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Aziz H, Seda P, Aswani Y, Gosse MD, Krishnakumari AJ, Pawlik TM. Cystic echinococcosis of the liver. J Gastrointest Surg 2025; 29:101974. [PMID: 39864780 DOI: 10.1016/j.gassur.2025.101974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2024] [Revised: 01/18/2025] [Accepted: 01/21/2025] [Indexed: 01/28/2025]
Abstract
BACKGROUND Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm, which is transmitted by dogs and found on every continent, except Antarctica. This study aimed to review the life cycle, epidemiology, symptoms, diagnostic methods, and treatment of E granulosus infection of the liver. METHODS A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 1990 and 2024. The main search focused on "CE of the liver." The following terms were used: cystic echinococcosis, hydatidosis, E granulosus, echinococcus life cycle, liver cyst, albendazole, liver resection, pericystectomy, cystobiliary fistula, and percutaneous aspiration injection and reaspiration (PAIR). RESULTS CE should be considered in the differential diagnosis of hepatic cysts, especially among individuals with risk factors, such as those who have traveled to or immigrated from areas with a high prevalence. Echinococcus species require 2 hosts to complete their life cycle, with humans acting as intermediate hosts that become infected by ingesting eggs from contaminated environments, leading to cyst formation, typically in the liver or lungs. Symptoms are based on cyst size and location, such as abdominal pain, jaundice, respiratory distress, or neurologic deficits, and can lead to severe complications, such as cyst rupture, allergic reactions, sepsis, or secondary hydatidosis. Imaging plays a key role in evaluating cyst stage, size, location, and potential complications and in determining the appropriateness of a minimally invasive PAIR procedure. Although serum antibody tests typically have a low sensitivity, antigen assays or recombinant proteins may provide useful diagnostic information. For uncomplicated active cysts, the treatment options include chemotherapy alone or in combination with the PAIR technique. CONCLUSION Hepatic echinococcal cysts, which are relatively rare in North America, should be considered in the differential diagnosis of hepatic cysts, especially in individuals with risk factors.
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Affiliation(s)
- Hassan Aziz
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
| | - Peyton Seda
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Yashant Aswani
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Matthew D Gosse
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Aparna Joshi Krishnakumari
- Department of Radiology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Liu H, Xie Y, An X, Xu D, Cai S, Chu C, Liu G. Advances in Novel Diagnostic Techniques for Alveolar Echinococcosis. Diagnostics (Basel) 2025; 15:585. [PMID: 40075832 PMCID: PMC11898896 DOI: 10.3390/diagnostics15050585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 02/10/2025] [Accepted: 02/24/2025] [Indexed: 03/14/2025] Open
Abstract
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.
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Affiliation(s)
- Huanhuan Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
- Department of Nuclear Medicine, School of Public Health, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610051, China
| | - Yijia Xie
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xiaoyu An
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Dazhuang Xu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Shundong Cai
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Chengchao Chu
- Xiamen University Affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Gang Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, Fujian Engineering Research Center of Molecular Theranostic Technology, School of Public Health, Xiamen University, Xiamen 361102, China
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Wu M, Yan C, Sen G. Computer-aided diagnosis of hepatic cystic echinococcosis based on deep transfer learning features from ultrasound images. Sci Rep 2025; 15:607. [PMID: 39753933 PMCID: PMC11698856 DOI: 10.1038/s41598-024-85004-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 12/30/2024] [Indexed: 01/06/2025] Open
Abstract
Hepatic cystic echinococcosis (HCE), a life-threatening liver disease, has 5 subtypes, i.e., single-cystic, polycystic, internal capsule collapse, solid mass, and calcified subtypes. And each subtype has different treatment methods. An accurate diagnosis is the prerequisite for effective HCE treatment. However, clinicians with less diagnostic experience often make misdiagnoses of HCE and confuse its 5 subtypes in clinical practice. Computer-aided diagnosis (CAD) techniques can help clinicians to improve their diagnostic performance. This paper aims to propose an efficient CAD system that automatically differentiates 5 subtypes of HCE from the ultrasound images. The proposed CAD system adopts the concept of deep transfer learning and uses a pre-trained convolutional neural network (CNN) named VGG19 to extract deep CNN features from the ultrasound images. The proven classifier models, k - nearest neighbor (KNN) and support vecter machine (SVM) models, are integrated to classify the extracted deep CNN features. 3 distinct experiments with the same deep CNN features but different classifier models (softmax, KNN, SVM) are performed. The experiments followed 10 runs of the five-fold cross-validation process on a total of 1820 ultrasound images and the results were compared using Wilcoxon signed-rank test. The overall classification accuracy from low to high was 90.46 ± 1.59% for KNN classifier, 90.92 ± 2.49% for transfer learned VGG19, and 92.01 ± 1.48% for SVM, indicating SVM classifiers with deep CNN features achieved the best performance (P < 0.05). Other performance measures used in the study are specificity, sensitivity, precision, F1-score, and area under the curve (AUC). In addition, the paper addresses a practical aspect by evaluating the system with smaller training data to demonstrate the capability of the proposed classification system. The observations of the study imply that transfer learning is a useful technique when the availability of medical images is limited. The proposed classification system by using deep CNN features and SVM classifier is potentially helpful for clinicians to improve their HCE diagnostic performance in clinical practice.
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Affiliation(s)
- Miao Wu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830017, China.
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830017, China
| | - Gan Sen
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830017, China
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Azizoğlu M, Aydogdu B, Kamci TO, Arslan S, Basuguy E, Bilici S, Okur MH. Analysis of Complications of a Neglected Disease: 13 Years of Experience with Liver Hydatid Cysts in a High-Volume Hospital. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1696. [PMID: 39459483 PMCID: PMC11509507 DOI: 10.3390/medicina60101696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 10/11/2024] [Accepted: 10/14/2024] [Indexed: 10/28/2024]
Abstract
Background and Objectives: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. Materials and Methods: This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. Results: Among the patients, 68% (n = 145) had a single cyst and 86% (n = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups (p > 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien-Dindo ≥ 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. Conclusions: We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).
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Affiliation(s)
- Mustafa Azizoğlu
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
- Department of Stem Cell and Tissue Engineering, Istinye University, Istanbul 34460, Turkey
- Pediatric Surgery Clinic, Esenyurt State Hospital, Istanbul 34517, Turkey
| | - Bahattin Aydogdu
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
| | - Tahsin Onat Kamci
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
| | - Serkan Arslan
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
| | - Erol Basuguy
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
| | - Salim Bilici
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
| | - Mehmet Hanifi Okur
- Department of Pediatric Surgery, Medical School, Dicle University, Diyarbakır 21280, Turkey; (B.A.); (T.O.K.); (S.A.); (E.B.); (S.B.); (M.H.O.)
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Hamad BS, Shnawa BH, Alrawi RA, Ahmed MH. Comparative analysis of host immune responses to Hydatid cyst in human and ovine hepatic cystic Echinococcosis. Vet Immunol Immunopathol 2024; 273:110775. [PMID: 38776648 DOI: 10.1016/j.vetimm.2024.110775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Hydatid disease is caused by the larval stages of the canine tapeworm Echinococcus granulosus. It is one of the most critical helminthic diseases, representing worldwide public health and socio-economic concern. AIM This study aimed to investigate the expression of apoptosis and immune response within hepatic tissues of humans and sheep infected with the Hydatid cyst. METHODS Paraffin-embedded tissue was prepared from each tissue sample and used for histopathological examination by Haematoxylin- Eosin. Also, toluidine blue staining was used for mast cell detection, while an immunohistochemical study was performed to assess CD3 T lymphocytes, CD4 helper T lymphocytes, CD8 cytotoxic T lymphocytes, CD20 memory B lymphocytes, CD68 macrophage, and caspase-3 antibodies. RESULTS The histological examination revealed significant changes, including the infiltration of inflammatory cells, predominantly lymphocytes with scattered giant cells, necrotic hepatic tissue, and fibrosis. Toluidine blue stain revealed a higher number of mast cells (5 cells/field) in humans compared to sheep (3.6 cells/field). The immunohistochemical analysis confirmed that the CD3 were the most predominant inflammatory cell in the hepatic tissue of humans (intensive 70%), and sheep (moderate 38.47%). Caspase-3 was observed in all samples in different grades and mostly in human liver tissue. CONCLUSION This data could aid in recognizing immunological markers for differentiating disease progression, as well as enhance the understanding of local immune responses to cystic Echinococcosis (CE). The findings could provide preliminary data for future studies on immune responses associated with Hydatid cysts.
