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Šufliarska Z, Tóth Š, Gentil M, Humeník F. Alveolar Echinococcosis in 11-Month-Old Dog-Clinical Case. Pathogens 2025; 14:450. [PMID: 40430770 PMCID: PMC12114745 DOI: 10.3390/pathogens14050450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2025] [Revised: 04/19/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025] Open
Abstract
In the present work, we describe the clinical-pathological case of an 11-month-old Border Collie dog, which was presented by its owner to a private veterinary clinic for the purpose of determining the diagnosis and subsequent therapy. The owner reports anamnestic data of abdominal enlargement, persistent apathy, fatigue, and vomiting. A complete examination of the patient was performed, consisting of clinical, hematological, and biochemical blood tests, X-ray, and USG examinations. Based on the findings, a probatory laparotomy was indicated, during which a large multi-lobular cystic irregular mass was detected, affecting the entire liver parenchyma, including macroscopic metastatic foci of the omentum and diaphragm. Due to the inoperable finding, the patient was humanely euthanized during the surgical procedure. Subsequently, an autopsy was performed with the collection of samples for histopathological and PCR examination of the tissue. Serological examination was also performed. The results confirmed a rare generalized form of alveococcosis (Echinococcus multilocularis) in the dog as an intermediate host.
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Affiliation(s)
- Zuzana Šufliarska
- PET Point Veterinary Clinic, 984 01 Lučenec, Slovakia
- Department of Morphological Science, University of Veterinary Medicine and Pharmacy in Košice, 041 81 Košice, Slovakia
| | - Štefan Tóth
- Department of Histology and Embryology, University of Pavol Jozef Šafárik, 041 80 Košice, Slovakia
| | - Michaela Gentil
- Laboklin GmbH & Co. KG, Steubenstr. 4, 97688 Bad Kissingen, Germany
| | - Filip Humeník
- Department of Morphological Science, University of Veterinary Medicine and Pharmacy in Košice, 041 81 Košice, Slovakia
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Gou Z, Yan H, Yu B, Xie X, Xiang B, Liu J, Luo Y. Case Report: Differentiating hepatic desmoplastic small round cell tumor from hydatidosis in a school-aged boy: the role of contrast-enhanced and interventional ultrasound. Front Oncol 2025; 15:1493237. [PMID: 40182042 PMCID: PMC11966410 DOI: 10.3389/fonc.2025.1493237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 02/26/2025] [Indexed: 04/05/2025] Open
Abstract
Background Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive malignant neoplasm, typically associated with poor prognosis. It predominantly affects adolescents and young males, with a lower incidence in pediatric populations. Due to its rarity, our understanding of DSRCT remains limited, with only a small number of case reports available. The clinical presentation is often non-specific and varies depending on the extent of tumor invasion. Diagnosis relies primarily on histopathological evaluation through biopsy. Although imaging studies contribute to the diagnostic process, they often lack specificity. Nonetheless, certain imaging features can aid in refining differential diagnoses and assessing disease severity. Moreover, minimally invasive, image-guided tissue sampling plays a critical role in confirming the diagnosis through pathological analysis. Case presentation A 7-year-old boy presented with abdominal distension and anorexia, without significant abdominal pain, fever, or jaundice. Physical examination revealed abdominal enlargement with hepatosplenomegaly. Laboratory tests showed abnormal liver function (AST 128 U/L, ALP 648 U/L, GGT 885 U/L) and an elevated CA-125 level (170 U/ml). An abdominal CT scan performed at a local hospital identified multiple round, low-density lesions in the liver, suggestive of echinococcosis. The patient was initially diagnosed with suspected echinococcosis and started on albendazole; however, his symptoms did not improve. Upon further evaluation at our institution, ultrasound imaging revealed multiple thick-walled, hyperechoic lesions in the liver with no significant blood flow signals. Contrast-enhanced ultrasound demonstrated that the solid components of the lesion exhibited significant enhancement during the early arterial phase, with rapid attenuation during the early portal venous phase. A metastatic malignant tumor was suspected, prompting a percutaneous biopsy under real-time enhanced ultrasound guidance. Histopathological examination revealed small round tumor cells infiltrating adjacent tissues. Fluorescence in situ hybridization (FISH) confirmed the diagnosis of DSRCT, based on the presence of an EWSR1-WT1 rearrangement. The patient subsequently underwent multimodal treatment, including chemotherapy and radiation therapy, and achieved disease-free survival at the six-month follow-up. Conclusions Traditional ultrasound is a convenient, real-time, non-invasive, and radiation-free diagnostic tool, making it particularly well-suited for the diagnosis, screening, and clinical follow-up of focal liver lesions (FLLs) in pediatric patients. This modality enables real-time evaluation of the number, size, location, and morphology of FLLs while assisting in the differential diagnosis. Moreover, it facilitates the assessment of liver parenchyma involvement and portal vein structures. Color Doppler imaging provides valuable insights into the vascular characteristics of tumors, while contrast-enhanced ultrasound (CEUS) agents allow for real-time observation of dynamic tumor perfusion patterns, further refining differential diagnoses based on perfusion characteristics. Compared to the contrast agents used in CT or MRI-which may require sedation or carry risks of renal injury due to radiation exposure-ultrasound microbubble contrast agents are excreted via respiration and do not require sedation, making them especially suitable for pediatric patients. Additionally, ultrasound-guided biopsy is a well-established and reliable method for diagnosing liver lesions. However, the presence of extensive necrosis and the use of fine-needle biopsy can sometimes limit diagnostic accuracy. Incorporating CEUS before or during percutaneous biopsy can help optimize sampling site selection, thereby reducing the likelihood of false-negative results.
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Affiliation(s)
- Zehui Gou
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Hualin Yan
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Boyang Yu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolong Xie
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Xiang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Juxian Liu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Ogul H, Aydin Y, Sakci Z. Simultaneous pachymeningeal and cerebral parenchymal involvement by alveolar echinococcosis. Intern Emerg Med 2025; 20:619-620. [PMID: 39361222 DOI: 10.1007/s11739-024-03784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 09/24/2024] [Indexed: 03/28/2025]
Affiliation(s)
- Hayri Ogul
- Department of Radiology, Medical Faculty, Istanbul Medipol University, Istanbul, Turkey.
| | - Yener Aydin
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Zakir Sakci
- Department of Radiology, Umraniye Training and Research Hospital, Istanbul, Turkey
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Liu H, Xie Y, An X, Xu D, Cai S, Chu C, Liu G. Advances in Novel Diagnostic Techniques for Alveolar Echinococcosis. Diagnostics (Basel) 2025; 15:585. [PMID: 40075832 PMCID: PMC11898896 DOI: 10.3390/diagnostics15050585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 02/10/2025] [Accepted: 02/24/2025] [Indexed: 03/14/2025] Open
Abstract
Alveolar echinococcosis (AE), caused by the larval stage of the tapeworm Echinococcus multilocularis, is a serious parasitic disease that presents significant health risks and challenges for both patients and healthcare systems. Accurate and timely diagnosis is essential for effective management and improved patient outcomes. This review summarizes the latest diagnostic methods for AE, focusing on serological tests and imaging techniques such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT). Each imaging modality has its strengths and limitations in detecting and characterizing AE lesions, such as their location, size, and invasiveness. US is often the first-line method due to its non-invasiveness and cost-effectiveness, but it may have limitations in assessing complex lesions. CT provides detailed anatomical information and is particularly useful for assessing bone involvement and calcification. MRI, with its excellent soft tissue contrast, is superior for delineating the extent of AE lesions and their relationship to adjacent structures. PET/CT combines functional and morphological imaging to provide insights into the metabolic activity of lesions, which is valuable for monitoring treatment response and detecting recurrence. Overall, this review emphasizes the importance of a multifaceted diagnostic approach that combines serological and imaging techniques for accurate and early AE diagnosis, which is crucial for effective management and improved patient outcomes.
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Affiliation(s)
- Huanhuan Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
- Department of Nuclear Medicine, School of Public Health, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610051, China
| | - Yijia Xie
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xiaoyu An
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Dazhuang Xu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Shundong Cai
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Chengchao Chu
- Xiamen University Affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Gang Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
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Tao Y, Kong H, Li J, Tan Z, Wang J, Luo Y. Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children. Front Pediatr 2025; 13:1458649. [PMID: 39936126 PMCID: PMC11810965 DOI: 10.3389/fped.2025.1458649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 01/15/2025] [Indexed: 02/13/2025] Open
Abstract
Introduction The prevalence of hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) is notably high among children in western China, with the mortality rate for untreated children potentially reaching up to 90%. Meanwhile, hepatoblastoma is the most common malignant liver tumor in children, yet its treatment differs significantly from that of hepatic echinococcosis. This study aimed to compare and analyze the ultrasonographic and contrast-enhanced ultrasound (CEUS) characteristics of hepatic CE, AE, and hepatoblastoma in children, providing more imaging evidence for accurate clinical diagnosis. Methods A retrospective analysis was conducted on preoperative data from children with pathologically confirmed hepatic echinococcosis in our hospital between 2012 and 2024. Furthermore, children consecutively diagnosed with hepatoblastoma between 2020 and 2024, confirmed by histopathological examination, were selected as the control group. Clinical data, conventional ultrasound images, and CEUS characteristics of hepatic echinococcosis and hepatoblastoma were analyzed and compared. Results The mean ages of 22 children with hepatic CE and nine children with hepatic AE were 11.6 ± 2.8 years and 11.8 ± 3.6 years, respectively. The mean age of 36 children with hepatoblastoma was 2.9 ± 3.0 years. Significant differences were observed in age and history of residence or travel to endemic areas among children with hepatic echinococcosis and hepatoblastoma (P < 0.001). Hepatic CE and hepatoblastoma showed a higher proportion of cystic degeneration [≥50% (54.5%, 12/22), and between 0% and <50% (47.2%, 17/36, respectively)], while hepatic AE predominantly showed no cystic degeneration (88.9%, 8/9). Clear boundaries were most commonly seen in hepatic CE lesions (95.5%, 21/22), while unclear boundaries were more frequent in hepatic AE lesions (88.9%, 8/9) (P < 0.05). Calcification was more prevalent in hepatic AE compared to hepatic CE and hepatoblastoma (P < 0.05). Hepatoblastoma exhibited richer color Doppler signals (94.4%, 34/36) compared to hepatic CE and AE (P < 0.05). CEUS was performed on two hepatic echinococcosis and nine hepatoblastoma lesions. On CEUS, one hepatic AE lesion showed peripheral hyperenhancement in the arterial phase, while one hepatic CE lesion showed no significant enhancement. In hepatoblastoma, nine lesions demonstrated hyperenhancement in the arterial phase and hypoenhancement in the late phase. Conclusion This study demonstrates the value of ultrasound in differentiating hepatic echinococcosis from hepatoblastoma in children. Hepatic CE typically manifests as a well-defined cystic or cystic-solid mass, while hepatic AE often presents as an ill-defined cystic-solid or solid mass with diffuse calcifications. Conversely, hepatoblastoma appears as a partially well-defined cystic-solid or solid mass with abundant color Doppler signals within and around the lesion.
