Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis

Figure 2 Schematic diagrams and grayscale ultrasound images of hepatic alveolar echinococcosis. A: Schematic structure of hepatic alveolar echinococcosis (HAE); B: Hemangioma-like: Hemangioma-like lesions of HAE manifest as well-defined and heterogeneous hyperechoic masses in comparison to the surrounding hepatic parenchyma; C: Metastasis-like: Metastasis-like lesions of HAE manifest as hypoechoic masses with indistinct margins, lacking a halo sign, and with a hyperechoic and heterogeneous scar at their center; D: Hailstorm: Hailstorm lesions of HAE are characterized by ill-defined boundaries and irregularly shaped masses of heterogeneous echogenicity, accompanied by scattered or diffuse calcifications, with or without a posterior acoustic shadow; E: Ossification: Ossified lesions of HAE present as small and sharply delineated lesions with internal clumps of calcification and a posterior acoustic shadow; F: Pseudocystic: Pseudocystic lesions of HAE are primarily characterized by a thickness exceeding 10 mm with high echogenicity, irregular and non-uniform margins, and a low-echogenicity liquefied necrotic area inside. IOUS: Intraoperative ultrasound.