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Affiliation(s)
- Bnar S Hamad
- Biology Department, Faculty of Science, Soran University, Soran, Kurdistan Region 30802, Iraq
| | - Bushra H Shnawa
- Biology Department, Faculty of Science, Soran University, Soran, Kurdistan Region 30802, Iraq
| | - Rafal A Alrawi
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Kurdistan Region, Iraq
| | - Mukhtar H Ahmed
- SISAF Drug Delivery Nanotechnology, Ulster University, Belfast BT37 0QB, UK.
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Tirelli C, Rondinone O, Italia M, Mira S, Belmonte LA, De Grassi M, Guido G, Maggioni S, Mondoni M, Miozzo MR, Centanni S. The Genetic Basis, Lung Involvement, and Therapeutic Options in Niemann-Pick Disease: A Comprehensive Review. Biomolecules 2024; 14:211. [PMID: 38397448 PMCID: PMC10886890 DOI: 10.3390/biom14020211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Niemann-Pick Disease (NPD) is a rare autosomal recessive disease belonging to lysosomal storage disorders. Three types of NPD have been described: NPD type A, B, and C. NPD type A and B are caused by mutations in the gene SMPD1 coding for sphingomyelin phosphodiesterase 1, with a consequent lack of acid sphingomyelinase activity. These diseases have been thus classified as acid sphingomyelinase deficiencies (ASMDs). NPD type C is a neurologic disorder due to mutations in the genes NPC1 or NPC2, causing a defect of cholesterol trafficking and esterification. Although all three types of NPD can manifest with pulmonary involvement, lung disease occurs more frequently in NPD type B, typically with interstitial lung disease, recurrent pulmonary infections, and respiratory failure. In this sense, bronchoscopy with broncho-alveolar lavage or biopsy together with high-resolution computed tomography are fundamental diagnostic tools. Although several efforts have been made to find an effective therapy for NPD, to date, only limited therapeutic options are available. Enzyme replacement therapy with Olipudase α is the first and only approved disease-modifying therapy for patients with ASMD. A lung transplant and hematopoietic stem cell transplantation are also described for ASMD in the literature. The only approved disease-modifying therapy in NPD type C is miglustat, a substrate-reduction treatment. The aim of this review was to delineate a state of the art on the genetic basis and lung involvement in NPD, focusing on clinical manifestations, radiologic and histopathologic characteristics of the disease, and available therapeutic options, with a gaze on future therapeutic strategies.
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Affiliation(s)
- Claudio Tirelli
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Ornella Rondinone
- Medical Genetics Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (O.R.); (M.R.M.)
| | - Marta Italia
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Sabrina Mira
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Luca Alessandro Belmonte
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Mauro De Grassi
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Gabriele Guido
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Sara Maggioni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
| | - Monica Rosa Miozzo
- Medical Genetics Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (O.R.); (M.R.M.)
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (M.I.); (S.M.); (L.A.B.); (M.D.G.); (G.G.); (S.M.); (M.M.); (S.C.)
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Wang Z, Bian H, Li J, Xu J, Fan H, Wu X, Cao Y, Guo B, Xu X, Wang H, Zhang L, Zhou H, Fan J, Ren Y, Geng Y, Feng X, Li L, Wei L, Zhang X. Detection and subtyping of hepatic echinococcosis from plain CT images with deep learning: a retrospective, multicentre study. Lancet Digit Health 2023; 5:e754-e762. [PMID: 37770335 DOI: 10.1016/s2589-7500(23)00136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Hepatic echinococcosis is a severe endemic disease in some underdeveloped rural areas worldwide. Qualified physicians are in short supply in such areas, resulting in low rates of accurate diagnosis of this condition. In this study, we aimed to develop and evaluate an artificial intelligence (AI) system for automated detection and subtyping of hepatic echinococcosis using plain CT images with the goal of providing interpretable assistance to radiologists and clinicians. METHODS We developed EDAM, an echinococcosis diagnostic AI system, to provide accurate and generalisable CT analysis for distinguishing hepatic echinococcosis from hepatic cysts and normal controls (no liver lesions), as well as subtyping hepatic echinococcosis as alveolar or cystic echinococcosis. EDAM includes a slice-level prediction model for lesion classification and segmentation and a patient-level diagnostic model for patient classification. We collected a plain CT database (n=700: 395 cystic echinococcosis, 122 alveolar echinococcosis, 130 hepatic cysts, and 53 normal controls) for developing EDAM, and two additional independent cohorts (n=156) for external validation of its performance and generalisation ability. We compared the performance of EDAM with 52 experienced radiologists in diagnosing and subtyping hepatic echinococcosis. FINDINGS EDAM showed reliable performance in patient-level diagnosis on both the internal testing data (overall area under the receiver operating characteristic curve [AUC]: 0·974 [95% CI 0·936-0·994]; accuracy: 0·952 [0·939-0·965] for cystic echinococcosis, 0·981 [0·973-0·989] for alveolar echinococcosis; sensitivity: 0·966 [0·951-0·979] for cystic echinococcosis, 0·944 [0·908-0·970] for alveolar echinococcosis) and the external testing set (overall AUC: 0·953 [95% CI 0·840-0·973]; accuracy: 0·929 [0·915-0·947] for cystic echinococcosis, 0·936 [0·919-0·950] for alveolar echinococcosis; sensitivity: 0·913 [0·879-0·944] for cystic echinococcosis, 0·868 [0·841-0·897] for alveolar echinococcosis). The sensitivity of EDAM was robust across images from different CT manufacturers. EDAM outperformed most of the enrolled radiologists in detecting both alveolar echinococcosis and cystic echinococcosis. INTERPRETATION EDAM is a clinically applicable AI system that can provide patient-level diagnoses with interpretable results. The accuracy and generalisation ability of EDAM demonstrates its potential for clinical use, especially in underdeveloped areas. FUNDING Project of Qinghai Provincial Department of Science and Technology of China, National Natural Science Foundation of China, and Tsinghua-Fuzhou Institute of Data Technology Project. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Zhan Wang
- Department of Biomedical Engineering, Tsinghua University, Beijing, China; Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Haiyang Bian
- Department of Automation, MOE Key Lab of Bioinformatics and Beijing National Research Center for Information Science & Technology (BNRIST), Tsinghua University, Beijing, China
| | - Jiaqi Li
- Department of Automation, MOE Key Lab of Bioinformatics and Beijing National Research Center for Information Science & Technology (BNRIST), Tsinghua University, Beijing, China
| | - Jin Xu
- Department of Medicine, Qinghai University, Xining, China
| | - Haining Fan
- Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Xinze Wu
- Department of Automation, MOE Key Lab of Bioinformatics and Beijing National Research Center for Information Science & Technology (BNRIST), Tsinghua University, Beijing, China
| | - Yuntai Cao
- Department of Radiology, Qinghai University Affiliated Hospital, Xining, China
| | - Bin Guo
- Department of Otorhinolaryngology, Qinghai University Affiliated Hospital, Xining, China
| | - Xiaolei Xu
- Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Haijiu Wang
- Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Lingqiang Zhang
- Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Hu Zhou
- Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Jianfeng Fan
- Department of Radiology, Zhenping People's Hospital, Nanyang, China
| | - Youyou Ren
- Department of Radiology, Nanyang Central Hospital, Nanyang, China
| | - Yunping Geng
- Department of Radiology, Nanyang Central Hospital, Nanyang, China
| | - Xiaobin Feng
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Luming Li
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Lei Wei
- Department of Automation, MOE Key Lab of Bioinformatics and Beijing National Research Center for Information Science & Technology (BNRIST), Tsinghua University, Beijing, China
| | - Xuegong Zhang
- Department of Automation, MOE Key Lab of Bioinformatics and Beijing National Research Center for Information Science & Technology (BNRIST), Tsinghua University, Beijing, China; School of Medicine and School of Life Sciences, Tsinghua University, Beijing, China.
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Bai Z, Ma X, Yan R, Lei W, Zhang Y, Ren Y, Liu S. Metabolomic profiling of early inactive hepatic alveolar and cystic echinococcosis. Acta Trop 2023; 242:106875. [PMID: 36940858 DOI: 10.1016/j.actatropica.2023.106875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/24/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023]
Abstract
Hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses and leading causes of parasitic liver damage. They pose a high mortality risk due to invisible clinical signs, especially at the early inactive stage. However, the specific metabolic profiles induced by inactive AE and CE lesions remain largely unclear. Therefore, we used gas chromatography-mass spectrometry-based metabolomic profiling to identify the global metabolic variations in AE and CE patient sera to differentiate between the two diseases and reveal the mechanisms underlying their pathogenesis. In addition, specific serum biomarkers of inactive hepatic AE and CE were screened using receiver operating curves, which can contribute to the clinical diagnosis of both diseases, especially in the earlier phase. These differential metabolites are involved in glycine, serine, tyrosine, and phenylalanine metabolism. Further analysis of key metabolic pathways showed that inactive AE lesions strongly alter amino acid metabolism in the host. CE lesions have an altered metabolism of oxidative stress response. These changes suggest these metabolite-associated pathways can serve as biomarkers to distinguish individuals with inactive AE and CE from healthy populations. This study also investigated the differences in serum metabolic profiles in patients with CE and AE. The biomarkers identified belonged to different metabolic pathways, including lipid, carnitine, androgen, and bile acid metabolism. Taken together, by investigating the different phenotypes of CE and AE with metabolomic profiling, serum biomarkers facilitating early diagnosis were identified.
