Magnetic resonance imaging evaluation of characteristics of vascular invasion in intermediate and advanced hepatic alveolar echinococcosis

Yang, Xiaofei; Kang, Yingli; Qiao, Yijie; Li, Weixia; Li, Hailong; Bao, Hui‐Fang

doi:10.3892/etm.2019.7460

Cited by 6 publications

(11 citation statements)

References 13 publications

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“…Involvement of vascular and biliary structures also significantly correlated with lesion size. A 2018 MRI study, which was not based on Kodama's classification, showed that the invasion of liver vessels by an AE lesion depends on the progression of the disease stages (34). Our observations add further support to earlier evidence that Chinese cases of AE are more advanced at detection, based on lesion size and of the distribution of the various morphological appearances of liver lesions (35).…”

Section: Discussionsupporting

confidence: 82%

Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study

et al. 2020

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Background The main endemic areas of alveolar echinococcosis (AE) are in central Europe and western China. The infiltration of intrahepatic vascular and bile ducts as well as extrahepatic disease can lead to complications and may increase morbidity in AE. Purpose To evaluate the vascular/biliary involvement of hepatic alveolar echinococcosis (HAE) and distant extrahepatic disease at each of four locations in Germany, France, and China. Material and Methods Contrast-enhanced abdominal magnetic resonance imaging (MRI) scans of patients with HAE, 200 in total, were evaluated by five examiners. AE liver lesions were classified according to Kodama’s classification. Furthermore, distant extrahepatic manifestations were documented with additionally performed imaging modalities. Vascular/biliary involvement of hepatic manifestations as well as the presence of extrahepatic manifestations were correlated with the respective Kodama type of the liver lesion. Results Distant extrahepatic AE manifestations were significantly more frequent in China than in Europe (12/100 vs. 3/100; Fisher’s exact test: P=0.0286). A significant relationship exists between presence of distant extrahepatic disease manifestation and size of the AE liver lesion (132.53 ± 48.65 vs. 92.49 ± 50.06; P = 0.0030). Vascular/biliary involvement is significantly more frequent in China than in Europe (86/100 vs. 65/100; χ2 = 11.92; P = 0.0006). Vascular/biliary involvement depends on lesion size (111.10 ± 47.44 vs. 47.36 ± 24.36; P<0.0001). Different types of AE liver lesions are associated with differences in vascular/biliary involvement and extrahepatic manifestations. Conclusion Vascular/biliary involvement and presence of distant extrahepatic manifestations depend on size of the HAE lesions and are more frequently detected in China. Different MRI morphological patterns influence vascular/biliary involvement and the occurrence of distant extrahepatic manifestations.

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Section: Discussionsupporting

confidence: 82%

Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study

et al. 2020

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“…This is consistent with the result that Xiaofei Yang et al 19 found that HAE has the characteristics of "venophilic vessels." The portal vein is mainly invaded by the lesions in the left lobe of the liver, which was inconsistent with the findings of Yang Xiaofei et al 19 that the lesions in the right lobe of the liver are prone to invade the portal vein. We also found that the left branch of the portal vein was mainly invaded.…”

Section: Vascular Invasion Analysissupporting

confidence: 92%

“…This is consistent with the findings of the YANGXIAOFEI study. 19 (2) The left lobe of the liver has a large volume and rich blood supply. (3) Intraperitoneal lesions directly invade the left lobe of the liver and growth in intrahepatic infiltrate.…”

Section: Discussionmentioning

confidence: 99%

7T Small Animal MRI Research for Hepatic Alveolar Echinococcosis

Zhang

Mou

Fan

et al. 2022

Topics in Magnetic Resonance Imaging

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Objectives: 7T small animal magnetic resonance imaging (MRI) was used to analyze the growth characteristics of hepatic alveolar echinococcosis (HAE).Methods: A mouse model of HAE was established by intraperitoneal injection of alveolar Echinococcus tissue suspension. Ten mouse models successfully inoculated by ultrasound screening were selected. The mouse model was scanned with T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI) sequence by 7T small animal MRI. Size, morphology, boundary, signal, and relationship with surrounding tissues of the lesions were recorded as characteristic alterations.Mice were killed at the end of the experiment, and the pathological specimens were taken for routine hematoxylin and eosin staining.Results: Lesions were mainly located in the right lobe of the liver. The multivesicular structure is the characteristic manifestation of this disease. In the liver, lesions invaded the portal vein and were mainly distributed at the hepatic hilum. The left branch of the portal vein was mainly invaded. The mean diameter of the lesions in the left lobe of the liver was larger than in other parts of the liver. The mean diameter of the cystic solid lesions was greater than the multilocular cystic lesions. HAE showed hypointense on T1WI, hyperintense on T2WI, and hypointense on DWI; the marginal zone of the lesion showed hyperintensity on DWI and grew toward the hilum. The MRI features of intraperitoneal lesions were similar to those of intrahepatic lesions. Intraperitoneal lesions increased faster than intrahepatic lesions in the same period. Conclusion:Polyvesicular structure is a characteristic manifestation of hepatic alveolar echinococcosis in mice. The noninvasive monitoring of liver HAE in mice by 7T small animal MRI provides a visual basis for the diagnosis and treatment integration of HAE.

