Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12392
Peer-review started: April 15, 2015
First decision: June 2, 2015
Revised: June 19, 2015
Accepted: September 13, 2015
Article in press: September 14, 2015
Published online: November 21, 2015
AIM: To establish an ultrasonographic classification based on a large sample of patients with confirmed hepatic alveolar echinococcosis (AE).
METHODS: Clinical data and ultrasonography (US) findings of 185 patients (100 males; 85 females; mean age at diagnosis: 51.4 ± 17.6 years; mean age at time of US examination: 58.7 ± 18.2 years) were retrospectively reviewed with respect to the US morphology of hepatic AE lesions. The sonomorphological findings were grouped according to a five-part classification scheme.
RESULTS: Application of the new classification resulted in the following distribution of sonomorphological patterns among the patients examined: hailstorm (54.1%); pseudocystic (13.5%); ossification (13.0%); hemangioma-like (8.1%); and metastasis-like (6.5%). Only 4.9% of lesions could not be assigned to a sonomorphological pattern.
CONCLUSION: The sonomorphological classification proposed in the present study facilitates the diagnosis, interpretation and comparison of hepatic alveolar echinococcosis in routine practice and in the context of scientific studies.
Core tip: Alveolar echinococcosis (AE) is a rare but potentially life-threatening parasitic disease. Despite the importance of ultrasonography as an imaging modality in the work-up of hepatic AE, there is no established sonomorphological classification of hepatic AE lesions analogous to the World Health Organization’s ultrasonographic classification for cystic echinococcosis. Objective of the present study was to establish an ultrasonographic classification based on a large sample of patients with confirmed hepatic AE. Assignment of hepatic AE lesions to one of the five sonomorphological patterns was successful in 95% of cases based on the ultrasonographic classification scheme proposed in the present study.