Characteristics of the imaging diagnosis of alveolar echinococcosis

Current considerations for the management of liver echinococcosis

Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis (alveolaris) and affects the liver predominantly. Hepatic alveolar echinococcosis is similar to carcinoma in appearance, and without treatment, it can lead to death. Diagnosis is based on current imaging modalities. Surgical management is the cornerstone of treatment. Complete removal of the cyst (total pericystectomy or hepatectomy) ensures a permanent cure and should be the first-choice treatment for cystic disease. Cyst evacuation, partial cystectomy, and drainage or omentoplasty, may be alternative choices in difficult cases. Albendazole, mebendazole and praziquantel are options for treating small cysts and preventing recurrence after surgery. Despite the efforts, alveolar echinococcus is not usually amenable to surgical management, except in the early stage, which is less common, and management by albendazole is indicated. However, there are few recent reports of major operations (ex-vivo hepatectomy, autotransplantation and vascular reconstruction) in advanced stages.

Hepatic cystic echinococcosis (type II): A case report

This article presents a case report of a rare instance of hepatic cystic echinococcosis (Type II). The patient is a young female who has resided in the Inner Mongolia region of China for an extended period and has a clear history of contact with dogs and sheep. She presented with recurrent upper abdominal pain accompanied by jaundice of skin and sclera for 2 months. Through comprehensive clinical history inquiry, physical examination, and imaging studies such as ultrasound and computed tomography, the diagnosis of hepatic cystic echinococcosis (Type II) was confirmed. The patient underwent a capsular excision, and the postoperative prognosis was good with no recurrence or implantation during short-term follow-up. This case report details the patient's clinical symptoms, signs, diagnostic process, and key points for differential diagnosis, emphasizing the crucial role of imaging studies in the diagnosis of hepatic cystic echinococcosis. Additionally, the treatment plan and postoperative follow-up for this case are discussed, aiming to provide a reference for clinical diagnosis and treatment of hepatic cystic echinococcosis.

Advances in Novel Diagnostic Techniques for Alveolar Echinococcosis

Alveolar echinococcosis (AE), caused by the larval stage of the tapeworm Echinococcus multilocularis, is a serious parasitic disease that presents significant health risks and challenges for both patients and healthcare systems. Accurate and timely diagnosis is essential for effective management and improved patient outcomes. This review summarizes the latest diagnostic methods for AE, focusing on serological tests and imaging techniques such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT). Each imaging modality has its strengths and limitations in detecting and characterizing AE lesions, such as their location, size, and invasiveness. US is often the first-line method due to its non-invasiveness and cost-effectiveness, but it may have limitations in assessing complex lesions. CT provides detailed anatomical information and is particularly useful for assessing bone involvement and calcification. MRI, with its excellent soft tissue contrast, is superior for delineating the extent of AE lesions and their relationship to adjacent structures. PET/CT combines functional and morphological imaging to provide insights into the metabolic activity of lesions, which is valuable for monitoring treatment response and detecting recurrence. Overall, this review emphasizes the importance of a multifaceted diagnostic approach that combines serological and imaging techniques for accurate and early AE diagnosis, which is crucial for effective management and improved patient outcomes.