Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2020; 26(29): 4302-4315
Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4302
Evaluation of intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis
Tilmann Graeter, Hai-Hua Bao, Rong Shi, Wen-Ya Liu, Wei-Xia Li, Yi Jiang, Julian Schmidberger, Eleonore Brumpt, Eric Delabrousse, Wolfgang Kratzer, the XUUB Consortium
Tilmann Graeter, Rong Shi, Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm 89081, Germany
Hai-Hua Bao, Wei-Xia Li, Qinghai University, Qinghai University First Affiliated Hospital, Xining 810001, Qinghai Province, China
Wen-Ya Liu, Yi Jiang, Xinjiang Medical University, First Affiliated Hospital, WHO Collaborating Centre on Prevention and Care Management of Echinococcosis, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China
Julian Schmidberger, Wolfgang Kratzer, Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
Eleonore Brumpt, Eric Delabrousse, WHO Collaborating Centre on Prevention and Treatment of Human Echinococcosis/National French Reference Centre for Echinococcosis, University Bourgogne Franche-Comté and Besançon University Hospital, Besançon 25030, France
Author contributions: The plan for this manuscript was developed during a personal XUUB meeting of the authors; the data were evaluated by the authors at a meeting in Besançon; all authors were involved in the interpretation of the results; Graeter T and Bao HH contributed equally to this work; Graeter T, Bao HH, Kratzer W, Delabrousse E and Liu WY prepared the first draft; the statistical analysis was performed by Schmidberger J, Brumpt E, Shi R, Li WX and Jiang Y; all partners read, amended, and approved the final version of the manuscript.
Supported by a German Research Foundation funded project called “ Establishment of a national database for alveolar echinococcosis” , No. KA 4356/3-1;“Implementation of interfaces for the standardization of national database systems for alveolar echinococcosis and its transformation processes” , No. KR 5204/1-2; Multiple imaging study of the Hepatic Alveolar Echinococcosis after albendazole treatment, the Qinghai Science and Technology Department, No. 2017-SF-158; and the Müller Holding Ltd. and Co. KG Ulm.
Institutional review board statement: The study was approved by the local ethics committee and conducted in accordance with the Declaration of Helsinki (ref. No. 409/15). Because of its retrospective design and pseudonymized evaluation of imaging, no ethics approval was necessary for France and China. All data were analyzed anonymously.
Informed consent statement: Because of the retrospective and anonymous character of this study the need for informed consent was waived by the institutional review board.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wolfgang Kratzer, MD, Professor, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89081, Germany.
Received: April 3, 2020
Peer-review started: April 3, 2020
First decision: May 26, 2020
Revised: June 9, 2020
Accepted: July 23, 2020
Article in press: July 23, 2020
Published online: August 7, 2020
Core Tip

Core tip: This study demonstrates for the first time how different computed tomography morphological types of liver lesions in alveolar echinococcosis (AE) affect the intrahepatic involvement pattern as well as distant extrahepatic disease manifestations. The disease shows different characteristics in an intercontinental comparison between Europe and China. These results may provide information about the behavior of this disease during its initial manifestation and its progression. A morphological classification of AE liver lesions seems therefore not only useful in order to facilitate the initial differential diagnosis but also indicates a direct clinical impact.