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Affiliation(s)
- Yi Tao
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hanqing Kong
- Department of Medical Ultrasound, Shandong Provincial Hospital Heze Hospital, Heze, Shandong, China
| | - Jiawu Li
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zhizhi Tan
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jun Wang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yan Luo
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Tao Y, Wang YF, Wang J, Long S, Seyler BC, Zhong XF, Lu Q. Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis. World J Gastroenterol 2024; 30:4115-4131. [PMID: 39474399 PMCID: PMC11514533 DOI: 10.3748/wjg.v30.i37.4115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/26/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Echinococcosis is a zoonotic disease caused by parasites belonging to the genus Echinococcus that primarily affect the liver. The western plateau and pastoral areas of China are high-risk regions for hepatic cystic echinococcosis and hepatic alveolar echinococcosis (HAE). The high late mortality rate associated with HAE underscores the critical need for early diagnosis to improve cure rates and mitigate the disease burden in endemic areas. Currently, the World Health Organization recommends ultrasonography as the preferred initial screening method for hepatic echinococcosis. However, distinguishing between specific types of lesions, such as those of hepatic cystic echinococcosis and HAE, and other focal liver lesions is challenging. To address this issue, contrast-enhanced ultrasound is recommended as a tool to differentiate solid and cysto-solid hepatic echinococcosis from other focal liver lesions, significantly enhancing diagnostic accuracy. In this comprehensive review, we discuss the progression of hepatic echinococcosis and detail the imaging features of various types of echinococcosis using conventional, contrast-enhanced, and intraoperative ultrasound techniques. Our objective is to provide robust imaging evidence and guidance for early diagnosis, clinical decision making, and postoperative follow-up in regions with high disease prevalence.
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Affiliation(s)
- Yi Tao
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Fei Wang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jun Wang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Shuang Long
- Department of Radiology, Gaoping District People’s Hospital, Nanchong 637100, Sichuan Province, China
| | - Barnabas C Seyler
- Shude International, Chengdu Shude High School, Chengdu 610066, Sichuan Province, China
- Department of Environment, Sichuan University, Chengdu 610065, Sichuan Province, China
| | - Xiao-Fei Zhong
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Lu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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Aydin S, Irgul B, Memis KB, Kızılgoz V, Kantarci M. Characteristics of the imaging diagnosis of alveolar echinococcosis. World J Gastrointest Surg 2024; 16:2748-2754. [PMID: 39351560 PMCID: PMC11438814 DOI: 10.4240/wjgs.v16.i9.2748] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/06/2024] [Accepted: 06/24/2024] [Indexed: 09/18/2024] Open
Abstract
Alveolar echinococcosis (AE) primarily manifests in the liver and exhibits characteristics resembling those of slow-growing malignant tumours. Untreated Echinococcus multilocularis infection can be lethal. By infiltrating the vascular systems, biliary tracts, and the hilum of the liver, it might lead to various problems. Due to its ability to infiltrate neighbouring tissues or metastasize to distant organs, AE can often be mistaken for malignancies. We present a concise overview of the epidemiological and pathophysiological characteristics of AE, as well as the clinical manifestations of the disease. This article primarily examines the imaging characteristics of AE using various imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging, diffusion-weighted imaging, and virtual non-enhanced dual-energy CT. We additionally examined the contribution of radiography in the diagnosis, treatment, and monitoring of the condition.
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Affiliation(s)
- Sonay Aydin
- Department of Radiology, Erzincan Binali Yıldırım University, Faculty of Medicine, Erzincan 24100, Türkiye
| | - Baris Irgul
- Department of Radiology, Erzincan Binali Yıldırım University, Faculty of Medicine, Erzincan 24100, Türkiye
| | - Kemal Bugra Memis
- Department of Radiology, Erzincan Binali Yıldırım University, Faculty of Medicine, Erzincan 24100, Türkiye
| | - Volkan Kızılgoz
- Department of Radiology, Erzincan Binali Yıldırım University, Faculty of Medicine, Erzincan 24100, Türkiye
| | - Mecit Kantarci
- Department of Radiology, Erzurum Ataturk University, Erzurum 25000, Türkiye
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Nijiati M, Tuerdi M, Damola M, Yimit Y, Yang J, Abulaiti A, Mutailifu A, Aihait D, Wang Y, Zou X. A deep learning radiomics model based on CT images for predicting the biological activity of hepatic cystic echinococcosis. Front Physiol 2024; 15:1426468. [PMID: 39175611 PMCID: PMC11338923 DOI: 10.3389/fphys.2024.1426468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction: Hepatic cystic echinococcosis (HCE) is a widely seen parasitic infection. Biological activity is crucial for treatment planning. This work aims to explore the potential applications of a deep learning radiomics (DLR) model, based on CT images, in predicting the biological activity grading of hepatic cystic echinococcosis. Methods: A retrospective analysis of 160 patients with hepatic echinococcosis was performed (127 and 33 in training and validation sets). Volume of interests (VOIs) were drawn, and radiomics features and deep neural network features were extracted. Feature selection was performed on the training set, and radiomics score (Rad Score) and deep learning score (Deep Score) were calculated. Seven diagnostics models (based on logistic regression algorithm) for the biological activity grading were constructed using the selected radiomics features and two deep model features respectively. All models were evaluated using the receiver operating characteristic curve, and the area under the curve (AUC) was calculated. A nomogram was constructed using the combined model, and its calibration, discriminatory ability, and clinical utility were assessed. Results: 12, 6 and 10 optimal radiomics features, deep learning features were selected from two deep learning network (DLN) features, respectively. For biological activity grading of hepatic cystic echinococcosis, the combined model demonstrated strong diagnostic performance, with an AUC value of 0.888 (95% CI: 0.837-0.936) in the training set and 0.876 (0.761-0.964) in the validation set. The clinical decision analysis curve indicated promising results, while the calibration curve revealed that the nomogram's prediction result was highly compatible with the actual result. Conclusion: The DLR model can be used for predicting the biological activity grading of hepatic echinococcosis.
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Affiliation(s)
- Mayidili Nijiati
- Department of Radiology, The Fourth Affiliated Hospital of Xinjiang Medical UniversityÜrümqi, Xinjiang, China
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
| | - Mireayi Tuerdi
- Department of Infectious Diseases, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Maihemitijiang Damola
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Yasen Yimit
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Jing Yang
- Huiying Medical Imaging Technology, The Fourth Affiliated Hospital of Xinjiang Medical University, Beijing, China
| | - Adilijiang Abulaiti
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | | | - Diliaremu Aihait
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Yunling Wang
- Department of Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Xiaoguang Zou
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
- Clinical Medical Research Center, The First People’s Hospital of Kashi Prefecture, Kashi, China
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Shen Z, Wang Y, Chen X, Chou S, Wang G, Wang Y, Xu X, Liu J, Wang R. Clinical value of the semi-quantitative parameters of 18F-fluorodeoxyglucose PET/CT in the classification of hepatic echinococcosis in the Qinghai Tibetan area of China. BMC Med Imaging 2024; 24:194. [PMID: 39085759 PMCID: PMC11289940 DOI: 10.1186/s12880-024-01371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 07/18/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND To investigate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) semi-quantitative parameters, including the lesion diameter, maximum standardized uptake value (SUVmax), maximum standardized uptake value corrected for lean body mass (SULmax), metabolic lesion volume (MLV), and total lesion glycolysis (TLG), for classifying hepatic echinococcosis. METHODS In total, 20 patients with 36 hepatic echinococcosis lesions were included in the study. Overall, these lesions were categorized as hepatic cystic echinococcosis (HCE) or hepatic alveolar echinococcosis (HAE) according to the pathological results. Multiple semi-parameters including the maximum diameter, SUVmax, SULmax, MLV, and TLG were measured to classify HCE and HAE compared with the pathological results. The receiver operator characteristic curve and area under the curve (AUC) of each quantitative parameter were calculated. The Mann-Whitney U test was used to compare data between the two groups. RESULTS In total, 12 cystic lesions and 24 alveolar lesions were identified after surgery. There were significant differences in SUV max, SUL max, MLV, and TLG between the HAE and HCE groups (Z = - 4.70, - 4.77, - 3.36, and - 4.23, respectively, all P < 0.05). There was no significant difference in the maximum lesion diameter between the two groups (Z = - 0.77, P > 0.05). The best cutoffs of SUV max, SUL max, MLV, and TLG for the differential diagnosis of HAE and HCE were 2.09, 2.67, 27.12, and 18.79, respectively. The AUCs of the four parameters were 0.99, 0.99, 0.85, and 0.94, respectively. The sensitivities were 91.7%, 87.5%, 66.7%, and 85.6%, respectively, and the specificities were 90.1%, 91.7%, 83.3%, and 90.9%, respectively. CONCLUSION 18F-FDG PET/CT semi-quantitative parameters had significant clinical value in the diagnosis and pathological classification of hepatic echinococcosis and evaluation of clinical treatment.
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Affiliation(s)
- Zhihui Shen
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yuan Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Xin Chen
- Department of Pathology, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Sai Chou
- Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Guanyun Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yong Wang
- Department of Nuclear Medicine, The Fifth Medical Center, Chinese PLA General Hospital, No. 8, Dongdajie Street, Fengtai District, Beijing, 100071, China
| | - Xiaodan Xu
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Jiajin Liu
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Ruimin Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
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Ruze R, Jiang T, Zhang W, Zhang M, Zhang R, Guo Q, Aboduhelili A, Zhayier M, Mahmood A, Yu Z, Ye J, Shao Y, Aji T. Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report. BMC Infect Dis 2024; 24:659. [PMID: 38956482 PMCID: PMC11218102 DOI: 10.1186/s12879-024-09545-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Alveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs. CASE PRESENTATION We present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries. CONCLUSIONS The multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary.
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Affiliation(s)
- Rexiati Ruze
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830011, China
| | - Tiemin Jiang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830011, China
| | - Weimin Zhang
- Department of Cardiac Surgery, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Mingming Zhang
- Department of Cardiac Surgery, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Ruiqing Zhang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Qiang Guo
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Aboduhaiwaier Aboduhelili
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Musitapa Zhayier
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Ahmad Mahmood
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Zhaoxia Yu
- Department of Critical Care Medicine, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Jianrong Ye
- Department of Anesthesia, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China
| | - Yingmei Shao
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China.
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830011, China.
| | - Tuerganaili Aji
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, 830011, China.
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830011, China.
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Frenette C, Mendiratta-Lala M, Salgia R, Wong RJ, Sauer BG, Pillai A. ACG Clinical Guideline: Focal Liver Lesions. Am J Gastroenterol 2024; 119:1235-1271. [PMID: 38958301 DOI: 10.14309/ajg.0000000000002857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/25/2024] [Indexed: 07/04/2024]
Abstract
Focal liver lesions (FLLs) have become an increasingly common finding on abdominal imaging, especially asymptomatic and incidental liver lesions. Gastroenterologists and hepatologists often see these patients in consultation and make recommendations for management of multiple types of liver lesions, including hepatocellular adenoma, focal nodular hyperplasia, hemangioma, and hepatic cystic lesions including polycystic liver disease. Malignancy is important to consider in the differential diagnosis of FLLs, and healthcare providers must be familiar with the diagnosis and management of FLLs. This American College of Gastroenterology practice guideline uses the best evidence available to make diagnosis and management recommendations for the most common FLLs.
