Learning objectives
The purpose of this study was to determine the role of DW-MRI and contrast enhanced MRI in diagnosing hepatic AE.
Background
Echinococcosis is a parasitic disease caused by larval forms of echinococci. There are four main species of the genus Echinococcus; E. granulosus, E. multilocularis, E. oligarthrus and E.vogeli (1). In humans, the E. granulosus cestodes causes cystic echinococcosis (CE), E. multilocularis cestodes causes alveolar echinococcosis (AE), and E. vogeli and E. oligarthrus cause polycystic echinococcosis. Although CE is common worldwide, AE is seen only in the northern hemisphere (Fig. 1). The exposure to Echinococcus eggs is affected by occupational and environmental factors. The incidence of...
Findings and procedure details
Imaging findings
Ultrasound is accepted as the first choice imaging modality in the diagnosis and follow-up. It is an adequate and efficient imaging modality in screening AE lesions. Since it is cheap, readily available, and does not contain radiation, US can be used in endemic regions as a fast diagnostic tool in large populations (6,7). But US have lower specificity and is highly operator dependent modality.
CT remains the most widely used imaging techniques for detecting AE liver lesions: the anatomic location, dissemination and characterization...
Conclusion
Hepatic AE is a tumor-like chronic disease, which can be fatal if untreated or undertreated. Contrast enhanced MRI and DWI MRI play an important role in ensuring the diagnosis and has a key role in guiding the clinician in terms of early diagnosis and appropriate treatment.
Personal information and conflict of interest
E. Salman Yalniz; Kocaeli/TR - nothing to disclose A. Yalnız; Kocaeli/TR - nothing to disclose
References
1. Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev 2004; 17:107–135.
2. Bulakçı M, Kartal MG, Yılmaz S, et al. Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update. Diagn Interv Radiol 2016; 22(3):247–256.
3. McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet 2003; 362:1295–1304.
4. Kantarci M, Bayraktutan U, Karabulut N, et al. Alveolar echinococcosis: spectrum of findings at cross-sectional imaging. Radiographics 2012; 32:2053–2070.
5. Kern P. Clinical features...