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Affiliation(s)
- Zhenzhong Bai
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, 810001 China
| | - Xiao Ma
- Department of Hydatid Disease Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control, Xining, Qinghai 810001, China
| | - Ranran Yan
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, 810001 China
| | - Wen Lei
- Department of Hydatid Disease Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control, Xining, Qinghai 810001, China
| | - Yifan Zhang
- Department of Medical Imaging PET-CT Center, Qinghai Provincial People's Hospital, Xining, Qinghai, 810001 China
| | - Yanming Ren
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, 810001 China.
| | - Shou Liu
- International School of Public Health and One Health, Hainan Medicla Univeristy, Haikou, Hainan 571199, China.
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9
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Shabunin AV, Karpov AA, Bedin VV, Tavobilov MM, Lebedev SS, Ozerova DS, Aladin MN, Alieva FF. [Preoperative radiation navigation in determining surgical strategy for liver echinococcosis]. Khirurgiia (Mosk) 2023:5-13. [PMID: 36800863 DOI: 10.17116/hirurgia20230315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To analyze the technology for diagnostic modeling of liver echinococcosis. MATERIAL AND METHODS In the Botkin Clinical Hospital, we developed a theory of diagnostic modeling of liver echinococcosis. Treatment outcomes were analyzed in 264 patients who underwent various surgical interventions. RESULTS A retrospective group enrolled 147 patients. When comparing the results of diagnostic and surgical stages, we identified 4 models of liver echinococcosis. The choice of surgical intervention in the prospective group was based on previous models. Diagnostic modeling reduced the number of general surgical and specific complications, as well as mortality in the prospective study group. CONCLUSION The technology for diagnostic modeling of liver echinococcosis made it possible not only to identify 4 models of liver echinococcosis, but also determine the most optimal surgical intervention for each of model.
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Affiliation(s)
- A V Shabunin
- Botkin Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - A A Karpov
- Botkin Clinical Hospital, Moscow, Russia
| | - V V Bedin
- Botkin Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - M M Tavobilov
- Botkin Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - S S Lebedev
- Botkin Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - D S Ozerova
- Botkin Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - M N Aladin
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - F F Alieva
- Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
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10
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Akhan O, Yildiz O, Unal E, Yildiz AE, Ciftci TT, Akinci D. Case Report: Imaging-Guided Percutaneous Catheterization and Microwave Ablation of a Bone Hydatid Cyst with Soft-Tissue Component. Am J Trop Med Hyg 2022; 107:tpmd220066. [PMID: 35895346 PMCID: PMC9490662 DOI: 10.4269/ajtmh.22-0066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/22/2022] [Indexed: 11/07/2022] Open
Abstract
Cystic echinococcosis (CE) of the bone is a rare disease compared with CE of the viscera, and the most involved bony structures are the spine and the pelvis. Both the diagnosis and the treatment of bone CE are challenging for several reasons. The combination of surgery and antimicrobial therapy is the most common approach, the results are far from adequate. Luckily, percutaneous treatment has appeared on the horizon for bone lesions as a more practical option with fewer drawbacks in light of current reports. This article deals with the successful result of ablation-assisted percutaneous treatment of a bone CE lesion and a soft tissue CE lesion treated by modified catheterization technique in a male patient with left hip pain that was unresponsive to previous surgery for CE.
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Affiliation(s)
- Okan Akhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Oguzhan Yildiz
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emre Unal
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Adalet Elcin Yildiz
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Turkmen Turan Ciftci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Devrim Akinci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
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11
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Rosette sign. Abdom Radiol (NY) 2022; 47:2560-2561. [PMID: 35716211 DOI: 10.1007/s00261-022-03564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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12
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Patmano M, Çetin DA, Gümüş T, Patmano G, Yenigül AE. Primary Soft Tissue Hydatid Cysts. TURKIYE PARAZITOLOJII DERGISI 2022; 46:145-149. [PMID: 35604194 DOI: 10.4274/tpd.galenos.2021.03511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Hydatid cyst disease is a helminthic infection caused by Echinococcus granulous, which is encountered with cysts in many organs, especially the liver and lungs. Soft tissue and intramuscular hydatid cyst are rare even in endemic countries. It is challengig to distinguish subcutaneous and intramuscular hydatid cysts from soft tissue tumors. This study aimed to present the clinical features of primary soft tissue hydatid cyst cases without liver and lung hydatid cyst in the Southeast Anatolian region, where hydatid cyst disease is endemic. METHODS Patients admitted to the Şanlıurfa Training and Research Hospital General Surgery and Orthopedics and Traumatology Outpatient Clinic between September 2018 and December 2019 with complaints of pain and/or swelling under the skin and soft tissue were evaluated. After the examinations, the records of the patients who were operated on with a pre-diagnosis of hydatid cyst and whose histopathologic evaluation was reported as a hydatid cyst were reviewed retrospectively. RESULTS Eight patients were included in the study. The mean age of the patients was 39.75±14.80 years. Lesions were located in neck (12.5%), left thoracic posterior area (25%), gluteus (25%), thigh (12.5%), right upper quadrant of abdominal wall (12.5%), and under the right clavicle (12.5%). When imaging methods were examined, ultrasonography was performed in 7 patients (87.5%), chest computed tomography was performed in 1 patient (12.5%), and magnetic resonance imaging was performed in 2 patients (25%). CONCLUSION Diagnosis of hydatid cyst should be considered in the differential diagnosis of soft tissue tumors in countries of endemic regions for hydatid cyst disease such as Southeastern Anatolia Region, Turkey.
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Affiliation(s)
- Mehmet Patmano
- Şanlıurfa Training and Research Hospital, Clinic of General Surgery, Şanlıurfa, Turkey
| | - Durmuş Ali Çetin
- Şanlıurfa Training and Research Hospital, Clinic of General Surgery, Şanlıurfa, Turkey
| | - Tufan Gümüş
- Şanlıurfa Training and Research Hospital, Clinic of General Surgery, Şanlıurfa, Turkey
| | - Gülçin Patmano
- Mehmet Akif İnan Training and Research Hospital, Clinicof Anesthesia and Reamination, Şanlıurfa, Turkey
| | - Ali Erkan Yenigül
- Şanlıurfa Training and Research Hospital, Clinic of Orthopedia and Traumatology, Şanlıurfa, Turkey
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13
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Liu T, Li H, Li Y, Wang L, Chen G, Pu G, Guo X, Cho WC, Fasihi Harandi M, Zheng Y, Luo X. Integrative Analysis of RNA Expression and Regulatory Networks in Mice Liver Infected by Echinococcus multilocularis. Front Cell Dev Biol 2022; 10:798551. [PMID: 35399512 PMCID: PMC8989267 DOI: 10.3389/fcell.2022.798551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
The larvae of Echinococcus multilocularis causes alveolar echinococcosis, which poses a great threat to the public health. However, the molecular mechanisms underlying the host and parasite interactions are still unclear. Exploring the transcriptomic maps of mRNA, miRNA and lncRNA expressed in the liver in response to E. multilocularis infection will help us to understand its pathogenesis. Using liver perfusion, different cell populations including the hepatic cells, hepatic stellate cells and Kupffer cells were isolated from mice interperitoneally inoculated with protoscoleces. Their transcriptional profiles including lncRNAs, miRNAs and mRNAs were done by RNA-seq. Among these cell populations, the most differentially-expressed (DE) mRNA, lncRNAs and miRNAs were annotated and may involve in the pathological processes, mainly including metabolic disorders, immune responses and liver fibrosis. Following the integrative analysis of 38 differentially-expressed DEmiRNAs and 8 DElncRNAs, the lncRNA-mRNA-miRNA networks were constructed, including F63-miR-223-3p-Fbxw7/ZFP36/map1b, F63-miR-27-5p-Tdrd6/Dip2c/Wdfy4 and IFNgAS1-IFN-γ. These results unveil the presence of several potential lncRNA-mRNA-miRNA axes during E. multilocularis infection, and further exploring of these axes may contribute to better understanding of the pathogenic mechanisms.