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Affiliation(s)
| | | | - Reena Salgia
- Department of Gastroenterology/Hepatology, Henry Ford Health, Detroit, Michigan, USA
| | - Robert J Wong
- Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, Palo Alto, California, USA
| | - Bryan G Sauer
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, Virginia, USA
| | - Anjana Pillai
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, USA
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12
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Kendyala S, Narayanan R. Encysted Odyssey: A Clinical and Pictorial Analysis of Hydatid Cysts From Head to Toe. Cureus 2024; 16:e61180. [PMID: 38933644 PMCID: PMC11205266 DOI: 10.7759/cureus.61180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Cystic echinococcosis, a zoonotic disease caused by the larval form of Echinococcus granulosus, predominantly affects the liver and lungs, with humans acting as accidental hosts. METHODS Our retrospective study at the Department of Radiology and Imageology, Nizam's Institute of Medical Sciences, included 187 histopathologically or serologically proven cases. The mean age of presentation was 49.4 years. RESULTS Liver involvement was most prevalent, accounting for 83.4% (n=156) of cases, followed by sporadic involvement of other organs such as the mesentery, spleen, pancreas, thalamus, kidney, lung, spine, and omentum. Characteristic diagnostic features observed on imaging included peripheral calcifications in 33% of cases, internal septations in 25% (n=47), dense calcifications in 15% (n=29), daughter cysts in 6% (n=11), and floating membranes in 5% (n=10). Among hepatic lesions, 90% (n=141) were showing involvement of a single lobe. Notably, 78% (n=110) of lesions were limited to the right lobe, 21% (n=30) to the left lobe, and 1% (n=1) to the caudate lobe. The most affected hepatic segment was segment VIII, while the least common was segment I (caudate lobe). Complications were identified in 13% (n=25) of cases of hepatic hydatidosis. CONCLUSIONS The findings of our study emphasize the systemic nature of E. granulosus infection which can affect various organs in the body. It also illustrates the invaluable insights imaging provides for timely and accurate diagnosis of hydatid disease.
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Van Steenberge S, Boyer A, Gillard RP. Rare Case of Multifocal Alveolar Echinococcosis. J Belg Soc Radiol 2024; 108:25. [PMID: 38495537 PMCID: PMC10941687 DOI: 10.5334/jbsr.3467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
Teaching Point: Hepatic alveolar echinococcosis can mimic a slow-growing tumor, and multi-organ involvement is rare; imaging has a crucial role in diagnosing this zoonosis that is endemic in the southern part of Belgium.
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Affiliation(s)
- Sarah Van Steenberge
- Intern in Gastroenterology. Gastroenterology Departement. CHU Sart-Tilman Belgium
| | - Axel Boyer
- Intern in Radiology. Radiology Department. CHR Citadelle Belgium
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Magzumova S, Isroilov U, Djuraeva N, Khaybullina Z, Amirkhamzaev A, Vakhidova N, Abdukhalimova K, Sultanov A, Abdullaev B. Computed tomography angiography of liver alveococcosis: a case report. J Med Case Rep 2024; 18:100. [PMID: 38462632 PMCID: PMC10926632 DOI: 10.1186/s13256-024-04399-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 01/19/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Alveococcosis, helminthiasis caused by the larvae of Alveococcus multilocularis, is characterized by the formation of parasitic nodes in the liver. This clinical case is a rare occurrence of liver alveococcosis in Uzbekistan. CASE PRESENTATION We present a case of a 33-year-old Asian woman from Uzbekistan who complained of discomfort in the epigastric region and right hypochondrium, along with general weakness. She had been experiencing symptoms for 5 months when a routine ultrasound examination revealed a structural formation in the liver. Patient was investigated by using contrast enhanced computed tomography (CT) and diagnosed with liver alveococcosis with multiple lesions. Patient underwent diagnostic laparotomy with obtaining gross specimen, biomaterial was examined microscopically and found that there were small fragments of fibrous tissue determined together with small groups of cystic formations and walls consisted of chitin. Moreover, contrast enhanced CT allowed us to differentiate liver alveococcosis from cavernous hemangioma, hepatocellular carcinoma, and liver metastases from unknown source. CONCLUSION Contrast enhanced CT plays a major role in differentially diagnosing liver alveococcosis and makes it the first line method of choice for the consideration of the future treatment and surgical interventions.
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Affiliation(s)
- Saodatkhon Magzumova
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan.
| | - Umidjon Isroilov
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Nigora Djuraeva
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan.
| | - Zarina Khaybullina
- Department of Biochemistry and Microbiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Aybek Amirkhamzaev
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Nargiza Vakhidova
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Khanum Abdukhalimova
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Alisher Sultanov
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
| | - Bekhzod Abdullaev
- Department of Radiology, National Specialized Scientific and Practical Medical Center for Surgery Named After Academician V.Vakhidov, Kichik Khalqa Yuli 10/1, 100115, Tashkent, Uzbekistan
- Research Department of Biotechnology, New Uzbekistan University, Movarounnahr 1, 100007, Tashkent, Uzbekistan
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Ruaux E, VanBuren WM, Nougaret S, Gavrel M, Charlot M, Grangeon F, Bolze PA, Thomassin-Naggara I, Rousset P. Endometriosis MR mimickers: T2-hypointense lesions. Insights Imaging 2024; 15:20. [PMID: 38267633 PMCID: PMC10808434 DOI: 10.1186/s13244-023-01588-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/27/2023] [Indexed: 01/26/2024] Open
Abstract
Endometriosis is a common crippling disease in women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While its sensitivity, especially in deep infiltrating endometriosis, is superior to that of ultrasonography, many sources of false-positive results exist, leading to a lack of specificity. Hypointense lesions or pseudo-lesions on T2-weighted images include anatomical variants, fibrous connective tissues, benign and malignant tumors, feces, surgical materials, and post treatment scars which may mimic deep pelvic infiltrating endometriosis. False positives can have a major impact on patient management, from diagnosis to medical or surgical treatment. This educational review aims to help the radiologist acknowledge MRI criteria, pitfalls, and the differential diagnosis of deep pelvic infiltrating endometriosis to reduce false-positive results. Critical relevance statement MRI in deep infiltrating endometriosis has a 23% false-positive rate, leading to misdiagnosis. T2-hypointense lesions primarily result from anatomical variations, fibrous connective tissue, benign and malignant tumors, feces, surgical material, and post-treatment scars. Key points • MRI in DIE has a 23% false-positive rate, leading to potential misdiagnosis.• Anatomical variations, fibrous connective tissues, neoplasms, and surgical alterations are the main sources of T2-hypointense mimickers.• Multisequence interpretation, morphologic assessment, and precise anatomic localization are crucial to prevent overdiagnosis.• Gadolinium injection is beneficial for assessing endometriosis differential diagnosis only in specific conditions.
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Affiliation(s)
- Edouard Ruaux
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | | | - Stéphanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, U1194, Montpellier University, 34295, Montpellier, France
| | - Marie Gavrel
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | - Mathilde Charlot
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | - Flavia Grangeon
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | - Pierre-Adrien Bolze
- Department of Gynecology and Obstetrics, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, 69495, Pierre Bénite, France
| | - Isabelle Thomassin-Naggara
- Department of Radiology, Service Imageries Radiologiques Et Interventionnelles Spécialisées, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Sorbonne Université, 75020, Paris, France
| | - Pascal Rousset
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France.
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Yimit Y, Yasin P, Tuersun A, Abulizi A, Jia W, Wang Y, Nijiati M. Differentiation between cerebral alveolar echinococcosis and brain metastases with radiomics combined machine learning approach. Eur J Med Res 2023; 28:577. [PMID: 38071384 PMCID: PMC10709961 DOI: 10.1186/s40001-023-01550-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cerebral alveolar echinococcosis (CAE) and brain metastases (BM) share similar in locations and imaging appearance. However, they require distinct treatment approaches, with CAE typically treated with chemotherapy and surgery, while BM is managed with radiotherapy and targeted therapy for the primary malignancy. Accurate diagnosis is crucial due to the divergent treatment strategies. PURPOSE This study aims to evaluate the effectiveness of radiomics and machine learning techniques based on magnetic resonance imaging (MRI) to differentiate between CAE and BM. METHODS We retrospectively analyzed MRI images of 130 patients (30 CAE and 100 BM) from Xinjiang Medical University First Affiliated Hospital and The First People's Hospital of Kashi Prefecture, between January 2014 and December 2022. The dataset was divided into training (91 cases) and testing (39 cases) sets. Three dimensional tumors were segmented by radiologists from contrast-enhanced T1WI images on open resources software 3D Slicer. Features were extracted on Pyradiomics, further feature reduction was carried out using univariate analysis, correlation analysis, and least absolute shrinkage and selection operator (LASSO). Finally, we built five machine learning models, support vector machine, logistic regression, linear discrimination analysis, k-nearest neighbors classifier, and Gaussian naïve bias and evaluated their performance via several metrics including sensitivity (recall), specificity, positive predictive value (precision), negative predictive value, accuracy and the area under the curve (AUC). RESULTS The area under curve (AUC) of support vector classifier (SVC), linear discrimination analysis (LDA), k-nearest neighbors (KNN), and gaussian naïve bias (NB) algorithms in training (testing) sets are 0.99 (0.94), 1.00 (0.87), 0.98 (0.92), 0.97 (0.97), and 0.98 (0.93), respectively. Nested cross-validation demonstrated the robustness and generalizability of the models. Additionally, the calibration plot and decision curve analysis demonstrated the practical usefulness of these models in clinical practice, with lower bias toward different subgroups during decision-making. CONCLUSION The combination of radiomics and machine learning approach based on contrast enhanced T1WI images could well distinguish CAE and BM. This approach holds promise in assisting doctors with accurate diagnosis and clinical decision-making.
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Affiliation(s)
- Yasen Yimit
- Medical Imaging Center, The First People's Hospital of Kashi (Kashgar) Prefecture, Kashi, 844000, People's Republic of China
| | - Parhat Yasin
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Abuduresuli Tuersun
- Medical Imaging Center, The First People's Hospital of Kashi (Kashgar) Prefecture, Kashi, 844000, People's Republic of China
| | - Abudoukeyoumujiang Abulizi
- Medical Imaging Center, The First People's Hospital of Kashi (Kashgar) Prefecture, Kashi, 844000, People's Republic of China
| | - Wenxiao Jia
- Medical Imaging Center, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, People's Republic of China
| | - Yunling Wang
- Medical Imaging Center, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, People's Republic of China
| | - Mayidili Nijiati
- Medical Imaging Center, The First People's Hospital of Kashi (Kashgar) Prefecture, Kashi, 844000, People's Republic of China.
