Ultrasound Elastography in the Differentiation of Simple Cyst and Type I Hydatid Cyst of the Liver

Abstract

Hydatid cyst (HC) is a parasitic disease that is endemic particularly to the sheep-breeding regions of the world, our country included. Given their propensity to materialize most commonly in the liver, our study evaluates the value of ultrasound elastography in the differential diagnosis of simple cyst and type I HCs of the liver. The study involved a total of 73 cysts (22 simple cysts, 51 type I HCs) that were removed using the puncture aspiration injection reaspiration technique between 2016 and 2018. All measurements were made using a Siemens ACUSON S2000 (Siemens Healthcare, Erlangen, Germany) device with a 4-MHZ 4C1 convex probe, an acoustic radiation force impulse elastography procedure, and a Virtual Touch IQ option. The difference between the mean shearwave elastography (SWE) values of both groups was analyzed with an independent t test. Of the 70 patients involved in the study, 29 were female and 41 were male, with a mean ± SD age of 38.85 ± 17.62 years (range, 5-82 years). Upon the examination of the 22 simple cysts and the 51 HCs, the mean ± SD SWE values were found to be 2.6 ± 0.96 (0.96-4.25) and 2.8 ± 1.69 (0.66-4.84), respectively. No statistically significant difference was identified between the SWE values of type I HCs and simple cysts (P > 0.005). Although HCs and simple cysts had similar radiological appearances, and a relative difference was noted in the differentiation of the elastographic measurements, this difference was not statistically significant. Accordingly, more comprehensive and various studies are needed.

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

“…Of particular importance is the differential diagnosis with alveolar echinococcosis caused by Echinococcus multilocularis, especially in co-endemic areas, as cystic echinococcosis and alveolar echinococcosis are two very different diseases and dramatic consequences may derive from their inaccurate differentiation [15]. Several studies published in the last decade have explored the usefulness of advanced imaging techniques, including ultrasound elastography, CT, and DW-MRI, for the differential diagnosis of cystic echinococcosis and other lesions; however, results were variable and overall disappointing when coming to clinical usefulness [16][17][18][19][20][21][22][23]. FDG-PET/CT, which has a defined role in alveolar echinococcosis, has been also applied to cystic echinococcosis, with potential usefulness to evaluate the presence of inflammatory complications [24][25][26], but not for evaluation of CE cysts in terms of viability [27].…”

Comparison of Medical Treatment Efficiency With Shear Wave Elastography Values of Thrombus in Patients With Lower Extremity Deep Vein Thrombosis

“…9 As is known, thrombi transform into a more rigid structure as it collagenize over time. 10 Ultrasound elastography imaging modality, which is used to assess local stiffness in tissues of organs like the liver, spleen, and lung, [11][12][13] also has an important role in determining the stiffness and stage of thrombus 9,14 Acute DVT patients are good candidates for endovascular treatment because of the absence of thrombus adhered to vein wall and the lack of thrombus organization with fibrinous changes. 9,15 Therefore, it is important to identify patients with stiff clot content, with completely occlusive DVT, who may be resistant to medical treatment and refer them to endovascular treatment during the early stages.…”

“…As is known, thrombi transform into a more rigid structure as it collagenize over time 10 . Ultrasound elastography imaging modality, which is used to assess local stiffness in tissues of organs like the liver, spleen, and lung, 11–13 also has an important role in determining the stiffness and stage of thrombus 9,14 …”