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Affiliation(s)
- Tingli Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Hong Li
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Yanping Li
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Liqun Wang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Guoliang Chen
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Guiting Pu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - Xiaola Guo
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Yadong Zheng
- Key Laboratory of Applied Technology on Green-Eco-Healthy Animal Husbandry of Zhejiang Province, Zhejiang International Science and Technology Cooperation Base for Veterinary Medicine and Health Management, Zhejiang Provincial Engineering Laboratory for Animal Health Inspection and Internet Technology, Zhejiang International Science and Technology Cooperation Base for Veterinary Medicine and Health Management, China-Australia Joint Laboratory for Animal Health Big Data Analytics, College of Animal Science and Technology and College of Veterinary Medicine of Zhejiang A&F University, Hangzhou, China
| | - Xuenong Luo
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, China
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14
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Diagnosis and Follow-up of Incidental Liver Lesions in Children. J Pediatr Gastroenterol Nutr 2022; 74:320-327. [PMID: 34984985 DOI: 10.1097/mpg.0000000000003377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Incidental liver lesions are identified in children without underlying liver disease or increased risk of hepatic malignancy in childhood. Clinical and imaging evaluation of incidental liver lesions can be complex and may require a multidisciplinary approach. This review aims to summarize the diagnostic process and follow-up of incidental liver lesions based on review of the literature, use of state-of-the-art imaging, and our institutional experience. Age at presentation, gender, alpha fetoprotein levels, tumor size, and imaging characteristics should all be taken into consideration to optimize diagnosis process. Some lesions, such as simple liver cyst, infantile hemangioma, focal nodular hyperplasia (FNH), and focal fatty lesions, have specific imaging characteristics. Recently, contrast-enhanced ultrasound (CEUS) was Food and Drug Administration (FDA)-approved for the evaluation of pediatric liver lesions. CEUS is most specific in lesions smaller than 3 cm and is most useful in the diagnosis of infantile hemangioma, FNH, and focal fatty lesions. The use of hepatobiliary contrast in MRI increases specificity in the diagnosis of FNH. Recently, lesion characteristics in MRI were found to correlate with subtypes of hepatocellular adenomas and associated risk for hemorrhage and malignant transformation. Biopsy should be considered when there are no specific imaging characteristics of a benign lesion. Surveillance with imaging and alpha fetoprotein (AFP) should be performed to confirm the stability of lesions when the diagnosis cannot be determined, and whenever biopsy is not feasible.
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15
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Dundar I, Ozgokce M, Durmaz F, Ozkacmaz S, Turkoglu S, Goya C. Efficiency of diffusion-weighted MRI for differentiating radiologically similar simple and type I hydatid cysts of the liver. Acta Radiol 2022; 63:143-148. [PMID: 33478235 DOI: 10.1177/0284185120988131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. PURPOSE To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. MATERIAL AND METHODS This single-center prospective study was conducted during 2016-2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. RESULTS Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5-82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2-7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64-5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8-14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36-3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs. CONCLUSION Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.
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Affiliation(s)
- Ilyas Dundar
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Mesut Ozgokce
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Fatma Durmaz
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Sercan Ozkacmaz
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Saim Turkoglu
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Cemil Goya
- Department of Radiology, Van Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
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16
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Kotelnikova LP, Mokina GY, Fedachuk AN. [Liver echinococcosis in a non-endemic region]. Khirurgiia (Mosk) 2022:61-68. [PMID: 35920224 DOI: 10.17116/hirurgia202208161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To study clinical manifestations and difficulties in diagnosis of liver echinococcosis in a non-endemic region and to assess the long-term results of surgical treatment and quality of life. MATERIAL AND METHODS The study included 36 residents of a non-endemic region with liver echinococcosis operated on in the Perm Regional Clinical Hospital over the past 15 years. IgG antibodies to echinococcal antigens were determined using enzyme immunoassay. Topical diagnosis was performed using ultrasound and contrast-enhanced computed tomography. We analyzed various difficulties of preoperative diagnosis. Long-term postoperative outcomes and quality of life were studied using the SF-36 questionnaire. RESULTS In the non-endemic Perm Region, 36% of patients with liver echinococcosis had complicated forms of disease. Sensitivity of detection of antibodies was 77%, ultrasound - 86.1%, CT - 91.7. Echinococcectomy was performed in 13.9% of cases, pericystecomy - 41.7%, liver resection - 30.6%, minimally invasive interventions - in 13.9% of patients. Long-term recurrence of liver echinococcosis (11.1%) developed after laparoscopic echinococcectomy (n=2) and open surgery for multiple liver echinococcosis (n=2). Median score of physical health in long-term period was slightly higher than mental health (67.51 and 62.75 points, respectively). Physical activity had a weak negative correlation with age (p=0.001, r= -0.251). Concomitant diseases significantly impaired vital activity (p=0.001, r= -0.332), role and emotional functioning (p=0.002, r= -0.494; p=0.003, r= -0.415). CONCLUSION In a non-endemic region, final diagnosis was established only during therapeutic measures in 8.33% of cases. Surgical treatment ensured favorable quality of life in long-term period.
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Affiliation(s)
- L P Kotelnikova
- Vagner Perm State Medical University, Perm, Russia
- Perm Regional Clinical Hospital, Perm, Russia
| | - G Yu Mokina
- Perm Regional Clinical Hospital, Perm, Russia
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17
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Yalcinoz K, Ikizceli T, Kahveci S, Karahan OI. Diffusion-weighted MRI and FLAIR sequence for differentiation of hydatid cysts and simple cysts in the liver. Eur J Radiol Open 2021; 8:100355. [PMID: 34136590 PMCID: PMC8181784 DOI: 10.1016/j.ejro.2021.100355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 11/16/2022] Open
Abstract
DWI signal characteristics are useful in differentiating between hydatid cysts and simple cysts. ADC values (b600 and b1000) can distinguish hydatid cyst and simple cyst. FLAIR sequence contributes to the differentiation of type 2 hydatid and simple cysts. Purpose The contribution of DWI and FLAIR to the differential diagnosis of type 1, 2, and 3 hydatid cysts and simple liver cysts was investigated according to the Gharbi classification. This study is the first report using FLAIR sequence for the differential diagnosis of liver hydatid cysts in this regard. Methods A total of 82 hydatid cysts and 40 simple cysts were scanned with DWI (in b600-b1000 values) and FLAIR sequence. In 64 patients included in the study, a total of 122 cystic lesions were diagnosed histopathologically or during follow-up. FLAIR and DWI signal characteristics were evaluated, and ADC values were calculated. Results The mean ADC value of hydatid cysts on DWI (b600) was 3.07 ± 0.41 × 10−3 s/mm2, while it was 3.91 ± 0.51 × 10−3 s/mm2 for simple cysts and the difference was statistically significant (p < 0.05). On b1000 DWI, the mean ADC values of hydatid and simple cysts were 2.99 ± 0.38 × 10−3 s/mm2 and 3.43 ± 0:29 × 10−3 s/mm2, respectively (p < 0.05). The qualitative evaluation of the signal intensity on b600−1000 DWI demonstrated the difference between the simple and hydatid cyst groups (p < 0.05). Type 2 hydatid cysts alone were distinguished from type 2–3 hydatid and simple cysts by FLAIR (p < 0.05). Conclusions ADC values can distinguish between hydatid cyst and simple cyst. FLAIR contributes to the differentiation of type 2 hydatid and simple cysts.
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Affiliation(s)
- Kursad Yalcinoz
- Elbistan State Hospital, Radiology Clinic, Kahramanmaras, Turkey
| | - Turkan Ikizceli
- University of Health Sciences, Istanbul Haseki Training and Research Hospital, Department of Radiology, Adnan Adivar Street, Number: 9, 34130, Fatih, Istanbul, Turkey
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18
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Mahami-Oskouei M, Norouzi B, Ahmadpour E, Kazemi T, Spotin A, Alizadeh Z, Ghorbani Sani R, Asadi M. Expression analysis of circulating miR-146a and miR-155 as novel biomarkers related to effective immune responses in human cystic echinococcosis. Microb Pathog 2021; 157:104962. [PMID: 34022359 DOI: 10.1016/j.micpath.2021.104962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/15/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022]
Abstract
Cystic echinococcosis, an important zoonotic disease, is caused by Echinococcus granulosus. MicroRNAs are a small group of single-stranded noncoding RNAs, which play an effective role in biological processes. This study aimed at comparing the expression levels of miR-146a and miR-155 in the plasma of patients with hydatidosis and healthy individuals. A group of 20 patients with hydatid cyst formed a study group and 20 healthy individuals with no known chronic diseases formed a control group. Plasma samples were collected from hydatidosis patients as well as sex- and age-matched healthy volunteers. After that, RNA extraction and cDNA synthesis were done and the expression levels of miR-146a and miR-155 were determined by quantitative real-time polymerase chain reaction (PCR) for both groups. The results indicated that the level of miR-146a increased in all patients with hydatidosis compared to the control group. Also, the level of miR-155 increased in all hydatidosis patients, but no correlation was observed in the level of miR-155 between the two groups. The results also revealed that miR-146a and miR-155 upregulation in the plasma leads to the development of novel biomarkers for echinococcosis. One of the reasons for the increase of miRNAs in hydatidosis may be their role in modulating the immune system. These miRNAs are likely to be considered as one of the most important biomarkers in determining the severity of hydatidosis.