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Kartal M, Aksungur N, Korkut E, Altundaş N, Kara S, Öztürk G. Significance of the Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Preoperative Nutritional Index as Predictors of Morbidity in Patients Who Underwent Liver Resection for Alveolar Echinococcosis. Cureus 2023; 15:e44842. [PMID: 37809135 PMCID: PMC10560077 DOI: 10.7759/cureus.44842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
AIM We aimed to evaluate the significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and preoperative nutritional index (PNI) as predictors of morbidity in patients who underwent liver resection for alveolar echinococcosis. MATERIAL AND METHODS This single-center study was designed as a retrospective study after obtaining ethical committee approval. The files of patients hospitalized at Ataturk University Faculty of Medicine, Erzurum, Turkey, between 2010 and 2019 and who underwent resection or liver transplantation for liver alveolar cysts were reviewed. Demographic features, laboratory parameters (complete blood count and biochemical parameters), lesion localizations and characteristics, type of surgery, intraoperative and postoperative complications (morbidity), and mortality status were evaluated by scanning patients' files. Preoperative blood samples were taken the day before the surgery, which is the period farthest from surgical stress, to have more accurate results. By contrast, postoperative blood samples were taken on the first postoperative day when surgical stress was the highest. The differences between the morbidity groups, including NLR, PLR, and PNI, were compared. RESULTS Of the 172 patients in the study, 96 (55.8%) were female. The mean age of all patients was 48.51±15.57 (18-90). Perioperative complications were seen in 30 (17.4%) patients, while the morbidity and mortality rates of the study were 28.5% and 19.2%, respectively. Age, gender of patients, and preoperative laboratory parameters, including NLR, PLR, and PNI, did not affect morbidity. However, the presence of perioperative vascular injury (P=0.040) and complications (P=0.047), low postoperative lymphocyte rates (P=0.038), and high postoperative NLR were associated with increased morbidity. In addition, the mortality rate was significantly increased in patients with morbidity (P<0.001). CONCLUSION From the results of the present study, it was found that preoperative parameters did not affect morbidity, while increased postoperative NLR levels and decreased lymphocyte rates increased morbidity.
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Affiliation(s)
- Murat Kartal
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Nurhak Aksungur
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Ercan Korkut
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Necip Altundaş
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Salih Kara
- General Surgery, Atatürk University Research Hospital, Erzurum, TUR
| | - Gürkan Öztürk
- General Surgery, Atatürk University Faculty of Medicine, Erzurum, TUR
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Yang Y, Cairang Y, Jiang T, Zhou J, Zhang L, Qi B, Ma S, Tang L, Xu D, Bu L, Bu R, Jing X, Wang H, Zhou Z, Zhao C, Luo B, Liu L, Guo J, Nima Y, Hua G, Wa Z, Zhang Y, Zhou G, Jiang W, Wang C, De Y, Yu X, Cheng Z, Han Z, Liu F, Dou J, Feng H, Wu C, Wang R, Hu J, Yang Q, Luo Y, Wu J, Fan H, Liang P, Yu J. Ultrasound identification of hepatic echinococcosis using a deep convolutional neural network model in China: a retrospective, large-scale, multicentre, diagnostic accuracy study. Lancet Digit Health 2023; 5:e503-e514. [PMID: 37507196 DOI: 10.1016/s2589-7500(23)00091-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/08/2023] [Accepted: 04/29/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Ultrasonography is the most widely used technique to diagnose echinococcosis; however, challenges in using this technique and the demand on medical resources, especially in low-income or remote areas, can delay diagnosis. We aimed to develop a deep convolutional neural network (DCNN) model based on ultrasonography to identify echinococcosis and its types, especially alveolar echinococcosis. METHODS This retrospective, large-scale, multicentre study used ultrasound images from patients assessed at 84 hospitals in China, obtained between Jan 1, 2002, and Dec 31, 2021. Patients with a diagnosis of cystic echinococcosis, alveolar echinococcosis, or seven other types of focal liver lesions were included. We tested ResNet-50, ResNext-50, and VGG-16 as the backbone network architecture for a classification DCNN model and input the perinodular information from the ultrasound images. We trained and validated the DCNN model to diagnose and classify echinococcosis using still greyscale ultrasound images of focal liver lesions in four stages: differentiating between echinococcosis and other focal liver lesions (stage one); differentiating cystic echinococcosis, alveolar echinococcosis, and other focal liver lesions (stage two); differentiating cystic echinococcosis, alveolar echinococcosis, benign other focal liver lesions, and malignant focal liver lesions (stage three); and differentiating between active and transitional cystic echinococcosis and inactive cystic echinococcosis (stage four). We then tested the algorithm on internal, external, and prospective test datasets. The performance of DCNN was also compared with that of 12 radiologists recruited between Jan 15, 2022, and Jan 28, 2022, from Qinghai, Xinjiang, Anhui, Henan, Xizang, and Beijing, China, with different levels of diagnostic experience for echinococcosis and other focal liver lesions in a subset of ultrasound data that were randomly chosen from the prospective test dataset. The study is registered at ClinicalTrials.gov (NCT03871140). FINDINGS The study took place between Jan 1, 2002, and Dec 31, 2021. In total, to train and test the DCNN model, we used 9631 liver ultrasound images from 6784 patients (2819 [41·7%] female patients and 3943 [58·3%] male patients) from 87 Chinese hospitals. The DCNN model was trained with 6328 images, internally validated with 984 images, and tested with 2319 images. The ResNet-50 network architecture outperformed VGG-16 and ResNext-50 and was generalisable, with areas under the receiver operating characteristic curve (AUCs) of 0·982 (95% CI 0·960-0·994), 0·984 (0·972-0·992), and 0·913 (0·886-0·935) in distinguishing echinococcosis from other focal liver lesions; 0·986 (0·966-0·996), 0·962 (0·946-0·975), and 0·900 (0·872-0·924) in distinguishing alveolar echinococcosis from cystic echinococcosis and other focal liver lesions; and 0·974 (0·818-1·000), 0·956 (0·875-0·991), and 0·944 (0·844-0·988) in distinguishing active and transitional cystic echinococcosis from inactive echinococcosis in the three test datasets. Specifically, in patients with the hepatitis B or hepatitis C virus, the model could distinguish alveolar echinococcosis from hepatocellular carcinoma with an AUC of 0·892 (0·812-0·946). In identifying echinococcosis, the model showed significantly better performance compared with senior radiologists from a high-endemicity area (AUC 0·942 [0·904-0·967] vs 0·844 [0·820-0·866]; p=0·027) and improved the diagnostic ability of junior, attending, and senior radiologists before and after assistance with AI with comparison of AUCs of 0·743 (0·714-0·770) versus 0·850 (0·826-0·871); p<0·0001, 0·808 (0·782-0·832) versus 0·886 (0·864-0·905); p<0·0001, and 0·844 (0·820-0·866) versus 0·870 (0·847-0·890); p=0·092, respectively. INTERPRETATION The DCNN model was shown to be accurate and robust, and could improve the ultrasound diagnostic ability of radiologists for echinococcosis and its types for highly endemic and remote regions. FUNDING National Natural Science Foundation of China and National Key Research & Development Program of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yongfeng Yang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China; Graduate School of Chinese People's Liberation Army, General Hospital, Beijing, China
| | - Yangdan Cairang
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Tian'an Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianhua Zhou
- Department of Ultrasound, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Li Zhang
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Baowen Qi
- Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Shumei Ma
- Department of Ultrasound Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Lina Tang
- Department of Diagnostic Ultrasound, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Dong Xu
- Colorectal Surgery and Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Hangzhou, China
| | - Lingdai Bu
- Department of Ultrasound, People's Hospital of Bortala Mongol Autonomous Prefecture, Bortala Mongol Autonomous Prefecture, China
| | - Rui Bu
- Department of Ultrasound, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiang Jing
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zubang Zhou
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liwen Liu
- Department of Ultrasound, The Xijing Hospital of Air Force Medical University, Xi'an, China
| | - Jianqin Guo
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Interventional Ultrasound, The First Affiliated Hospital of Hainan Medical College, Hainan, China
| | - Yuzhen Nima
- Department of Intervention Ultrasound, Qinghai Provincial People's Hospital, Xining, China; Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Guoyong Hua
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Zengcheng Wa
- Department of Ultrasound, Qinghai Red Cross Hospital, Xining, China
| | - Yuying Zhang
- Department of Ultrasound, Qinghai Provincial People's Hospital, Xining, China
| | - Guoyi Zhou
- Innovation Research Center, SonoScape, Shenzhen, China
| | - Wen Jiang
- Innovation Research Center, SonoScape, Shenzhen, China
| | | | - Yang De
- Department of Ultrasound, The People's Hospital of the Tibet Autonomous Region, Lasa, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hui Feng
- Department of Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Chong Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ruifang Wang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jie Hu
- Department of Interventional Ultrasound, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qi Yang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yanchun Luo
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiapeng Wu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Haining Fan
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Jie Yu
- Department of Interventional Ultrasound, The Fifth Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, China.
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19
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Eren S, Aydın S, Kantarci M, Kızılgöz V, Levent A, Şenbil DC, Akhan O. Percutaneous management in hepatic alveolar echinococcosis: A sum of single center experiences and a brief overview of the literature. World J Gastrointest Surg 2023; 15:398-407. [PMID: 37032805 PMCID: PMC10080597 DOI: 10.4240/wjgs.v15.i3.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/18/2022] [Accepted: 02/14/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Hepatic alveolar echinococcosis (HAE) is a serious zoonotic infection that affects humans. It may have a tumor-like appearance at times. Percutaneous treatment of HAE patients is extremely relaxing for them. HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae. It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period. The disease is endemic over central Europe, Asia, and North America. AIM To characterize HAE patients who were treated percutaneously, their outcomes, and the major technical features of percutaneous treatment in HAE. METHODS Patients who were treated with percutaneous cyst drainage and/or percutaneous biliary drainage were included in the study. Uncorrected abnormal coagulation values and solid or non-infected HAE with minor necrotic change were excluded. RESULTS Thirty-two patients underwent percutaneous cyst drainage, two patients underwent percutaneous biliary drainage, and four patients underwent percutaneous biliary drainage alone. Interventional radiology is utilized to drain echinococcal necrosis and abscesses within/without the liver, as well as diseased and clogged bile ducts. CONCLUSION Percutaneous drainage of cyst contents and/or biliary channels using a minimally invasive technique is a very beneficial. Percutaneous cyst drainage with albendazole therapy improves quality of life in patients who are unable to undergo surgery, even when the mass resolves with long-term treatment.
