Interventional treatment of echinococcosis radiology key. Statistical analyses were performed using the sas statistical software. The role of delayed 18 ffdg pet imaging in the followup of patients with alveolar echinococcosis. Complementary imaging exams at diagnosis and for followup include ctscan, magnetic resonance imaging, and for ae only, positron emission tomography 1 and 3 hours after iv. Quantitative analysis of cerebral alveolar echinococcosis.
Diagnostic imaging and interventional procedures in a. Innovation in hepatic alveolar echinococcosis imaging. Diagnosis of alveolar echinococcosis is based on clinical findings and epidemiological data, imaging techniques, histopathology andor nucleic acid detection, and serology. Visualization and pathological characteristics of hepatic. Alveolar hydatid disease ahd, is a form of echinococcosis, a disease that originates from a parasite. Calcification was seen on plain abdominal films in five of seven patients 66. Echinococcus multilocularis infection is fatal if left untreated. Multimodality imaging in diagnosis and management of. Alveolar echinococcosis radiology reference article. Clinical presentation, diagnosis, therapy and outcome of. It mimics a slowgrowing tumor, as in contrast to e. Alveolar echinococcosis ae is caused by the larval metacestode stage of the cyclophyllid tapeworm, echinococcus multilocularis.
Application of 3d reconstruction for surgical treatment of. Diagnosis of alveolar echinococcosis is confirmed by 1 positive histopathology, if available andor 2 typical liver lesion morphology identified by imaging techniques ultrasound scan. We compared the clinical results of hepatectomy for hepatic alveolar echinococcosis based on 3d software with traditional assessment. Diagnostic imaging us and ct supplemented by mri, pet and contrast enh. Symptoms of echinococcosis are intense and can quickly become lifethreatening, so prompt medical treatment is key to a good prognosis. Evaluation of direct costs associated with alveolar and. The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. The solid components consist of coagulation necrosis, granuloma, and calcifications.
Characteristic mr imaging features of alveolar echinococcosis include a heterogeneous infiltrative mass with irregular margins and a necrotic center that exhibits low to intermediate signal intensity on t1weighted images and heterogeneous signal intensity areas of low and high signal intensity on t2weighted images 2 fig 10. Alveolar echinococcosis is typically found in older people. Research article quantitative analysis of cerebral alveolar echinococcosis and brain tuberculoma by mr diffusion weighted imaging juan ma a, sailike duishanbai b, chunhui jiang a, jun lu a. Imaging techniques such as ct scans are used to visually confirm the parasitic vesicles and cystlike structures. The lethal disease alveolar echinococcosis ae is caused by the. Cystic and alveolar echinococcosis are diseases of animals and humans. Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite echinococcus multilocularis that is potentially fatal if left untreated. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising.
Echinococcosis fact sheet world health organization. Studies have revealed that in the 18 ffdg petct imaging of alveolar echinococcosis, fdg was perfused to micrangia through blood circulation, and participated in cellular metabolism. On a voluntary basis, 559 patients were reported to the registry. Diagnostic imaging and in terventional procedures in a growing problem. Magnetic resonance imaging and immunoblot analyses in rats with experimentally induced cerebral alveolar echinococcosis. Alveolar echinococcosis is a rare chronic and progressive disease, which can involve mostly liver and in rare cases lung and brain. Surveillance for alveolar echinococcosis in central europe was initiated in 1998. Magnetic resonance imaging evaluation of characteristics.
To clarify the magnetic resonance mr imaging findings of alveolar echinococcosis in the liver. This does not apply equally to alveolar echinococcosis, which unfortunately continues to be a diagnostic and therapeutic chameleon. People who accidentally swallow the eggs of the echinococcus multilocularis tapeworm are at risk for infection. Human cystic echinococcosis is diagnosed with imaging tools such as ultrasound or computed tomography, and its laboratory confirmation relies on serological tests. Cluster of complex cysts, with non enhancing debris centrally, mimicking scars. Worldwide literature on epidemiology of human alveolar. Alveolar echinococcosis is a rare parasitic disease caused by the fox tapeworm echinococcus multilocularis, which is endemic in many parts of the world. Author summary echinococcosis is one of the most neglected tropical diseases caused by the metacestodes of echinococcus spp. Exposure to the responsible parasite, a worm of the echinococcus species, often occurs when a person consumes food tainted by the worm in its larval stage. Disseminated alveolar hydatid disease resembling a.
