Control program implementation for ce has historically relied on a. Dwi diffusionweighted imaging, fdg fluorodeoxyglucose, hae hepatic alveolar echinococcosis, petct positron. Echinococcus multilocularis diagnosis peter deplazes swiss tph. Alveolar echinococcosis how is alveolar echinococcosis. Alveolar echinococcosis ae, a parasitic disease primarily of the liver caused by the larval stage of echinococcus multilocularis, is highly endemic in switzerland. 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.
Thirtyfive patients with 50 lesions histologically proven. It mimics a slowgrowing tumor, as in contrast to e. The role of diffusionweighted imaging in differentiation. Patients with hepatic alveolar echinococcosis hae infringing on the inferior vena cava ivc have a poor prognosis when radical resection cannot be performed because. Human alveolar echinococcosis ae is a potentially lethal zoonosis. A new treatment strategy for endstage hepatic alveolar. 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. Diagnostic imaging us and ct supplemented by mri, pet and contrast enh. 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. Hae is prevalent in asia, africa, europe and north america, and has become a serious. Alveolar echinococcosis, also referred as hepatic alveolar echinococcosis or e. Ultrasonography imaging is the technique of choice for the diagnosis of both cystic.
Hepatic alveolar echinococcosis hae, caused by larvae of echinococcus multilocularis, is a rare but potentially lethal parasitic disease. Imaging diagnosis of alveolar echinococcosis in young. 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. Alveolar echinococcosis primarily consists of cystic and solid components. Alveolar echinococcosis of the liver in a sixyearold girl with acquired immunodeficiency syndrome. Research supported by operational program for crossborder. Alveolar echinococcosis is a rare parasitic disease caused by the fox tapeworm echinococcus multilocularis, which is endemic in many parts of the world. 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.
Author summary echinococcosis is one of the most neglected tropical diseases caused by the metacestodes of echinococcus spp. Cluster of complex cysts, with non enhancing debris centrally, mimicking scars. There is no difficulty in distinguishing typical hce and ihcc via imaging methods. This does not apply equally to alveolar echinococcosis, which unfortunately continues to be a diagnostic and therapeutic chameleon. In contrast, alveolar echinococcosis is typically surrounded by an exuberant granulomatous response, which includes both fibrosis and necrosis. 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. Alveolar hydatid disease or alveolar echinococcosis is a disease of the parasite echinococcus multilocularis that is potentially fatal if left untreated.
Author summary cystic and alveolar echinococcosis, caused by e. Hepatic alveolar echinococcosis hae is a malignant parasitic disease of the liver. 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. Cystic and alveolar echinococcosis are diseases of animals and humans. Disseminated alveolar hydatid disease resembling a. Worldwide literature on epidemiology of human alveolar. Diagnosis of alveolar echinococcosis is based on clinical findings and epidemiological data, imaging techniques, histopathology andor nucleic acid detection, and serology. Diagnostic imaging and interventional procedures in a. Echinococcosis fact sheet world health organization. People who accidentally swallow the eggs of the echinococcus multilocularis tapeworm are at risk for infection. Guidelines for the treatment of alveolar echinococcosis ae were published in 1996 and updated in 2010 by the whoinformal working group on echinococcosis. Alveolar echinococcosis is typically found in older people.
Multimodality imaging in diagnosis and management of alveolar. Hae diagnosis may thus also be an incidental finding on imaging. To clarify the magnetic resonance mr imaging findings of alveolar echinococcosis in the liver. On a voluntary basis, 559 patients were reported to the registry. Echinococcus multilocularis infection is fatal if left untreated. Imaging of alveolar echinococcosis while radiologic imaging modalities play a major role, histopathologic examinations and pcr analysis are used for making the definite diagnosis. To compare the echinococcus multilocularis ultrasound us classification emucus. Magnetic resonance imaging evaluation of characteristics. Visualization and pathological characteristics of hepatic. The first diagnostic suspicion is usually based on.
We compared the imaging findings in patients with alveolar liver echinococcosis using ultrasound us, computerized tomography ct and magnetic. Diagnosis of alveolar echinococcosis is confirmed by 1 positive histopathology, if available andor 2 typical liver lesion morphology identified by imaging techniques ultrasound scan. 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. We compared the clinical results of hepatectomy for hepatic alveolar echinococcosis based on 3d software with traditional assessment. Interventional treatment of echinococcosis radiology key. Echinococcosis is a serious tapeworm infection that can affect humans. Echinococcosis is a parasitic disease of tapeworms of the echinococcus type. A diagnosis of alveolar echinococcosis ae is most often suspected based on imaging results ultrasonography or ct scanning. The first diagnostic suspicion is usually based on hepatic ultrasound exam performed because of abdominal symptoms or in the context of a general checkup. 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.
Qgis software was used for the mapping of the affected countries. Calcification was seen on plain abdominal films in five of seven patients 66. Alveolar hydatid disease ahd, is a form of echinococcosis, a disease that originates from a parasite. The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. Imaging techniques such as ct scans are used to visually confirm the parasitic vesicles and cystlike structures. Innovation in hepatic alveolar echinococcosis imaging.
Alveolar echinococcosis ae, caused by the larval stage of echinococcus multilocularis, is a serious parasitic disease of humans in northern hemisphere countries in the. Alveolar echinococcosis is a rare chronic and progressive disease, which can involve mostly liver and in rare cases lung and brain. Symptoms of echinococcosis are intense and can quickly become lifethreatening, so prompt medical treatment is key to a good prognosis. The role of delayed 18 ffdg pet imaging in the followup of patients with alveolar echinococcosis. Diagnostic imaging and in terventional procedures in a growing problem. Statistical analyses were performed using the sas statistical software. Multimodality imaging in diagnosis and management of. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. Human cystic echinococcosis is diagnosed with imaging tools such as ultrasound or computed tomography, and its laboratory confirmation relies on serological tests. Radiographic, ultrasonographic, and computed tomographic. 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. Alveolar echinococcosis ae is caused by the larval metacestode stage of the cyclophyllid tapeworm, echinococcus multilocularis.
Data that were based on serological investigations without additional imaging. Evaluation of direct costs associated with alveolar and. Quantitative analysis of cerebral alveolar echinococcosis. 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. Application of 3d reconstruction for surgical treatment of. We compared the clinical results of hepatectomy for hepatic alveolar echinococcosis based on 3d software. The solid components consist of coagulation necrosis, granuloma, and calcifications.