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Affiliation(s)
- Suat Eren
- Department of Radiology, Faculty of Medicine, Atatürk University, Erzurum 25100, Turkey
| | - Sonay Aydın
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey
| | - Mecit Kantarci
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey
| | - Volkan Kızılgöz
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey
| | - Akın Levent
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey
| | - Düzgün Can Şenbil
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey
| | - Okan Akhan
- Department of Radiology, Hacettepe University, Ankara 06090, Turkey
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20
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Stefaniak M, Derda M, Zmora P, Nowak SP. Risk Factors and the Character of Clinical Course of the Echinococcus multilocularis Infection in Patients in Poland. Pathogens 2023; 12:pathogens12020199. [PMID: 36839470 PMCID: PMC9962699 DOI: 10.3390/pathogens12020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Alveolar echinococcosis (AE) is a chronic zoonotic disease caused by the larval form of Echinococcus multilocularis. In humans, it may become a serious chronic infection of the liver which resembles a slow malignant process leading to death when untreated. The aim of the study was an assessment of the risk factors of the E. multilocularis infections and the description of AE clinical course in the group of 36 patients with confirmed AE, hospitalized at the Department and Clinic of Tropical and Parasitic Diseases, Poznan University of Medical Sciences between 2013 and 2022. Among the study participants, most patients cultivated land, bred livestock, worked in the forest, or were employed in animal shelters. The E. multilocularis infection was diagnosed based on imaging and immunoassay techniques within 6 months in the majority of patients hospitalized in the Department. All patients hospitalized in the Department initiated anti-parasitic therapy at the moment of the diagnosis. Pharmacological treatment combined with surgery was applied in most of the study participants, who were presented with more advanced stages of infection. We conclude the following: 1. For humans in the risk group, regular abdominal imaging examinations and the detection of specific antibodies against E. multilocularis are recommended. 2. Regular screening tests in the hyperendemic areas of AE would increase the early detection of the disease and to improve the clinical prognosis in this extremely life-threatening parasitic disease.
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Affiliation(s)
- Magdalena Stefaniak
- Department of Biology and Medical Parasitology, Institute of Biostructural Basics of Medical Sciences, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Monika Derda
- Department of Biology and Medical Parasitology, Institute of Biostructural Basics of Medical Sciences, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Pawel Zmora
- Department of Molecular Virology, Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland
| | - Szymon Pawel Nowak
- Department and Clinic of Tropical and Parasitic Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland
- Correspondence: ; Tel.: +48-61-869-13-63
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21
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Eroglu A, Ogul H, Aydin Y. CT Imaging Findings of Pulmonary Alveolar Echinococcosis. Curr Med Imaging 2023; 19:97-102. [PMID: 35088676 DOI: 10.2174/1573405618666220128160440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/02/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022]
Abstract
Alveolar echinococcosis is a parasitic infection caused by Echinococcus multilocularis in the metacestode stage. The disease involves the liver in almost all cases, and additionally, lung involvement is accompanied in approximately 13% of the cases. Due to the low incidence of pulmonary alveolar echinococci, there are few case reports of lung involvement in the literature. In this study, computed tomography (CT) findings related to pulmonary involvement in alveolar echinococcosis cases, which have increased worldwide in recent years, were evaluated.
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Affiliation(s)
- Atilla Eroglu
- Department of Thoracic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Yener Aydin
- Department of Thoracic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey
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22
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Al-Tawfiq JA, Kim H, Memish ZA. Parasitic lung diseases. Eur Respir Rev 2022; 31:31/166/220093. [DOI: 10.1183/16000617.0093-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Parasitic lung diseases are caused by a number of parasites as a result of transient passage in the lung or as a result of an immunologic reaction. The clinical presentation may be in the form of focal or cystic lesions, pleural effusion or diffuse pulmonary infiltrates. With increasing globalisation, it is important to consider parasitic infections in the differential diagnosis of lung diseases. This is particularly important since early identification and prompt therapy result in full cure of these conditions. In this review, we summarise the most common parasitic lung diseases.
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23
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Chuelov SB, Rossina AL. Alveolar and neotropical echinococcosis. CHILDREN INFECTIONS 2022. [DOI: 10.22627/2072-8107-2022-21-4-57-61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The urgency of the problem of human alveolar and neotropic echinococcosis is due to polymorphism and the severity of clinical manifestations. The purpose and result of the work is to summarize the data available in the literature on the etiology, epidemiology, clinic, diagnosis, treatment, prevention of alveolar and neotropic echinococcosis in humans. Conclusion. The causative agent of human alveolar echinococcosis is E. multilocularis, neotropic – E. vogeli, E. oligarthra. The liver and lungs are most often affected, less often other organs of the abdominal cavity, bones, brain, spinal cord, eyes, etc. Diagnostics is carried out on the basis of a complex of clinical, instrumental, serological, molecular genetic studies. Treatment includes surgical removal of parasitic cysts and drug therapy.
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Affiliation(s)
- S. B. Chuelov
- Pirogov Russian National Medical Research University
| | - A. L. Rossina
- Pirogov Russian National Medical Research University
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24
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Chenin M, Paisant A, Lebigot J, Bazeries P, Debbi K, Ronot M, Laurent V, Aubé C. Cystic liver lesions: a pictorial review. Insights Imaging 2022; 13:116. [PMID: 35838923 PMCID: PMC9287528 DOI: 10.1186/s13244-022-01242-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Hepatic cysts (HC) are sac-like structures mainly filled with liquid and showing a distinct membrane. They are usually found incidentally through imaging. A wide spectrum of imaging patterns may be observed for common and uncommon, neoplastic and non-neoplastic diseases. While simple hepatic cysts occur frequently and do not require any treatment or follow-up, non-typical cysts should be carefully analysed to avoid misdiagnosing a lesion that would require appropriate management. Therefore, adequate knowledge of all the relevant imaging patterns is critical to secure an accurate diagnosis. The aim of this review is to describe the imaging features of the different types of hepatic cysts.
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Affiliation(s)
- Mégane Chenin
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.
| | - Anita Paisant
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Jérôme Lebigot
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Paul Bazeries
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France
| | - Kawtar Debbi
- Department of Radiology, La Timone Children Hospital of Marseille, 264 rue St Pierre, 13385, Marseille Cedex 05, France
| | - Maxime Ronot
- Department of Radiology, Beaujon Hospital, APHP.Nord, 100 boulevard du Général Leclerc, 92110, Clichy, France.,Université de Paris, Paris, France
| | - Valérie Laurent
- Department of Radiology, University Hospital of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - Christophe Aubé
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
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25
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Yamamoto Y, Sakamoto Y, Kamiyama T, Nagatsu A, Asahi Y, Orimo T, Kakisaka T, Kamachi H, Otsuka T, Mitsuhashi T, Taketomi A. A case of alveolar echinococcosis in the liver that ruptured into the pericardium treated by a combination of hepatectomy and albendazole. Surg Case Rep 2022; 8:63. [PMID: 35394220 PMCID: PMC8993950 DOI: 10.1186/s40792-022-01417-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Alveolar echinococcosis (AE) is a rare parasitic disease caused by the larva of Echinococcus multilocularis. It nearly always occurs in the liver, and cardiac involvement is extremely rare. Liver resection is the most effective intervention for AE because the only potentially curative treatment is removal of the lesion. Even when complete resection is not performed, long-term survival can be expected after surgical removal of most of the lesion with lifelong administration of albendazole (ABZ). Case presentation A 64-year-old man who lived in Hokkaido was referred to our hospital due to abnormalities in biliary enzymes. According to the findings from enhanced computed tomography and magnetic resource imaging of the abdomen, transthoracic echocardiography and serologic tests, he was diagnosed with hepatic AE with rupture into the pericardium. He underwent extended left hemi-hepatectomy with reconstruction of the inferior vena cava and opening of the pericardium with drainage as reduction surgery. Pathological examination revealed echinococcal infection in the pericardium as well as the liver. He started chemotherapy with 400 mg ABZ per Day 67 days after surgery. Although the surgical margin was positive in the pathological findings, he was alive 19 months later with no regrowth of the echinococcal lesion. Conclusion AE with cardiac involvement is extremely rare. Even if the complete removal of cardiac-involved AE is not possible, surgical debulking with lifelong ABZ treatment can successfully manage the disease.
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Affiliation(s)
- Yoichi Yamamoto
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan.
| | - Yuzuru Sakamoto
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan.
| | - Toshiya Kamiyama
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Akihisa Nagatsu
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yoh Asahi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Tatsuya Orimo
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Tatsuhiko Kakisaka
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hirofumi Kamachi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Takuya Otsuka
- Department of Surgical Pathology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Tomoko Mitsuhashi
- Department of Surgical Pathology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan
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26
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Calame P, Weck M, Busse-Cote A, Brumpt E, Richou C, Turco C, Doussot A, Bresson-Hadni S, Delabrousse E. Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis. Insights Imaging 2022; 13:68. [PMID: 35394226 PMCID: PMC8994011 DOI: 10.1186/s13244-022-01190-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
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Affiliation(s)
- Paul Calame
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France.
| | - Mathieu Weck
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Andreas Busse-Cote
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Eleonore Brumpt
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Carine Richou
- Department of Hepatology, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Celia Turco
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Alexandre Doussot
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire de Parasitologie-Mycologie, University Hospital Besançon, 25030, Besançon, France.,Centre National de Référence Echinococcoses, University Hospital Besançon, 25030, Besançon, France
| | - Eric Delabrousse
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France
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27
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Raymenants K, Van Malenstein H, Pirenne J, Monbaliu D, Vandecaveye V, De Leyn P, Verslype C. Primary combined lobar/diaphragm resection and liver transplantation for locally advanced alveolar echinococcosis: Report of a challenging case. JOURNAL OF LIVER TRANSPLANTATION 2022. [DOI: 10.1016/j.liver.2021.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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28
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Greenberg DJ, Canoy J, Tomac Pavosevic H, Epelbaum O. Pulmonary Cystic Echinococcosis. Mayo Clin Proc 2022; 97:752-753. [PMID: 35379421 DOI: 10.1016/j.mayocp.2022.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Oleg Epelbaum
- Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, Valhalla, NY, USA
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29
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Gulati S, Goyal A, Sharma R. Mimics of cholangiocarcinoma-exploring beneath the surface! Abdom Radiol (NY) 2022; 47:1507-1508. [PMID: 35218382 DOI: 10.1007/s00261-022-03459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Shrea Gulati
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ankur Goyal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Raju Sharma
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India
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30
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18F-FDG-PET/MR in Alveolar Echinococcosis: Multiparametric Imaging in a Real-World Setting. Pathogens 2022; 11:pathogens11030348. [PMID: 35335672 PMCID: PMC8951377 DOI: 10.3390/pathogens11030348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
Recent improvements in alveolar echinococcosis (AE) therapy can provide long-term disease control, and even allow structured treatment interruption in selected cases. Imaging has a pivotal role in monitoring disease activity, with 18-fluoro-deoxyglucose positron emission and computed tomography (18F-FDG-PET/CT) in particular having proven beneficial for assessing disease activity. Repetitive regular examinations to monitor therapy response, however, can lead to substantial radiation burden. Therefore, by combining metabolic information and excellent tissue contrast in magnetic resonance imaging (MRI), PET/MR appears ideally suited for this task. Here, we retrospectively analyzed 51 AE patients that underwent 18F-FDG-PET/MR. Patients had a ‘confirmed/probable’ diagnosis in 22/29 cases according to the WHO classification. FDG uptake, diffusion restriction, and MRI morphology were evaluated. We found significant differences in FDG uptake between responders to benzimidazole therapy and progressive manifestations (SUVavg 2.7 ± 1.3 vs. 5.4 ± 2.2, p < 0.001) as well as between Kodama Types 1 and 3 (F = 9.9, p < 0.003). No significant differences were detected for ADC values or MRI morphology concerning response and no correlations were present between FDG uptake and ADC values. The mean radiation dose was 5.9−6.5 mSv. We conclude that the combination of metabolic information and MRI morphology at a low radiation dose proposes PET/MR as a suitable imaging modality for AE assessment. Longitudinal studies are needed to define the role of this imaging modality.
