Tao Y, Wang YF, Wang J, Long S, Seyler BC, Zhong XF, Lu Q. Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis. World J Gastroenterol 2024; 30(37): 4115-4131 [DOI: 10.3748/wjg.v30.i37.4115]
Corresponding Author of This Article
Qiang Lu, MD, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. luqiang@scu.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2024; 30(37): 4115-4131 Published online Oct 7, 2024. doi: 10.3748/wjg.v30.i37.4115
Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis
Yi Tao, Yi-Fei Wang, Jun Wang, Shuang Long, Barnabas C Seyler, Xiao-Fei Zhong, Qiang Lu
Yi Tao, Yi-Fei Wang, Jun Wang, Xiao-Fei Zhong, Qiang Lu, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Shuang Long, Department of Radiology, Gaoping District People’s Hospital, Nanchong 637100, Sichuan Province, China
Barnabas C Seyler, Shude International, Chengdu Shude High School, Chengdu 610066, Sichuan Province, China
Barnabas C Seyler, Department of Environment, Sichuan University, Chengdu 610065, Sichuan Province, China
Author contributions: Tao Y and Wang YF collected and screened clinical cases; Tao Y drafted the initial manuscript; Wang YF was responsible for subsequent manuscript revisions; Wang J and Seyler BC assisted in refining the English quality of the article and participated in manuscript revisions; Long S provided radiological expertise; Zhong XF meticulously reverified the conventional, contrast-enhanced, and intraoperative ultrasound images for publication; Lu Q conceived and designed the protocol, oversaw the overall design, supervised the study, and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Lu, MD, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. luqiang@scu.edu.cn
Received: June 10, 2024 Revised: August 26, 2024 Accepted: September 12, 2024 Published online: October 7, 2024 Processing time: 107 Days and 21.8 Hours
Abstract
Echinococcosis is a zoonotic disease caused by parasites belonging to the genus Echinococcus that primarily affect the liver. The western plateau and pastoral areas of China are high-risk regions for hepatic cystic echinococcosis and hepatic alveolar echinococcosis (HAE). The high late mortality rate associated with HAE underscores the critical need for early diagnosis to improve cure rates and mitigate the disease burden in endemic areas. Currently, the World Health Organization recommends ultrasonography as the preferred initial screening method for hepatic echinococcosis. However, distinguishing between specific types of lesions, such as those of hepatic cystic echinococcosis and HAE, and other focal liver lesions is challenging. To address this issue, contrast-enhanced ultrasound is recommended as a tool to differentiate solid and cysto-solid hepatic echinococcosis from other focal liver lesions, significantly enhancing diagnostic accuracy. In this comprehensive review, we discuss the progression of hepatic echinococcosis and detail the imaging features of various types of echinococcosis using conventional, contrast-enhanced, and intraoperative ultrasound techniques. Our objective is to provide robust imaging evidence and guidance for early diagnosis, clinical decision making, and postoperative follow-up in regions with high disease prevalence.
Core Tip: Accurate diagnosis of hepatic echinococcosis is crucial, especially for high-mortality hepatic alveolar echinococcosis. Ultrasonography is recommended as the first-line examination for hepatic echinococcosis in endemic areas. This review focuses on the clinical features and ultrasonographic diagnosis of this disease, emphasizing the importance of early detection in endemic regions to improve clinical outcomes. Additionally, this review presents classic images of conventional ultrasound, contrast-enhanced ultrasound, and intraoperative ultrasound to illustrate different stages and types of hepatic cystic and alveolar echinococcosis, thereby facilitating their differentiation from other focal liver lesions.
