Cystic and alveolar echinococcosis of the hepatobiliary tract – the role of new imaging techniques for improved diagnosis

Dietrich, Christoph F.; Douira-Khomsi, W.; Gharbi, H A; Sharma, Malay; Cui, Xin; Spârchez, Zeno; Richter, Joachim; Kabaalioğlu, Adnan; Atkinson, Nathan; Schreiber-Dietrich, Dagmar; Ye, Dong

doi:10.11152/mu-2421

Cited by 13 publications

(16 citation statements)

References 86 publications

(116 reference statements)

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“…It has nonspecific features on conventional abdominal ultrasound and can present as a homogeneous, hypoechoic lesion in patients with fatty liver, a hyperechoic lesion in patients with a normal liver, or a heterogeneous lesion if complicated by hemorrhage [ 7 ]. Previous reports have described that the imaging features of focal PH can mimic a mass and may be difficult to distinguish from other hepatic lesions including hemangioma, HCC, metastases, adenoma, focal nodular hyperplasia (FNH), and multiple abscesses [ 6 , 7 , 18 , 19 ]. Most cases of PH are detected incidentally as a hypervascular tumor on cross-sectional imaging (CT/MRI, ultrasonography).…”

Section: Discussionmentioning

confidence: 99%

“…Most cases of PH are detected incidentally as a hypervascular tumor on cross-sectional imaging (CT/MRI, ultrasonography). PH may part of the histological features of hepatocellular adenoma [ 8 , 20 ], HCC [ 21 ], sarcoma, FNH [ 20 ], hemangioma [ 8 ], and other focal liver lesions including focal tuberculosis, as well as severe hepatic infections [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound findings in peliosis hepatis

Wang

Lim

et al. 2021

Ultrasonography

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Purpose: The aim of this study was to retrospectively evaluate contrast-enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH).Methods: A retrospective analysis was conducted of CEUS features in 24 patients with histopathologically confirmed PH (11 men and 13 women; mean age, 32.4±7.1 years; range, 28 to 41 years). All lesions were histologically proven, either by core needle biopsy (n=10) or by hepatic surgery (n=14).Results: The mean size was 36.8±12.4 mm (range, 10 to 80 mm). On B-mode ultrasonography (BMUS), all PH lesions were heterogeneously hypoechoic, with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneous hyperenhancement (83.3%, 20/24) or isoenhancement (16.7%, 4/24). Furthermore, 87.5% of the PH lesions showed mild washout after 1 minute in the portal venous phase (30-120 seconds) and mild washout in the late phase (>120 seconds).Conclusion: The lack of a mass effect on BMUS, mild heterogeneous arterial hyperenhancement, and washout in the very late portal venous phase (after 1 minute) on CEUS are characteristic of PH. Although it is a histological diagnosis, PH should be considered in the differential diagnosis when the clinical context does not favor a malignancy or infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound findings in peliosis hepatis

Wang

Lim

et al. 2021

Ultrasonography

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“…Parasitic infection with Echinococcus granulosus (hydatid disease) is usually asymptomatic. The spleen is the third most common site for hydatic cysts, and therefore, in some geographical regions E. granulosus is among the most common etiologies of splenic cystic lesions (Akbulut et al 2013;Rasheed et al 2013;Brunetti et al 2018 (Schwarze et al 2018;Dietrich et al 2020bDietrich et al , 2020c.…”

Section: Splenic Cystsmentioning

confidence: 99%

WFUMB Position Paper—Incidental Findings, How to Manage: Spleen

Trenker

Görg

Freeman

et al. 2021

Ultrasound in Medicine & Biology

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The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled "Incidental Imaging Findings-The Role of Medical Ultrasound." IFs are less commonly encountered in the spleen than in many other abdominal organs but remain a frequent dilemma in clinical practice. A histological diagnosis is rarely necessary for patient management. Many IFs, such as secondary spleens and splenic cysts, are harmless and do not require any further investigation. The diagnosis of many other focal splenic lesions is, however, often problematic. The following overview is intended to illustrate a variety of incidentally detected spleen pathologies such as size variants, shape variants, secondary spleens, focal splenic lesions and splenic calcifications. It should aid the examiner in establishing the diagnosis. Moreover, it should help the ultrasound practitioner decide which pathologies need no further investigation, those requiring interval imaging and cases in which immediate further diagnostic procedures are required.In patients with splenomegaly (>13 £ 6 cm), an imaging, clinical and laboratory evaluation is usually required to determine the underlying cause.Most congenital variants of the spleen, and accessory spleens, have characteristic ultrasound appearances and do not require further evaluation or follow-up.The use of ultrasound contrast microbubbles (contrast-enhanced ultrasound) is of particular value in ultrasound imaging of the spleen when an indeterminate incidental finding is encountered.Splenosis can be confidently diagnosed with contrast-enhanced ultrasound and usually requires no additional imaging or follow-up.The cause of an inhomogeneous splenic parenchyma must be clarified, especially to exclude sarcoidosis or lymphomatous infiltration. Incidental indeterminate focal splenic lesions (with the exception of simple cysts) are often best managed by an interval follow-up examination (initially after 3 months) unless there clearly malignant clinical or sonographic features.For splenic calcifications, including the "starry sky" spleen, no follow-up is necessary.

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“…In terms of viability, CE1, CE2, and CE3b are viable; CE3a have variable viability; CE4 and C5 are not viable or have low viability. CE1 and CE3a are early stages, and CE4 and CE5 are late stages (see also [63] for further illustrations) [38].…”

Section: Echinococcosis (Ce Cysts) Hydatid Cysts (Hc)mentioning

confidence: 99%

“…CEUS may distinguish hydatid cysts from neoplasms; the absence of arterial contrast enhancement in CE due to fluid-filled avascular cysts may be demonstrated. CEUS demonstrates perifocal inflammatory reactions, as nodular zones of peripheral ring enhancement are seen [65,66,67]. Thus, echinococcal cysts can be differentiated from dysontogenetic cysts under some circumstances [68,69].…”

Section: Echinococcosis (Ce Cysts) Hydatid Cysts (Hc)mentioning

confidence: 99%

Ultrasound and contrast-enhanced ultrasound (CEUS) in infective liver lesions

Chaubal

Thomsen²,

Kabaalioğlu

et al. 2021

Z Gastroenterol

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ZusammenfassungInfektiöse fokale Leberläsionen (FLL) treten in der klinischen Praxis häufig auf, wobei bakterielle Leberabszesse die Hälfte ausmachen. Eine genaue Diagnose der FLL ist für die Auswahl der am besten geeigneten Therapie und zur Vorbeugung von Komplikationen unerlässlich. Ziel der aktuellen Arbeit ist es, den Nutzen von Ultraschall und kontrastmittelverstärktem Ultraschall (CEUS) zur Erkennung und Charakterisierung infektiöser Leberläsionen zu beschreiben.

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Cystic and alveolar echinococcosis of the hepatobiliary tract – the role of new imaging techniques for improved diagnosis

Cited by 13 publications

References 86 publications

Ultrasound findings in peliosis hepatis

Ultrasound findings in peliosis hepatis

WFUMB Position Paper—Incidental Findings, How to Manage: Spleen

Ultrasound and contrast-enhanced ultrasound (CEUS) in infective liver lesions

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