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Kim JG, Han X, Kong Y. Echinococcus granulosus Protoscolex DM9 Protein Shows High Potential for Serodiagnosis of Alveolar Echinococcosis. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:25-34. [PMID: 35247951 PMCID: PMC8898642 DOI: 10.3347/kjp.2022.60.1.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 11/23/2022]
Abstract
Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.
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Affiliation(s)
- Jeong-Geun Kim
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon 16419,
Korea
| | - Xiumin Han
- Clinical Research Institute of Hydatid Disease, Qinghai Provincial People’s Hospital, Xining 810007,
China
| | - Yoon Kong
- Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon 16419,
Korea
- Corresponding author ()
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Dalaqua M, Nascimento FBPD, Miura LK, Garcia MRT, Barbosa Junior AA, Reis F. Magnetic resonance imaging of the cranial nerves in infectious, neoplastic, and demyelinating diseases, as well as other inflammatory diseases: a pictorial essay. Radiol Bras 2022; 55:38-46. [PMID: 35210663 PMCID: PMC8864690 DOI: 10.1590/0100-3984.2021.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/14/2021] [Indexed: 12/04/2022] Open
Abstract
The cranial nerves, which represent extensions of the functional structures of
the brain, traverse the head and neck. They are connected to various cranial
structures and are associated with several diseases. An in-depth understanding
of their complex anatomy and normal imaging appearance allows the examiner to
identify and characterize abnormalities with greater precision. One important
tool for evaluating the cranial nerves is contrast-enhanced magnetic resonance
imaging, especially that employing three-dimensional steady-state free
precession sequences, which provide high soft-tissue and spatial resolution,
despite the slen-derness of the nerves. In most cases of cranial nerve
abnormalities, the imaging findings are nonspecific. Therefore, to narrow the
differential diagnosis, it is necessary to take a full patient history, perform
a focused physical examination, and order laboratory tests. In this pictorial
essay, we review, illustrate, and discuss, from a pathophysiological
perspective, infectious, neoplastic, and demyelinating disorders, as well as
other inflammatory disorders, affecting the cranial nerves, the aim being to
provide a practical, tangible reference for radiologists to use in daily
practice.
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Affiliation(s)
| | | | | | | | | | - Fabiano Reis
- Universidade Estadual de Campinas (Unicamp), Brazil
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Kovač JD, Janković A, Đikić-Rom A, Grubor N, Antić A, Dugalić V. Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI. Curr Oncol 2022; 29:698-723. [PMID: 35200560 PMCID: PMC8870737 DOI: 10.3390/curroncol29020061] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/23/2022] [Accepted: 01/29/2022] [Indexed: 12/14/2022] Open
Abstract
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, with mass-forming growth pattern being the most common. The typical imaging appearance of mass-forming ICC (mICC) consists of irregular ring enhancement in the arterial phase followed by the progressive central enhancement on portal venous and delayed phases. However, atypical imaging presentation in the form of hypervascular mICC might also be seen, which can be attributed to distinct pathological characteristics. Ancillary imaging features such as lobular shape, capsular retraction, segmental biliary dilatation, and vascular encasement favor the diagnosis of mICC. Nevertheless, these radiological findings may also be present in certain benign conditions such as focal confluent fibrosis, sclerosing hemangioma, organizing hepatic abscess, or the pseudosolid form of hydatid disease. In addition, a few malignant lesions including primary liver lymphoma, hemangioendothelioma, solitary hypovascular liver metastases, and atypical forms of hepatocellular carcinoma (HCC), such as scirrhous HCC, infiltrative HCC, and poorly differentiated HCC, may also pose a diagnostic dilemma by simulating mICC in imaging studies. Diffusion-weighted imaging and the use of hepatobiliary contrast agents might be helpful for differential diagnosis in certain cases. The aim of this manuscript is to provide a comprehensive overview of mICC imaging features and to describe useful tips for differential diagnosis with its potential mimickers.
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Affiliation(s)
- Jelena Djokic Kovač
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia;
- Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia; (N.G.); (A.A.); (V.D.)
- Correspondence: ; Tel.: +381-65-8270-290
| | - Aleksandra Janković
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia;
| | - Aleksandra Đikić-Rom
- Department of Pathology, University Clinical Centre of Serbia, Pasterova No.2, 11000 Belgrade, Serbia;
| | - Nikica Grubor
- Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia; (N.G.); (A.A.); (V.D.)
- Clinic for Digestive Surgery, University Clinical Centre of Serbia, Koste Todorovica Street, No. 6, 11000 Belgrade, Serbia
| | - Andrija Antić
- Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia; (N.G.); (A.A.); (V.D.)
- Clinic for Digestive Surgery, University Clinical Centre of Serbia, Koste Todorovica Street, No. 6, 11000 Belgrade, Serbia
| | - Vladimir Dugalić
- Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia; (N.G.); (A.A.); (V.D.)
- Clinic for Digestive Surgery, University Clinical Centre of Serbia, Koste Todorovica Street, No. 6, 11000 Belgrade, Serbia
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Weingartner M, Stücheli S, Jebbawi F, Gottstein B, Beldi G, Lundström-Stadelmann B, Wang J, Odermatt A. Albendazole reduces hepatic inflammation and endoplasmic reticulum-stress in a mouse model of chronic Echinococcus multilocularis infection. PLoS Negl Trop Dis 2022; 16:e0009192. [PMID: 35030165 PMCID: PMC8794265 DOI: 10.1371/journal.pntd.0009192] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 01/27/2022] [Accepted: 12/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Echinococcus multilocularis causes alveolar echinococcosis (AE), a rising zoonotic disease in the northern hemisphere. Treatment of this fatal disease is limited to chemotherapy using benzimidazoles and surgical intervention, with frequent disease recurrence in cases without radical surgery. Elucidating the molecular mechanisms underlying E. multilocularis infections and host-parasite interactions ultimately aids developing novel therapeutic options. This study explored an involvement of unfolded protein response (UPR) and endoplasmic reticulum-stress (ERS) during E. multilocularis infection in mice. METHODS E. multilocularis- and mock-infected C57BL/6 mice were subdivided into vehicle, albendazole (ABZ) and anti-programmed death ligand 1 (αPD-L1) treated groups. To mimic a chronic infection, treatments of mice started six weeks post i.p. infection and continued for another eight weeks. Liver tissue was then collected to examine inflammatory cytokines and the expression of UPR- and ERS-related genes. RESULTS E. multilocularis infection led to an upregulation of UPR- and ERS-related proteins in the liver, including ATF6, CHOP, GRP78, ERp72, H6PD and calreticulin, whilst PERK and its target eIF2α were not affected, and IRE1α and ATF4 were downregulated. ABZ treatment in E. multilocularis infected mice reversed, or at least tended to reverse, these protein expression changes to levels seen in mock-infected mice. Furthermore, ABZ treatment reversed the elevated levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ in the liver of infected mice. Similar to ABZ, αPD-L1 immune-treatment tended to reverse the increased CHOP and decreased ATF4 and IRE1α expression levels. CONCLUSIONS AND SIGNIFICANCE AE caused chronic inflammation, UPR activation and ERS in mice. The E. multilocularis-induced inflammation and consecutive ERS was ameliorated by ABZ and αPD-L1 treatment, indicating their effectiveness to inhibit parasite proliferation and downregulate its activity status. Neither ABZ nor αPD-L1 themselves affected UPR in control mice. Further research is needed to elucidate the link between inflammation, UPR and ERS, and if these pathways offer potential for improved therapies of patients with AE.
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Affiliation(s)
- Michael Weingartner
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Simon Stücheli
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Fadi Jebbawi
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | | | - Junhua Wang
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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Tamarozzi F, Manciulli T, Brunetti E, Vuitton DA. Echinococcosis. HELMINTH INFECTIONS AND THEIR IMPACT ON GLOBAL PUBLIC HEALTH 2022:257-312. [DOI: 10.1007/978-3-031-00303-5_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Cakir IM, Bekci T, Eryuruk U. A Case of Disseminated Alveolar Echinococcosis Mimicking Metastatic Malignant Disease with Cerebral Involvement. Rev Soc Bras Med Trop 2022; 55:e02842022. [PMID: 36197382 PMCID: PMC9536802 DOI: 10.1590/0037-8682-0284-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/03/2022] [Indexed: 11/21/2022] Open
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Single-stage versus two-stage surgery of pulmonary and hepatic hydatid cysts. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2021; 18:139-144. [PMID: 34703470 PMCID: PMC8525277 DOI: 10.5114/kitp.2021.109374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/01/2021] [Indexed: 11/26/2022]
Abstract
Introduction Concomitant lung and liver hydatid cyst is a rare condition. Most surgeons agree that both sites should be resected in one-time surgery. Aim We present a case series of hepatic and pulmonary hydatid cyst treated in one-stage surgery (OSS) compared with patients who underwent two-stage surgery (TSS). Material and methods This retrospective study included 47 patients separated into two groups (33 TSS and 14 OSS) between 2008 and 2019. Data on clinical symptoms, sites, radiological features, techniques, postoperative complications, mean hospital stay and outcome were analyzed separately for TSS and OSS procedures. Results A total of 33 patients who underwent TSS (70.2%) were compared to 14 patients operated on by OSS (29.8%). No significant differences were found between groups for age (45.3 vs. 42.7, p = 0.45), sex (male: 57.6% vs. 64.2%) and socio-geographic status (urban: 72.7% vs. 78.6%). But there were more postoperative complications (24.3% vs. 14.3%, p = 0.036) in the TSS group, and operative duration (154 minutes vs. 122 minutes, p = 0.047), postoperative hospital stay (13.8 days vs. 8.7 days, p = 0.022), and interruption of activities and work (56 days vs. 31 days, p = 0.045) were longer in the TSS group. There was no difference in postoperative mortality between the 2 groups. Conclusions Single-stage surgical management by trans-thoraco-phrenotomy can be recommended to treat dual-seat hepatic and pulmonary hydatid disease with fewer complications and a rapid return to work. This technique is easier and safer for right lung and liver dome hydatid cysts.