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Affiliation(s)
- Mahmoud Mahami-Oskouei
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Behrooz Norouzi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Kazemi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Spotin
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Alizadeh
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Ghorbani Sani
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Asadi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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Typical imaging finding of hepatic infections: a pictorial essay. Abdom Radiol (NY) 2021; 46:544-561. [PMID: 32715334 PMCID: PMC7897188 DOI: 10.1007/s00261-020-02642-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/25/2020] [Accepted: 07/04/2020] [Indexed: 02/08/2023]
Abstract
Hepatic infections are frequent in clinical practice. Although epidemiological, clinical and laboratory data may suggest hepatic infection in certain cases, imaging is nearly always necessary to confirm the diagnosis, assess disease extension and its complications, evaluate the response to treatment, and sometimes to make differential diagnoses such as malignancies. Ultrasound (US) is usually the first-line investigation, while computed tomography (CT) and magnetic resonance imaging (MRI) provide better characterization and a more precise assessment of local extension, especially biliary and vascular. The purpose of this article is to describe the typical features and main complications of common hepatic infections. Familiarity with the radiological features of this entity can help suggest the correct diagnosis and the need for further studies as well as determine appropriate and timely treatment.
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20
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Hammouda SB, Njima M, Hadhri R, Zakhama A. Incidentally diagnosed hydatid cyst of uterus. Eur J Obstet Gynecol Reprod Biol 2020; 255:267-268. [PMID: 33097310 DOI: 10.1016/j.ejogrb.2020.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Seifeddine Ben Hammouda
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia.
| | - Manel Njima
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Rim Hadhri
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Abdelfattah Zakhama
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
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21
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Wu J, Gui X, Jiang H, Liang X, Wang E, Xu X, Chen X, Wu X. [Study on effect of echinococcus granulosus protoscolices on fibrosis of bone marrow mesenchymal stem cells]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:630-636. [PMID: 32410432 DOI: 10.7507/1002-1892.201909050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To investigate the effect of echinococcus granulosus protoscolices on the differentiation of bone marrow mesenchymal stem cells (BMSCs) into fibroblasts. Methods Femur bone marrow of 4-week-old C57BL/6 mice was taken and BMSCs were isolated and cultured by adherent culture. Echinococcus granulosus protoscolices was extracted from the liver of sheep infected with echinococcus granulosus. The experiment was divided into two groups. The experimental group was co-cultured with the 3rd generation BMSCs and the echinococcus granulosus protoscolices, and the control group was the 3rd generation BMSCs. Before and after co-culture, the morphology of BMSCs and the activity of echinococcus granulosus protoscolices were observed by inverted microscope. After cultured for 1, 3, 5, and 7 days, the mRNA expressions of transforming growth factor β 1 (TGF-β 1), collagen type Ⅰ, and collagen type Ⅲ were detected by real-time fluorescent quantitative PCR, the protein expressions of TGF-β 1, collagen type Ⅰ, collagen type Ⅲ, Smad7, and phosphorylated Smad2/3 were detected by Western blot, and the contents of collagen type Ⅰ and collagen type Ⅲ in the supernatant of the two groups were detected by ELISA. Results After 7 days of co-culture, the morphology of BMSCs changed into fusiform and irregular triangle, which was closer to the mouse fibroblasts. The relative mRNA expressions of TGF-β 1, collagen type Ⅰ, and collagen type Ⅲ in the experimental group were significantly higher than those in the control group; the relative protein expressions of TGF-β 1, collagen type Ⅰ, collagen type Ⅲ, and phosphorylated Smad2/3 in the experimental group were significantly higher than those in the control group, and the relative protein expression of Smad7 in the experimental group was significantly lower than that in the control group; the contents of collagen type Ⅰ and collagen type Ⅲ in the supernatant of the experimental group were significantly higher than those in the control group. The differences between the two groups were significant ( P<0.05). Conclusion Echinococcus granulosus protoscolices may promote the secretion of collagen type Ⅰ, collagen type Ⅲ, and TGF-β 1 by TGF-β 1/Smad signal pathway, which can promote the fibrosis of BMSCs that related to the formation of fibrocystic wall by echinococcosis.
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Affiliation(s)
- Jie Wu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Xianwei Gui
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Huijiao Jiang
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Xueqi Liang
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Erqiang Wang
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Xiaodan Xu
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Xueling Chen
- Department of Immunology, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
| | - Xiangwei Wu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi Xinjiang, 832008, P.R.China
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Xin S, Shi H, Jide A, Zhu M, Ma C, Liao H. Automatic lesion segmentation and classification of hepatic echinococcosis using a multiscale-feature convolutional neural network. Med Biol Eng Comput 2020; 58:659-668. [PMID: 31950330 DOI: 10.1007/s11517-020-02126-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 01/07/2020] [Indexed: 11/24/2022]
Abstract
Hepatic echinococcosis (HE) is a life-threatening liver disease caused by parasites that requires a precise diagnosis and proper treatments. To assess HE lesions accurately, we propose a novel automatic HE lesion segmentation and classification network that contains lesion region positioning (LRP) and lesion region segmenting (LRS) modules. First, we used the LRP module to obtain the probability map of the lesion distribution and the position of the lesion. Then, based on the result of the LRP module, we used the LRS module to precisely segment the HE lesions within the high-probability region. Finally, we classified the HE lesions and identified the lesion types by a convolutional neural network (CNN). The entire dataset was delineated by the hospital's senior radiologist. We collected CT slices of 160 patients from Qinghai Provincial People's Hospital. The Dice score of the final segmentation result reached 89.89%. The Dice scores, indicating the classification accuracy, for cystic vs. alveolar echinococcosis and calcified vs. noncalcified lesions were 80.32% and 82.45%, the sensitivities were 72.41% and 75.17%, the specificities were 83.72% and 86.04%, the NPVs were 80.01% and 86.96%, the PPVs were 80.45% and 81.74%, and the areas under the ROC curves were 0.8128 and 0.8205, respectively. Graphical abstract.
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Affiliation(s)
- Shenghai Xin
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China.,Qinghai Provincial People's Hospital, Xining, 810007, China
| | - Huabei Shi
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - A Jide
- Qinghai Provincial People's Hospital, Xining, 810007, China
| | - Mingyu Zhu
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Cong Ma
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Hongen Liao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China.
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Dulundu E. Management of Hepatic Echinococcal Disease and Its Complications. THE SURGICAL MANAGEMENT OF PARASITIC DISEASES 2020:129-141. [DOI: 10.1007/978-3-030-47948-0_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Abstract
Hepatobiliary infections account for a small but clinically important proportion of emergency department presentations. They present a clinical challenge due to the broad range of imaging characteristics on presentation. Recognition of complications is imperative to drive appropriate patient care and resource utilization to avoid diagnostic pitfalls and avert adverse patient outcomes. A thorough understanding of anatomy infectious pathology of hepatobiliary system is essential in the emergency setting to confidently diagnose and guide medical intervention. Many presentations of hepatobiliary infection have characteristic imaging features on individual imaging modalities with others requiring the assimilation of findings of multiple imaging modalities along with incorporating the clinical context and multispecialist consultation. Familiarity with the strengths of individual imaging modalities in the radiologists' arsenal is imperative to guide the appropriate utilization of resources, particularly in the emergent time sensitive setting. Accurate identification and diagnosis of hepatobiliary infections is vital for appropriate patient care and management stratification.
