Percutaneous management in hepatic alveolar echinococcosis: A sum of single center experiences and a brief overview of the literature

Figure 1 Male, 28 years old. Hepatic alveolar echinococcosis is a serious infection that requires liver replacement. A: On axial portal venous phase contrast enhanced computed tomography, a large cystic mass is visible; B: After percutaneous treatment, the lesion's size has decreased, and a drainage catheter is visible (arrow); C: Percutaneous drainage was unable to heal the lesion, and liver transplantation was undertaken.

Figure 2 Female, 50-year-old. Treatment of hepatic alveolar echinococcosis with right hepatectomy. A: On axial portal venous phase contrast enhanced computed tomography, a large cystic mass is visible; B: After percutaneous treatment, the lesion's size has decreased, and a drainage catheter is visible (arrow); C: Percutaneous drainage was unable to heal the condition, and a right hepatectomy was performed.

Figure 3 Female, 32-year-old. A: Alveolar Echinococcosis at right liver lobe, with typical peripheral calcifications and large central necrosis; B: 3D image in the coronal plane illustrates the location of the percutaneous drainage catheter and the external biliary drainage catheter in the patient; C: Drainage catheter can be seen in within the lesion (arrow); D: The shrunken lesion cavity and the regression of the dilatation in the left intrahepatic bile ducts are illustrated by 3D coronal plane image. PDC: Percutaneous drainage catheter; IVC: Inferior vena cava; EBDC: External biliary drainage catheter; LHV: Left hepatic vein; RHD: Right hepatic duct; LHD: Left hepatic duct; CHA: Common hepatic artery; HPV: Hepatic portal vein; CBD: Common biliary duct; Gb: Gallbladder; CD: Cystic duct.

Figure 4 Male, 45 years old. A and B: Axial magnetic resonance imaging demonstrates enhancing brain lesions associated with alveolar echinococcosis (circles). Alveolar Echinococcosis is also prevalent in the parenchyma of the left lung (arrow); C: Percutaneous drainage was performed; typical calcifications (white arrow) are visible, as is the drainage catheter (black arrow); D: 3D axial plane cross sectional illustration image shows the percutaneous drainage catheter placement in the lesion cavity. PDC: Percutaneous drainage catheter; IVC: Inferior vena cava; Ao: Abdominal aorta; IVC: Inferior vena cava; St: Stomach; Sp: Spleen.