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Schuhbaur J, Schweizer M, Philipp J, Schmidberger J, Schlingeloff P, Kratzer W. Long-term follow-up of liver alveolar echinococcosis using echinococcosis multilocularis ultrasound classification. World J Gastroenterol 2021; 27:6939-6950. [PMID: 34790016 PMCID: PMC8567478 DOI: 10.3748/wjg.v27.i40.6939] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/01/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND When Echinococcus multilocularis infects humans as a false intermediate host, alveolar echinococcosis (AE) usually manifests primarily intrahepatically and is initially asymptomatic. If the disease remains undiagnosed and untreated, progressive growth occurs, reminiscent of malignant tumours. The only curative therapy is complete resection, which is limited to localised stages, and palliative drug therapy is used otherwise. Consequently, early diagnosis and reliable detection of AE lesions are important. For this reason, abdominal ultrasonography, as the most common primary imaging for AE, relies on classification systems.
AIM To investigate how hepatic AE lesion sonomorphology changes over time in the Echinococcosis Multilocularis Ulm Classification (EMUC)-ultrasound (US) classification.
METHODS Based on data from Germany’s national echinococcosis database, we evaluated clinical and US imaging data for 59 patients according to the AE case definition in our preliminary retrospective longitudinal study. There had to be at least two liver sonographies ≥ 6 mo apart, ≥ 1 hepatic AE lesion, and complete documentation in all US examinations. The minimum interval between two separately evaluated US examinations was 4 wk. The AE reference lesion was the largest hepatic AE lesion at the time of the first US examination. To classify the sonomorphologic pattern, we used EMUC-US. In addition to classifying the findings of the original US examiner, all reference lesions at each examination time point were assigned EMUC-US patterns in a blinded fashion by two investigators experienced in US diagnosis. Statistical analysis was performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, United Stated). P values < 0.05 were considered statistically significant.
RESULTS The preliminary study included 59 patients, 38 (64.5%) women and 21 (35.6%) men. The mean age at initial diagnosis was 59.9 ± 16.9 years. At the time of initial ultrasonography, a hailstorm pattern was present in 42.4% (25/59) of cases, a hemangioma-like pattern in 16.9% (10/59), a pseudocystic pattern in 15.3% (9/59), and a metastasis-like pattern in 25.4% (15/59). For the hailstorm pattern, the average lesion size was 67.4 ± 26.3 mm. The average lesion size was 113.7 ± 40.8 mm with the pseudocystic pattern and 83.5 ± 27.3 mm with the hemangioma-like pattern. An average lesion size of 21.7 ± 11.0 mm was determined for the metastasis-like pattern. Although the sonomorphologic pattern remained unchanged in 84.7% (50/59) of AE reference lesions, 15.3% (9/59) showed a change over time. A change in pattern was seen exclusively for AE lesions initially classified as hemangioma-like or pseudocystic. A total of 70% (7/10) of AE lesions initially classified as hemangioma-like showed a relevant change in pattern over time, and 85.7% (6/7) of these were secondarily classified as having a hailstorm pattern, with the remainder (1/7; 14.3%) classified as having a pseudocystic pattern. A total of 22.2% (2/9) of AE lesions initially classified as pseudocystic showed a relevant change in pattern over time and were classified as having a hailstorm pattern. For AE lesions initially classified as having a hailstorm or metastatic pattern, no pattern change was evident. All patients with pattern change were on continuous drug therapy with albendazole.
CONCLUSION The sonomorphology of hepatic AE lesions may change over time. The hemangioma-like and pseudocystic patterns are affected.
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Affiliation(s)
- Jasmin Schuhbaur
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | - Melissa Schweizer
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | - Jana Philipp
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | - Julian Schmidberger
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
| | | | - Wolfgang Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
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Yangdan CR, Wang C, Zhang LQ, Ren B, Fan HN, Lu MD. Recent advances in ultrasound in the diagnosis and evaluation of the activity of hepatic alveolar echinococcosis. Parasitol Res 2021; 120:3077-3082. [PMID: 34370071 DOI: 10.1007/s00436-021-07262-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/20/2021] [Indexed: 12/11/2022]
Abstract
Echinococcosis is a worldwide neglected zoonotic disease. Alveolar echinococcosis (AE) poses a more serious threat to life and health than cystic echinococcosis, and has been one of the world's most lethal chronic parasitosis. Assessment of metacestode activity status is essential for individual treatment strategy design for a given AE patient, and fluorodeoxyglucose positron-emission tomography (FDG-PET) has been the gold standard. In this study, we reviewed previous evidence on AE activity assessment using contrast-enhanced ultrasound (CEUS), and its comparison with FDG-PET. The results showed good consistency between them, indicating CEUS as a suitable substitute for FDG-PET. With its advantage as being readily portable, widely available, and not costly, CEUS is more suitable for use in the developing countries and rural areas.
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Affiliation(s)
- Cai-Rang Yangdan
- Department of Hepatopancreatobiliary Surgery, the Qinghai University Affiliated Hospital; The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Cong Wang
- Department of Hepatopancreatobiliary Surgery, the Qinghai University Affiliated Hospital; The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Ling-Qiang Zhang
- Department of Hepatopancreatobiliary Surgery, the Qinghai University Affiliated Hospital; The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Bin Ren
- Department of Hepatopancreatobiliary Surgery, the Qinghai University Affiliated Hospital; The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China
| | - Hai-Ning Fan
- Department of Hepatopancreatobiliary Surgery, the Qinghai University Affiliated Hospital; The Research Key Laboratory for Echinococcosis of Qinghai Province, Xining, China.
| | - Ming-De Lu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Peters L, Burkert S, Grüner B. Parasites of the liver - epidemiology, diagnosis and clinical management in the European context. J Hepatol 2021; 75:202-218. [PMID: 33636243 DOI: 10.1016/j.jhep.2021.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Parasites in the liver cause significant global morbidity and mortality, as they can lead to recurrent cholangitis, cirrhosis, liver failure and cancer. Due to climate change and globalisation, their incidence is increasing, especially in Europe. The correct diagnosis of a hepatic parasite is often delayed because clinicians are unfamiliar with respective entities. Therefore, in this review, we aim to provide clinicians with a comprehensive clinical picture of hepatic parasites and to bring these neglected parasitic liver diseases to the wider attention of hepatology stakeholders in Europe and around the world.
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Affiliation(s)
- Lynn Peters
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Sanne Burkert
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Beate Grüner
- University Hospital of Ulm, Department of Internal Medicine III, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
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Liu C, Fan H, Ge RL. A Case of Human Hepatic Alveolar Echinococcosis Accompanied by Lung and Brain Metastases. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:291-296. [PMID: 34218601 PMCID: PMC8255489 DOI: 10.3347/kjp.2021.59.3.291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/09/2021] [Indexed: 01/14/2023]
Abstract
Alveolar echinococcosis (AE) is considered as a fatal zoonosis caused by the larvae of Echinococcus multilocularis. The lungs and brain are the most common metastatic organs. We report a human case of hepatic alveolar echinococcosis accompanied by lung and brain metastasis. In particular, the patient had a history of tuberculosis and the lung lesions were easily misdiagnosed as lung abscesses. The lesions of liver and lung underwent radical resection and confirmed as alveolar echinococcosis by pathological examination. The patient had no surgical complications after operation and was discharged after symptomatic treatment. Unfortunately, the patient later developed multiple intracerebral AE metastases. We required the patient to take albendazole orally for life and follow up.
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Affiliation(s)
- Chuanchuan Liu
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai 810001, China.,Qinghai University Affiliated Hospital, Xining, Qinghai 810001, China.,Qinghai Key Laboratory for Echinococcosis, Xining, Qinghai 810001, China
| | - Haining Fan
- Qinghai University Affiliated Hospital, Xining, Qinghai 810001, China.,Qinghai Key Laboratory for Echinococcosis, Xining, Qinghai 810001, China
| | - Ri-Li Ge
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai 810001, China.,Qinghai University Affiliated Hospital, Xining, Qinghai 810001, China.,Qinghai Key Laboratory for Echinococcosis, Xining, Qinghai 810001, China
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Reuss AM, Wulf MA, Oertel MF, Bozinov O, Henzi A, Kaelin MB, Reinehr M, Grimm F, Rushing EJ. An immunocompetent farmer with isolated cerebral alveolar echinococcosis: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 1:CASE2187. [PMID: 35855465 PMCID: PMC9245736 DOI: 10.3171/case2187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Alveolar echinococcosis is a rare condition, but living or working in a rural environment is a substantial risk factor. The liver is the organ primarily affected, with additional extrahepatic manifestations in approximately 25% of cases. Primary extrahepatic disease is rare, and isolated cerebral involvement is extremely unusual. OBSERVATIONS The authors described an illustrative case of isolated cerebral alveolar echinococcosis in an immunocompetent farmer. Magnetic resonance imaging of the brain showed a predominantly cystic lesion with perifocal edema and a “bunch of grapes” appearance in the left frontal lobe. Histology revealed sharply demarcated fragments of a fibrous cyst wall accompanied by marked inflammation and necrosis. Higher magnification showed remnants of protoscolices with hooklets and calcified corpuscles. Immunohistochemistry and polymerase chain reaction (PCR) analysis confirmed the diagnosis of cerebral alveolar echinococcosis. Interestingly, serology and thoracic and abdominal computed tomography results were negative, indicative of an isolated primary extrahepatic manifestation. LESSONS Isolated, primary central nervous system echinococcosis is extremely rare, with only isolated case reports. As in the authors’ case, it can occur in immunocompetent patients, especially persons with a rural vocational history. Negative serology results do not exclude cerebral echinococcosis, which requires histological confirmation. Immunohistochemical staining and PCR analysis are especially useful in cases without classic morphological findings.
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Affiliation(s)
| | | | | | | | | | | | - Michael Reinehr
- Division of Infectious Diseases and Hospital Epidemiology; and
| | - Felix Grimm
- Institute of Parasitology, University Hospital Zurich, University of Zurich, Switzerland
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Peng J, Duan Z, Guo Y, Li X, Luo X, Han X, Luo J. Identification of candidate biomarkers of liver hydatid disease via microarray profiling, bioinformatics analysis, and machine learning. J Int Med Res 2021; 49:300060521993980. [PMID: 33787392 PMCID: PMC8020228 DOI: 10.1177/0300060521993980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives Liver echinococcosis is a severe zoonotic disease caused by
Echinococcus (tapeworm) infection, which is epidemic in
the Qinghai region of China. Here, we aimed to explore biomarkers and
establish a predictive model for the diagnosis of liver echinococcosis. Methods Microarray profiling followed by Gene Ontology and Kyoto Encyclopedia of
Genes and Genomes analysis was performed in liver tissue from patients with
liver hydatid disease and from healthy controls from the Qinghai region of
China. A protein–protein interaction (PPI) network and random forest model
were established to identify potential biomarkers and predict the occurrence
of liver echinococcosis, respectively. Results Microarray profiling identified 1152 differentially expressed genes (DEGs),
including 936 upregulated genes and 216 downregulated genes. Several
previously unreported biological processes and signaling pathways were
identified. The FCGR2B and CTLA4 proteins were identified by the PPI
networks and random forest model. The random forest model based on FCGR2B
and CTLA4 reliably predicted the occurrence of liver hydatid disease, with
an area under the receiver operator characteristic curve of 0.921. Conclusion Our findings give new insight into gene expression in patients with liver
echinococcosis from the Qinghai region of China, improving our understanding
of hepatic hydatid disease.