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Affiliation(s)
- Daniel Hynes
- University of Massachusetts Medical School, Baystate Medical Center, Department of Radiology, Springfield, MA.
| | - Christina Duffin
- University of Massachusetts Medical School, Baystate Medical Center, Department of Radiology, Springfield, MA
| | - Tara Catanzano
- University of Massachusetts Medical School, Baystate Medical Center, Department of Radiology, Springfield, MA
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Tran Cao HS, Marcal LP, Mason MC, Yedururi S, Joechle K, Wei SH, Vauthey JN. Benign hepatic incidentalomas. Curr Probl Surg 2019; 56:100642. [DOI: 10.1067/j.cpsurg.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/09/2019] [Indexed: 12/13/2022]
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Liu Y, Wang Z, Pang S, Zhao W, Kang L, Zhang Y, Zhang H, Yang J, Wang Z, Lu P, Xu M, Wang W, Bo X, Li Z. Evaluation of dynamic developmental processes and the molecular basis of the high body fat percentage of different proglottid types of Moniezia expansa. Parasit Vectors 2019; 12:390. [PMID: 31382993 PMCID: PMC6683355 DOI: 10.1186/s13071-019-3650-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Moniezia expansa (Cyclophyllidea: Anoplocephalidae) is a large species of tapeworm that occurs in sheep and cattle and inhabits the small intestine, causing diarrhea and weight declines, leading to stockbreeding losses. Interestingly, the body fat percentage of M. expansa, which lacks the ability to synthesize fatty acids, is as high as 78% (dry weight) and all of the proglottids of M. expansa exhibit a dynamic developmental process from top to bottom. The aim of this paper is to identify the molecular basis of this high body fat percentage, the dynamic expression of developmental genes and their expression regulation patterns. RESULTS From 12 different proglottids (four sections: scolex and neck, immature, mature and gravid with three replicates), 13,874 transcripts and 680 differentially expressed genes (DEGs) were obtained. The gene expression patterns of the scolex and neck and immature proglottids were very similar, while those of the mature and gravid proglottids differed greatly. In addition, 13 lipid transport-related proteins were found in the DEGs, and the expression levels showed an increasing trend in the four proglottid types. Furthermore, it was shown that 33 homeobox genes, 9 of which were DEGs, had the highest expression in the scolex and neck section. The functional enrichment results of the DEGs were predominantly indicative of development-related processes, and there were also some signal transduction and metabolism results. The most striking result was the finding of Wnt signaling pathways, which appeared multiple times. Furthermore, the weighted gene co-expression networks were divided into 12 modules, of which the brown module was enriched with many development-related genes. CONCLUSIONS We hypothesize that M. expansa uses lipid transport-associated proteins to transport lipids from the host gut to obtain energy to facilitate its high fecundity. In addition, homeobox genes and Wnt signaling pathways play a core role in development and regeneration. The results promote research on the cell differentiation involved in the continuous growth and extension of body structures.
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Affiliation(s)
- Yi Liu
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Zhengrong Wang
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Shuai Pang
- Novogene Bioinformatics Institute, Beijing, China
| | - Wenjuan Zhao
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Lichao Kang
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Yanyan Zhang
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Hui Zhang
- Yangcheng Country Animal Husbandry and Veterinary Bureau, Jincheng, China
| | - Jingquan Yang
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Zhixin Wang
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Pingping Lu
- Xinjiang Tiankang Feed Technology Co., Ltd, Ürümqi, China
| | - Mengfei Xu
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Weiyi Wang
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China
| | - Xinwen Bo
- State Key Laboratory of Sheep Genetic Improvement and Healthy Production/Institute of Animal Husbandry and Veterinary, Xinjiang Academy of Agricultural and Reclamation Sciences, Shihezi, China.
| | - Zhenzhen Li
- Novogene Bioinformatics Institute, Beijing, China.
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Kuscher S, Kronberger IE, Loizides A, Plaikner M, Ninkovic M, Brunner A, Auer H, Gassner EM, Öfner D, Schneeberger S. Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria. Eur Surg 2019; 51:189-196. [DOI: 10.1007/s10353-019-0596-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/15/2019] [Indexed: 12/28/2022]
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Chaouch MA, Dougaz MW, Khalfallah M, Jerraya H, Nouira R, Bouasker I, Dziri C. A case report of complicated appendicular hydatid cyst mimicking an appendiceal mucocele. Clin J Gastroenterol 2019; 12:574-577. [PMID: 30972709 DOI: 10.1007/s12328-019-00981-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/03/2019] [Indexed: 01/23/2023]
Abstract
Retaining the etiology of a cystic lesion in the right iliac fossa can be difficult. Appendicular hydatid cyst is a very uncommon cause of a such lesion. In some cases, diagnosis is not obvious. It can radiologically mimic an appendix mucocele, a complicated ovarian cyst, an appendicular lymphangioma or an abscess. Our case highlights the difficulties encountered in this kind of situation and despite the contribution of imaging. We present a case of a 75 years-old woman presented with a right lower quadrant continuous pain. Abdominal CT-scan revealed a multilocular cystic and hydro-aeric mass. The diagnosis of an appendiceal mucocele complicated with gelatinous peritonitis was suspected. An open debulking surgery with right hemicolectomy was performed. The pathological exam has concluded to an infected appendicular hydatid cyst with thick calcified walls. The aim of this work is to report a case of an appendicular hydatid cyst that has imitated an appendicular mucocele to discuss the importance of differential diagnostic reflections and the appropriate treatment.
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Affiliation(s)
| | | | - Mehdi Khalfallah
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hichem Jerraya
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ramzi Nouira
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Chadli Dziri
- Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia
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The hepatoduodenal ligament revisited: cross-sectional imaging spectrum of non-neoplastic conditions. Abdom Radiol (NY) 2019; 44:1269-1294. [PMID: 30448917 DOI: 10.1007/s00261-018-1829-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The hepatoduodenal ligament is frequently involved by conditions affecting the portal triad and surrounding structures, including a vast array of non-neoplastic conditions. Due its unique location between the retroperitoneum and the peritoneal space, the hepatoduodenal ligament is also targeted by inflammatory conditions involving the retroperitoneum and the liver. Finally, the presence of lymphatics and of the biliary tracts makes the hepatoduodenal ligament a route of spread for a variety of infections. The purpose of this pictorial essay is twofold: to review the cross-sectional radiological anatomy and variants of the structures within the hepatoduodenal ligament, and to illustrate the non-neoplastic conditions that may arise within the hepatoduodenal ligament. CONCLUSION Familiarity with these specific entities and their cross-sectional imaging findings is fundamental for a more accurate diagnosis.
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Vural U, Aglar AA, Kayacioglu İ. Intracoronary Hydatid Cyst Resulted in Coronary Artery Disease in a Young Patient. Braz J Cardiovasc Surg 2019; 34:107-110. [PMID: 30810684 PMCID: PMC6385834 DOI: 10.21470/1678-9741-2018-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac
involvement. Only 10% of these become symptomatic. Considering the long time
interval between the start of infestation and symptoms to occur, it is hard to
diagnose cystic echinococcosis. When detected, even if it is asymptomatic,
intramyocardial hydatid cyst requires surgical intervention due to risks of
spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst
located in the coronary arterial wall has been reported. Twenty-two-year-old
male patient with previous history of pulmonary cystic echinococcosis was
referred to us with typical symptoms of coronary artery disease. Coronary
cineangiography revealed proximal left diagonal artery (LAD) occlusion.
Pre-operative transthoracic echocardiography of the patient planned to undergo
coronary artery bypass grafting unveiled an intracoronary calcified cystic mass.
In operation, the calcified cystic mass with well-defined borders and size of
2x2 cm located within wall of proximal segment of the LAD artery was excised and
double bypass with left internal thoracic artery (LITA) and great saphenous vein
grafts to the LAD and first diagonal arteries, respectively, was done.
Pathological analysis of the mass revealed it to be an inactive calcified
hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole
treatment (2x400 mg/day) was launched postoperatively and the patient was
discharged on 7th postoperative day.
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Affiliation(s)
- Unsal Vural
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - Ahmet Arif Aglar
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - İlyas Kayacioglu
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
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Abstract
Cystic hepatic lesions are commonly encountered in daily practice. The diagnosis of these lesions ranges from benign lesions of no clinical significance to malignant and potentially lethal conditions. The prevalence of hepatic cyst (HC) has been reported to be as high as 15-18% in the United States. Imaging with conventional ultrasound, computed tomography, magnetic resonance imaging, or contrast-enhanced ultrasound can be used to characterize further and diagnose. The pre-test probability of a diagnosis is highly affected by the patient's comorbidities and the clinical and laboratory data; thus, imaging studies should be interpreted in the context of the other clinical information for that particular patient. Treatment modalities for hepatic cyst include fenestration, aspiration sclerotherapy, or surgical resection. In the current review, we discuss the pathophysiology, diagnosis, and treatment modalities for various cystic hepatic lesions.
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Abstract
RATIONALE A characteristic metabolic finding of hepatic alveolar echinococcosis (HAE) on positron emission tomography/computed tomography (PET/CT) correlates with morphologic features on CT and magnetic resonance imaging (MRI). PATIENT CONCERNS A young man from an endemic area was admitted to our hospital due to right upper quadrant pain for 2 months. DIAGNOSIS CT and MRI revealed a heterogeneous mass with calcification, consisting of central necrosis and peripheral solid inflammatory tissues. Accordingly, FDG PET/CT demonstrated a characteristic metabolic finding of doughnut sign. Combining the above characteristic imaging features with positive serologic findings, the patient was diagnosed as HAE. INTERVENTIONS He then underwent extracorporeal hepatectomy and liver autotransplantation followed by medical treatment of benzimidazoles. OUTCOMES He remained asymptomatic without evidence of recurrence at 2-year follow-up. LESSONS The characteristic metabolic appearance of HAE on FDG PET/CT, correlated with its morphologic features of CT and MRI, may allow to make accurate diagnoses.