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“…HAE exhibits an invasive growth and tends to occupy the hepatic parenchyma and invade intrahepatic vessels in particular 4 , 12 . Unlike malignant tumors, a relatively long time interval between primary infection and presentation of symptoms enables adequate compensatory function of the disease-free lobe of the liver in end-stage HAE patients.…”

Section: Discussionmentioning

confidence: 99%

“…Three-dimensional (3D) reconstruction allows for intuitive and omnidirectional information of vascular and biliary anatomy, and accurate measurement of remnant liver volume (RLV) after virtual surgery. Up to now, most of the studies focus on the imaging diagnosis, the relationship between the lesion and intrahepatic vessels, and whether invasion of intrahepatic vessels or not 12 – 15 . There were no publications to report the utility of triphase enhanced CT together with 3D reconstruction in the comprehensive evaluation of preoperative indications for ALT in patients with end-stage HAE in detail.…”

Section: Introductionmentioning

confidence: 99%

Triphase contrast-enhanced CT to evaluate indications for autologous liver transplantation in patients with end-stage hepatic alveolar echinococcosis

Chen

et al. 2021

Sci Rep

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Autologous liver transplantation (ALT) to cure end-stage hepatic alveolar echinococcosis (HAE) requires that hepatobiliary surgeons understand the invasion of intrahepatic structure and adjacent tissues or organs. Triphase contrast-enhanced CT of the liver has been widely used for diagnosis and preoperative evaluation of HAE. Three-dimensional (3D) reconstruction allows for accurate measurement of remnant liver volume (RLV). The objective of the study was to evaluate value of triphase contrast-enhanced CT together with 3D reconstruction in preoperative evaluation of indications for ALT in patients with end-stage HAE. This cohort include twenty-one consecutive patients with end-stage HAE, who preoperatively underwent triphase enhanced CT together with 3D reconstruction for ALT. To depict the indications, the 2D image data were reviewed statistically focusing on porta hepatis invasion, retrohepatic vena cava (RHVC) involvement and degrees of intrahepatic vessel invasion, and the 3D reconstruction was performed to obtain ratio of RLV to standard liver volume (SLV). The results showed that 95.24% patients (20/21) had porta hepatis invasion. When lesions located in right liver lobe, porta hepatis invasion occurred most commonly in the second and third porta hepatis (7/10), whereas the first, second and third porta hepatis were most commonly invaded by lesions in the right and caudate / left medial liver lobes (7/11) (P < 0.05). The mean value of longitudinal invasion of RHVC was 8.0 cm, and 95.2% (20/21) of patients had RHVC invasion with ≥ 180° circumferential invasion. As for the important vascular events, moderate and severe invasion occurred most commonly in the right hepatic vein, right branch of portal vein and RHVC each in 95.2% (20/21) patients (P < 0.05). We also found that preoperative CT had a good agreement with intraoperative findings in assessing intrahepatic vascular involvement by HAE (kappa index = 0.77). The estimated average ratio of RLV to SLV was 0.95 (range, 0.43–1.62). In conclusion, the 2D contrast-enhanced CT could well depict anatomic location and size of HAE, and invasion of porta hepatis and vascular by this disease, and involvement of other adjacent organs and tissues. Above all, 3D reconstruction could accurately measure RLV in patients with end-stage HAE for ALT.

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Magnetic resonance imaging evaluation of characteristics of vascular invasion in intermediate and advanced hepatic alveolar echinococcosis

Cited by 6 publications

References 13 publications

Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study

Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study

7T Small Animal MRI Research for Hepatic Alveolar Echinococcosis

Triphase contrast-enhanced CT to evaluate indications for autologous liver transplantation in patients with end-stage hepatic alveolar echinococcosis

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