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Affiliation(s)
- Jinwu Peng
- Department of Pathology, Xiangya Basic Medical School, Central South University, Changsha, Hunan, China.,Department of Pathology, Xiangya Changde Hospital, Changde, Hunan, China.,Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhili Duan
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Yamin Guo
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiaona Li
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiaoqin Luo
- Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Xiumin Han
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Junming Luo
- Department of Pathology, Xiangya Changde Hospital, Changde, Hunan, China.,Department of Pathology, Qinghai Provincial People's Hospital, Xining, Qinghai, China
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Emerging human alveolar echinococcosis in Hungary (2003-2018): a retrospective case series analysis from a multi-centre study. BMC Infect Dis 2021; 21:168. [PMID: 33568075 PMCID: PMC7877032 DOI: 10.1186/s12879-021-05859-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/31/2021] [Indexed: 02/06/2023] Open
Abstract
Background Human alveolar echinococcosis (AE) caused by Echinococcus multilocularis is an underreported, often misdiagnosed and mistreated parasitic disease mainly due to its low incidence. The aim of this study was to describe the epidemiological and clinical characteristics of human AE patients in Hungary for the first time. Method Between 2003 and 2018, epidemiological and clinical data of suspected AE patients were collected retrospectively from health database management systems. Results This case series included a total of 16 AE patients. The mean age of patients was 53 years (range: 24–78 years). The sex ratio was 1:1. Four patients (25%) revealed no recurrence after radical surgery and adjuvant albendazole (ABZ) therapy. For five patients (31.3%) with unresectable lesions, a stabilization of lesions with ABZ treatment was achieved. In seven patients (43.8%), progression of AE was documented. The mean diagnostic delay was 33 months (range: 1–122 months). Three AE related deaths (fatality rate 18.8%) were recorded. Conclusions AE is an emerging infectious disease in Hungary with a high fatality rate since based on our results, almost every fifth AE patient died in the study period. Differential diagnosis and appropriate surgical and medical therapy for AE is an urging challenge for clinicians in Hungary, as well as in some other European countries where E. multilocularis is prevalent.
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Renal Alveolar Echinococcosis Mimicking Renal Neoplasm with Brain Metastasis. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02337-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ahmad I, Ilyas M, Ashraf A, Rather AA, Gojwari TA. Prevalence of Hepatic Alveolar hydatid in a Nonendemic Region of North India in Hospital-based Population. JOURNAL OF DATTA MEGHE INSTITUTE OF MEDICAL SCIENCES UNIVERSITY 2021; 16:86-89. [DOI: 10.4103/jdmimsu.jdmimsu_86_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
Objective:
The objective of this study was to calculate the prevalence of hepatic alveolar hydatid disease in hospital-based population in North India, a nonendemic region for alveolar hydatid disease.
Materials and Methods:
This study was conducted at a tertiary care center in North India between April 2017 and March 2019. Patients with suspected hepatic alveolar hydatid on ultrasonography were evaluated with further imaging studies based on classical radiological findings and then confirmed by histopathology.
Results:
Twenty-five cases of hepatic alveolar hydatid were diagnosed primarily based on the classical imaging/radiological findings with histopathology confirmation, with a 2-year period prevalence of 0.207 cases/1000 population. Majority of the cases were in the age group of 41–60 years, with a mean age of 53.04 years. Fifty-two percent of the cases were female. Majority of them were from hilly areas and working with livestock animals. Abdominal pain was the most common presenting symptom.
Conclusion:
Hepatic alveolar hydatid is considered as a rare disease in India; however, the increased number of cases been diagnosed in our study could be either due to increased diagnostic modalities or due to actual increase in the number of cases. Therefore, hepatic alveolar hydatid should be considered in the differentials of suspicious liver mass in nonendemic regions.
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Bonnin A, Durot C, Djelouah M, Dohan A, Arrivé L, Rousset P, Hoeffel C. MR Imaging of the Perihepatic Space. Korean J Radiol 2020; 22:547-558. [PMID: 33236541 PMCID: PMC8005346 DOI: 10.3348/kjr.2019.0774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/02/2020] [Accepted: 06/23/2020] [Indexed: 11/24/2022] Open
Abstract
The perihepatic space is frequently involved in a spectrum of diseases, including intrahepatic lesions extending to the liver capsule and disease conditions involving adjacent organs extending to the perihepatic space or spreading thanks to the communication from intraperitoneal or extraperitoneal sites through the hepatic ligaments. Lesions resulting from the dissemination of peritoneal processes may also affect the perihepatic space. Here we discuss how to assess the perihepatic origin of a lesion and describe the magnetic resonance imaging (MRI) features of normal structures and fluids that may be abnormally located in the perihepatic space. We then review and illustrate the MRI findings present in cases of perihepatic infectious, tumor-related, and miscellaneous conditions. Finally, we highlight the value of MRI over computed tomography.
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Affiliation(s)
- Angèle Bonnin
- Department of Radiology, Centre Hospitalo-Universitaire de Reims, Reims, France.
| | - Carole Durot
- Department of Radiology, Centre Hospitalo-Universitaire de Reims, Reims, France
| | - Manel Djelouah
- Department of Radiology, Centre Hospitalo-Universitaire de Reims, Reims, France
| | - Anthony Dohan
- Department of Abdominal and Interventional Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, APHP, Paris, France.,Paris Descartes University, Sorbonne Paris-Cité-Paris V, Paris, France
| | - Lionel Arrivé
- Department of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Pascal Rousset
- Department of Radiology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France.,Lyon 1 Claude Bernard University, Lyon, France
| | - Christine Hoeffel
- Department of Radiology, Centre Hospitalo-Universitaire de Reims, Reims, France.,CRESTIC, Reims Champagne-Ardenne University, Reims, France
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The spectrum of multimodality imaging findings in hepatic alveolar echinococcosis and the potential role of diffusion-weighted imaging in its characterisation. Pol J Radiol 2020; 85:e613-e623. [PMID: 33376563 PMCID: PMC7757515 DOI: 10.5114/pjr.2020.101015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose To study the spectrum of imaging findings in hepatic alveolar echinococcosis (HAE) and to evaluate the potential role of diffusion-weighted imaging (DWI) in its characterisation. Material and methods Two radiologists with more than seven years of experience retrospectively studied ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) findings in 23 histopathologically proven cases of HAE with emphasis on the appearance and extent of disease. DWI characteristics of lesions were noted, and their apparent diffusion values (ADC) were calculated. Results Ultrasonography features of HAE included heterogeneous, hyperechoic hepatic mass with or without calcification (n = 20), or heterogeneous mass with solid-cystic appearance (n = 2). CT revealed heterogeneous density infiltrative hepatic mass with no contrast enhancement in 19 patients or thick-walled cystic mass (n = 4). Following Kodama classification one type 1, six type 2, two type 3, eight type 4, and two type 5 lesions were identified on T2-weighted MRI. No enhancement was seen on post-contrast T1-weighted images. Mean ADC values were 1.74 ± 0.48 × 10-3 mm2/s (range: 1.39 × 10-3 mm2/s to 2.3 × 10-3 mm2/s). Conclusions HAE by virtue of its infiltrative growth pattern with a tendency to involve biliary, vascular, and extra hepatic structures can be easily misdiagnosed as malignant hepatic neoplasm. Knowledge of varied imaging appearances of HAE is essential to suspect the condition and to make an appropriate diagnosis. Diffusion-weighted imaging is a useful adjunct with relatively high diffusivity (high ADC values) suggesting diagnosis of alveolar hydatid.
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Graeter T, Bao H, Delabrousse E, Brumpt E, Shi R, Li W, Jiang Y, Schmidberger J, Kratzer W, Liu W, the XUUB consortium. Hepatic alveolar echinococcosis: Comparative computed tomography study between two Chinese and two European centres. Food Waterborne Parasitol 2020; 19:e00082. [PMID: 32435708 PMCID: PMC7232088 DOI: 10.1016/j.fawpar.2020.e00082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023] Open
Abstract
The main endemic areas for alveolar echinococcosis (AE) are in Central Europe and Western China, and in >98% of cases, AE manifests in the liver. The aim of this work was to compare European and Chinese patient groups for number, size, and computed tomography (CT) appearance of hepatic AE lesions. A total of 200 CT scans of patients with hepatic AE were evaluated by four blinded, experienced radiologists from two European (Besancon, Ulm) and two Chinese centres (Xining, Urumqi). In addition to noting the number, size, and localisation of the lesions, the radiologists evaluated morphological appearance using the Echinococcus multilocularis Ulm Classification - CT scheme. Chinese patients were younger than European patients (36.8 ± 13.2 vs. 63.5 ± 17.7; p < 0.0001) and had significantly larger lesions (120.4 ± 50.8 vs. 70.9 ± 39.8; p < 0.0001). The morphological appearance of the lesions on CT differed significantly between the two groups (p < 0.05), as did the number of lesions (2.6 ± 3.9 in European centres versus 3.8 ± 5.0 in Chinese centres; p = 0.0062). Patient age and AE-related morphological manifestations differ between Europe and China, but the reasons for the differences are unknown.
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Affiliation(s)
- Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, Germany
| | - Haihua Bao
- Qinghai University, Qinghai University First Affiliated Hospital, Qinghai Province, 810001 Xining, PR China
| | - Eric Delabrousse
- WHO Collaborating Centre on Prevention and Treatment of Human Echinococcosis/National French Reference Centre for Echinococcosis, University Bourgogne Franche-Comté (UFC), 25030 Besançon, France
- Besançon University Hospital, 25030 Besançon, France
| | - Eleonore Brumpt
- WHO Collaborating Centre on Prevention and Treatment of Human Echinococcosis/National French Reference Centre for Echinococcosis, University Bourgogne Franche-Comté (UFC), 25030 Besançon, France
- Besançon University Hospital, 25030 Besançon, France
| | - Rong Shi
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, Germany
| | - Weixia Li
- Qinghai University, Qinghai University First Affiliated Hospital, Qinghai Province, 810001 Xining, PR China
| | - Yi Jiang
- Xinjiang Medical University, First Affiliated Hospital, WHO Collaborating Centre on Prevention and Care Management of Echinococcosis, 830054 Urumqi, Xinjiang Uyghur Autonomous Region, PR China
| | - Julian Schmidberger
- Department of Internal Medicine I, University Hospital Ulm, 89081 Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, University Hospital Ulm, 89081 Ulm, Germany
- Corresponding author at: Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
| | - Wenya Liu
- Xinjiang Medical University, First Affiliated Hospital, WHO Collaborating Centre on Prevention and Care Management of Echinococcosis, 830054 Urumqi, Xinjiang Uyghur Autonomous Region, PR China
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Abstract
Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.
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