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Liver alveolar hydatid cyst diagnosed patient with right intrahepatic biliary tract obstruction: A case report with special emphasis on radiological features. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.478202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liver Calcifications and Calcified Liver Masses: Pattern Recognition Approach on CT. AJR Am J Roentgenol 2018; 211:76-86. [DOI: 10.2214/ajr.18.19704] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Performance of Magnetic Resonance Susceptibility-Weighted Imaging for Detection of Calcifications in Patients With Hepatic Echinococcosis. J Comput Assist Tomogr 2018; 42:211-215. [PMID: 29189399 DOI: 10.1097/rct.0000000000000687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We evaluated the performance of susceptibility-weighted imaging (SWI) for identification of hepatic calcifications in alveolar echinococcosis and cystic echinococcosis. METHODS The SWI images of 58 lesions in 40 patients (age, 49 ± 14 y) with alveolar echinococcosis (n = 22) or cystic echinococcosis (n = 18) were reviewed for calcifications. First, calcifications were suggested by visual assessment. Second, ratios of minimum intralesional intensity and mean lumbar muscle intensity were recorded. Computed tomography (CT) served as the criterion standard. RESULTS Thirty-seven lesions showed calcifications on CT. Susceptibility-weighted imaging provided a sensitivity of 89.2% (95% confidence interval [CI], 50.1-75.7) and a specificity of 57.1% (95% CI, 34.4-77.4) for calcifications detected by visual assessment. Receiver operating characteristic curves demonstrated a sensitivity of 67.6% and a specificity of 85.0% for an intensity ratio of 0.61. A specificity of 100% (95% CI, 80.8-100) and a sensitivity of 84.5% (95% CI, 67.3-93.2) were achieved by SWI for calcifications with a density greater than 184 HU in CT. CONCLUSIONS Identification of hepatic calcifications is possible with SWI. Susceptibility-weighted imaging offers the potential to reduce the need for of CT imaging for evaluation of echinococcosis.
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Dagoglu-Kartal MG, Ciftci T, Ozer C, Akinci D, Akhan O. Case Report: Role of Interventional Radiology in the Management of Patients with Alveolar Echinococcus: Successful Management of Three Cases. Am J Trop Med Hyg 2018; 98:1403-1407. [PMID: 29611496 DOI: 10.4269/ajtmh.17-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Alveolar echinococcus (AE) is an infestation by Echinococcus multilocularis. Partial hepatectomy or liver transplantation is the first choice of treatment. However, the disease is usually diagnosed at an unresectable stage. In those cases, invasion of the bile ducts and vessels, and necrosis in the center of the lesion lead to severe complications, such as cholangitis and liver abscesses. Palliative surgery has been reported to not offer advantages in management, and percutaneous and endoscopic interventions have become more prominent in management. In this case series, outcomes in three cases with unresectable AE were reported. In one of the cases, interventional procedures were used to manage the complications after surgery. In the second case, the cystic component was aspirated to decrease the size before the surgery and in the third case, it was used to drain biliary tree and no surgery was done.
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Affiliation(s)
| | - Turkmen Ciftci
- Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Cigdem Ozer
- Numune Training and Research Hospital Radiology Clinic, Ankara, Turkey
| | - Devrim Akinci
- Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Okan Akhan
- Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
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Ferreira Alves VA, Abdalla E. Nonviral Infections of the Liver. PRACTICAL HEPATIC PATHOLOGY: A DIAGNOSTIC APPROACH 2018:265-286. [DOI: 10.1016/b978-0-323-42873-6.00018-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Shanshan W, Hui L, Yan L, Li W, Yongfang R, Yan W, Kader M, Wenxiao J. The study of biochemical profile of cyst fluid and diffusion-weighted magnetic resonance imaging in differentiating hepatic hydatid cysts from liver simple cysts. J Clin Lab Anal 2018; 32:e22192. [PMID: 28303600 PMCID: PMC6084328 DOI: 10.1002/jcla.22192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/31/2017] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the value of biochemical profile of cyst fluid and diffusion-weighted imaging (DWI) in differentiating hepatic hydatid cysts (HCs) from liver simple cysts. MATERIALS AND METHODS Forty-six patients underwent MR imaging. Twenty-nine patients had 29 hydatid cysts and 17 patients had liver simple cysts. Thirteen patients with hydatid cysts and seven patients with liver simple cysts were evaluated with cyst fluid biochemical analysis. The concentration of glucose, protein, calcium ion (Ca2+ ) electrolyte, macroscopic appearance, and parasitological sediment were evaluated in this study. RESULTS In the respect of biochemical analysis cyst fluid, the concentration of glucose and calcium ion of HCs was significantly higher than that of the liver simple cysts. In the respect of DWI, in the b 1000 s/mm2 value in respect of mean application data center (ADC) values, there was a statistically significant difference between HCs group (the mean value was (2.50±0.79)×10-3 mm/s2 ) and liver simple cysts group (the mean value was (2.92±0.66)×10-3 mm/s2 ). However, no statistically significant results were obtained in the ADC measurements of b 500 s/mm2 between two groups. CONCLUSION The analysis of cyst fluid combined with the measurement of ADC values in the b 1000 s/mm2 value could be considered a promising parameter as an alternative to the differential diagnosis of hepatic hydatid cysts from liver simple cysts.
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Affiliation(s)
- Wang Shanshan
- Department of RadiologySecond Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Li Hui
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Liu Yan
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Wang Li
- Department of OrthopaedicsPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Ren Yongfang
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Wang Yan
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Muhetarjiang Kader
- Department of RadiologyPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Jia Wenxiao
- Department of RadiologySecond Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina
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Sade R, Kantarci M, Ogul H, Gundogdu B, Aydınlı B. Differentiation between hepatic alveolar echinococcosis and primary hepatic malignancy with diffusion-weighted magnetic resonance imaging. Diagn Interv Imaging 2017; 99:169-177. [PMID: 29110943 DOI: 10.1016/j.diii.2017.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/03/2017] [Accepted: 09/20/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE To determine the value of diffusion-weighted magnetic resonance imaging (DW-MRI) in discriminating between hepatic alveolar echinococcosis (AE) and hepatocellular carcinoma and intrahepatic cholangiocarcinoma. METHODS We included 49 patients (27 men, 22 women; mean age: 52.02±9.76 [SD] years; range: 25-72years) with 57 histopathologically confirmed hepatic AE lesions. Fifty patients (18 men, 32 women; mean age: 58.93±8.42 [SD] years; range: 42-71years) with 61 histopathologically confirmed hepatocellular carcinoma and 50 patients (24 men, 26 women; mean age: 50.11±7.70 [SD] years; range: 38-69years) with 54 histopathologically confirmed intrahepatic cholangiocarcinoma lesions were used as control groups. All patients had MRI examination of the liver that included conventional MRI sequences and DW-MRI using b values of 50, 400 and 800s/mm2. Two radiologists evaluated conventional MRI and DW-MRI images and calculated ADC values of hepatic lesions. RESULTS The mean ADC value of solid components of hepatic AE lesions was 1.34±0.41×10-3 mm2/s (range: 0.9-1.59×10-3 mm2/s) and was significantly higher than that of the solid components of hepatocellular carcinoma lesions (mean ADC value, 0.99±0.29×10-3 mm2/s; range: 0.7-1.15×10-3 mm2/s) and of intrahepatic cholangiocarcinoma lesions (mean ADC value, 1.05±0.22×10-3 mm2/s; range: 0.86-1.18×10-3 mm2/s) (P<0.001). CONCLUSION In general ADC values can help discriminate between AE and hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, the use of ADC values cannot help differentiating Type 4 AE from hepatocellular carcinoma or intrahepatic cholangiocarcinoma.
