdiagnosed as cystic echinococcosis in alveolar echinococcosis

Case report ： A case misdiagnosed as cystic echinococcosis in alveolar echinococcosis

Can contrast-enhanced ultrasound differentiate the type of hepatic echinococcosis: cystic echinococcosis or alveolar echinococcosis?

Proteomic profiling of serum extracellular vesicles identifies diagnostic markers for echinococcosis

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