Human alveolar echinococcosis ae is a potentially lethal zoonosis. Alveolar echinococcosis primarily consists of cystic and solid components. Biological characteristics of 18ffdg petct imaging of. The first diagnostic suspicion is usually based on hepatic ultrasound exam performed because of abdominal symptoms or in the context of a general checkup. Hepatic alveolar echinococcosis hae is a malignant parasitic disease of the liver. Patients with hepatic alveolar echinococcosis hae infringing on the inferior vena cava ivc have a poor prognosis when radical resection cannot be performed because. With the rapid development of digital medicine, threedimensional 3d reconstruction software has become a new tool in surgery, and it is a quantitative imaging analysis system that provides realtime interactive tools for presurgical evaluation and planning. Control program implementation for ce has historically relied on a. In contrast, alveolar echinococcosis is typically surrounded by an exuberant granulomatous response, which includes both fibrosis and necrosis. Guidelines for the treatment of alveolar echinococcosis ae were published in 1996 and updated in 2010 by the whoinformal working group on echinococcosis. Qgis software was used for the mapping of the affected countries.
Alveolar echinococcosis ae, a parasitic disease primarily of the liver caused by the larval stage of echinococcus multilocularis, is highly endemic in switzerland. The role of diffusionweighted imaging in differentiation. Imaging of alveolar echinococcosis while radiologic imaging modalities play a major role, histopathologic examinations and pcr analysis are used for making the definite diagnosis. Hae is prevalent in asia, africa, europe and north america, and has become a serious. Data that were based on serological investigations without additional imaging. Alveolar echinococcosis how is alveolar echinococcosis. Echinococcosis is a serious tapeworm infection that can affect humans.
Alveolar echinococcosis of the liver in a sixyearold girl with acquired immunodeficiency syndrome. Echinococcus multilocularis diagnosis peter deplazes swiss tph. There is no difficulty in distinguishing typical hce and ihcc via imaging methods. Alveolar echinococcosis, also referred as hepatic alveolar echinococcosis or e. We compared the imaging findings in patients with alveolar liver echinococcosis using ultrasound us, computerized tomography ct and magnetic. A new treatment strategy for endstage hepatic alveolar. Hae diagnosis may thus also be an incidental finding on imaging. Author summary cystic and alveolar echinococcosis, caused by e.
Imaging diagnosis of alveolar echinococcosis in young. The sonographic and ct investigations the latter primarily as petct carried out as part of the treatment and diagnosis of alveolar echinococcosis were assigned to the emucct and emucus classifications according to the morphological imaging criteria described by the authors 9, 10. Ultrasonography imaging is the technique of choice for the diagnosis of both cystic. Dwi diffusionweighted imaging, fdg fluorodeoxyglucose, hae hepatic alveolar echinococcosis, petct positron. Alveolar echinococcosis ae, caused by the larval stage of echinococcus multilocularis, is a serious parasitic disease of humans in northern hemisphere countries in the. Research supported by operational program for crossborder. Echinococcus multilocularis is a small, zoonotic, tapeworm that occurs in central europe, much of northern, central and eastern eurasia and parts of north america eckert and. A diagnosis of alveolar echinococcosis ae is most often suspected based on imaging results ultrasonography or ct scanning. Imaging techniques such as ct scans are used to visually confirm the parasitic vesicles and cystlike structures and serologic tests can confirm the parasitic infection. Multimodality imaging in diagnosis and management of alveolar. Conventional imaging methods, including xray, ultrasonography us, computed tomography ct, and magnetic resonance imaging mri, have been used in the diagnosis, followup, and management of ae for several years. Alveolar echinococcosis is a rare metacestodal infection of humans and domestic animals with echinococcus multilocularis and predominantly affects the liver.
We compared the clinical results of hepatectomy for hepatic alveolar echinococcosis based on 3d software. Echinococcosis is a parasitic disease of tapeworms of the echinococcus type. Albeit alveolar echinococcosis is an uncommon disease, its presentation can be very serious, leading to a case fatality rate of 50% or greater in symptomatic cases. After a suspected alveolar echinococcosis lesion is found on initial imaging, complementary imaging is the second step, followed by serology. The first diagnostic suspicion is usually based on.