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Affiliation(s)
- R Sade
- Ataturk University, School of Medicine, Department of Radiology, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum, Turkey
| | - M Kantarci
- Ataturk University, School of Medicine, Department of Radiology, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum, Turkey.
| | - H Ogul
- Ataturk University, School of Medicine, Department of Radiology, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum, Turkey
| | - B Gundogdu
- Ataturk University, School of Medicine, Department of Pathology, Erzurum, Turkey
| | - B Aydınlı
- Akdeniz University, School of Medicine, Department of General Surgery, Antalya, Turkey
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Pitchaimuthu M, Duxbury M. Cystic lesions of the liver-A review. Curr Probl Surg 2017; 54:514-542. [PMID: 29173653 DOI: 10.1067/j.cpsurg.2017.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/08/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Maheswaran Pitchaimuthu
- Department of General Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom; Department of HPB and Transplant Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
| | - Mark Duxbury
- Department of General Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom
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Rencuzogulları A, Koltas IS, Akcam AT, Ulku A, Yalav O, Saritas AG, Dalcı K, Eray IC. Challenges, Prognosis and Outcomes of Surgical Resection for Hepatic Alveolar Echinococcosis: A Single Centre Experience. DICLE MEDICAL JOURNAL 2017. [DOI: 10.5798/dicletip.319757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Expression profiling of circulating miRNAs in mouse serum in response to Echinococcus multilocularis infection. Parasitology 2017; 144:1079-1087. [DOI: 10.1017/s0031182017000300] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
SUMMARYEchinococcus multilocularis is a most pathogenic zoonotic tapeworm that causes devastating echinococcosis in both humans and animals. Circulating microRNAs (miRNAs) are stably existed in the serum/plasma of mammalian hosts during helminthic infection. In this study, we compared the host-circulating miRNA expression in the sera from the E. multilocularis-infected and uninfected mice. A total of 58 host-origin serum miRNAs were differentially expressed (2 ⩾ fold change, P < 0·05), of which 21 were upregulated and 37 were significantly downregulated. Consistent with the sequencing data, quantitative polymerase chain reaction (PCR) results showed that the expression levels of four miRNAs were elevated gradually and one decreased gradually at the E. multilocularis infection time points. Moreover, seven of E. multilocularis specific miRNAs were identified in the sera. Real-time PCR analyses further demonstrated that only two parasite-derived miRNAs (emu-miR-10 and emu-miR-227) were specifically amplified in all the sera from mice infected with E. multilocularis. These findings will be helpful to understand the roles of miRNAs in host–parasite interaction and to potentiate serum miRNAs as diagnostic targets for echinococcosis.
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Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
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Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
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Hepatic hydatid disease complications: review of imaging findings and clinical implications. Abdom Radiol (NY) 2017; 42:199-210. [PMID: 27487777 DOI: 10.1007/s00261-016-0860-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hydatid disease is a zoonotic parasitic disease. The liver is the most commonly affected organ, and hepatic hydatid disease complications are not uncommon. Hydatid cyst superinfection, intrabiliary rupture, and direct rupture into the thoracic or abdominal cavities are the frequently encountered complications. Other exceedingly rare complications include rupture of the cyst into hollow viscera, abdominal wall invasion, and hepatic vasculature-related complications such as portal vein thrombosis and Budd-Chiari syndrome. These complications have variable clinical presentations and imaging findings and require different medical and surgical managements. We aim to provide a spectrum of imaging findings of different common and uncommon complications of hepatic hydatid disease with emphasis on their clinical implications.
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Unexpected hosts: imaging parasitic diseases. Insights Imaging 2016; 8:101-125. [PMID: 27882478 PMCID: PMC5265192 DOI: 10.1007/s13244-016-0525-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/08/2016] [Accepted: 09/28/2016] [Indexed: 12/28/2022] Open
Abstract
Radiologists seldom encounter parasitic diseases in their daily practice in most of Europe, although the incidence of these diseases is increasing due to migration and tourism from/to endemic areas. Moreover, some parasitic diseases are still endemic in certain European regions, and immunocompromised individuals also pose a higher risk of developing these conditions. This article reviews and summarises the imaging findings of some of the most important and frequent human parasitic diseases, including information about the parasite's life cycle, pathophysiology, clinical findings, diagnosis, and treatment. We include malaria, amoebiasis, toxoplasmosis, trypanosomiasis, leishmaniasis, echinococcosis, cysticercosis, clonorchiasis, schistosomiasis, fascioliasis, ascariasis, anisakiasis, dracunculiasis, and strongyloidiasis. The aim of this review is to help radiologists when dealing with these diseases or in cases where they are suspected. Teaching Points • Incidence of parasitic diseases is increasing due to migratory movements and travelling. • Some parasitic diseases are still endemic in certain regions in Europe. • Parasitic diseases can have complex life cycles often involving different hosts. • Prompt diagnosis and treatment is essential for patient management in parasitic diseases. • Radiologists should be able to recognise and suspect the most relevant parasitic diseases.
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Kumar A, Saini NS, Mohindroo J, Singh BB, Sangwan V, Sood NK. Comparison of radiography and ultrasonography in the detection of lung and liver cysts in cattle and buffaloes. Vet World 2016; 9:1113-1120. [PMID: 27847421 PMCID: PMC5104720 DOI: 10.14202/vetworld.2016.1113-1120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 08/31/2016] [Indexed: 11/16/2022] Open
Abstract
AIM Echinococcosis is the major cause of lung and liver cysts in ruminants. This study compared usefulness of radiography and ultrasonography (USG) in the detection of lung and/or liver cysts in sick bovine animals. The study also worked out cooccurrence of lung and liver cysts, and whether these cysts were primary cause of sickness or not. MATERIALS AND METHODS This study was conducted on 45 sick bovine (37 buffaloes and 8 cattle) suffering from lung and liver cysts. A complete history of illness and clinical examination was carried out. Lateral radiographs of chest and reticular region were taken. In radiographically positive or suspected cases of cysts, USG of the lung and liver region was done. Depending on the location of cyst and clinical manifestations of the animal, the cysts were categorized as primary or secondary causes of sickness. RESULTS Using either imaging technique, it was observed that 46.7% of the animals had both lung and liver cysts, whereas 33.3% had only lung and 20% had only liver cyst. Cysts were identified as primary cause of sickness in 31.1% animals only. For diagnosing lung cysts, radiography (71.1%) and USG (62.2%) had similar diagnostic utility. However, for detecting liver cysts, USG was the only imaging tool. CONCLUSION The lung and liver cysts, depending on their number and size may be a primary cause of sickness in bovine. Radiography and USG are recommended, in combination, as screening tools to rule out echinococcosis.
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Affiliation(s)
- Ashwani Kumar
- Department of Veterinary Surgery and Radiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Narinder Singh Saini
- Department of Veterinary Surgery and Radiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Jitender Mohindroo
- Department of Veterinary Surgery and Radiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Balbir Bagicha Singh
- School of Public Health and Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Vandana Sangwan
- Department of Teaching Veterinary Clinical Complex, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Naresh Kumar Sood
- Department of Teaching Veterinary Clinical Complex, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
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Vennarecci G, Manfredelli S, Guglielmo N, Laurenzi A, Goletti D, Ettorre GM. Major liver resection for recurrent hydatid cyst of the liver after suboptimal treatment. Updates Surg 2016; 68:179-84. [PMID: 27126358 DOI: 10.1007/s13304-016-0368-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 04/16/2016] [Indexed: 12/24/2022]
Abstract
Recurrent hydatid disease (HD) of the liver after a previous suboptimal invasive treatment is a clinical situation not well codified in terms of management and surgical treatment. Between June 2001 and July 2015, 1525 liver resection were performed at our unit, of whom 217 were with a laparoscopic and 20 with a robotic approach. The most common indications were hepatocellular carcinoma grown on a cirrhotic liver and colorectal metastasis. During the same period, we performed liver surgery for HD in 34 patients (21 females, 13 males). This retrospective study focused on the management and surgical treatment of three unusual cases of recurrent hydatid cyst. All patients had a course of perioperative albendazole. Thirty-four patients had a surgical treatment [open surgery in 30 (88 %) and laparoscopic in four (12 %)]. Surgical procedures were classified as radical resections in 33 patients [total cystopericystectomy (10), left lateral hepatectomy (5), left hepatectomy (2), right hepatectomy (7), segmentectomy/bisegmentectomy (9)]. One patient underwent subtotal pericystectomy as the cyst was close to a major vascular pedicle in a cirrhotic liver. Post operative complications of grade I-II occurred in 11 (32 %) patients, of grade III-IV in one (3 %). Three patients had HD recurrence after a previous suboptimal invasive treatment [PAIR (2), unroofing (1)] and all had to undergo a major liver resection for the complete removal of parasites. The HD first relapse rate for the whole surgical series was 3 %. The second relapse rate was 33 %. The overall survival rate was 100 %. Operations for recurrent HD of the liver represent a surgical challenge due to volume of the cyst, presence of adhesions related to previous invasive treatments and proximity to major vascular structures of the liver. In such instances, pericystectomy can be difficultly achieved making necessary a formal major liver resection.
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Affiliation(s)
- Giovanni Vennarecci
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy.
| | - Simone Manfredelli
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Nicola Guglielmo
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Andrea Laurenzi
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
| | - Delia Goletti
- Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Giuseppe Maria Ettorre
- Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00100, Rome, Italy
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Bulakci M, Ilhan M, Bademler S, Yilmaz E, Gulluoglu M, Bayraktar A, Asik M, Guloglu R. Efficacy of ultrasound-guided core-needle biopsy in the diagnosis of hepatic alveolar echinococcosis: a retrospective analysis. ACTA ACUST UNITED AC 2016; 23:19. [PMID: 27101838 PMCID: PMC4840258 DOI: 10.1051/parasite/2016019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 03/21/2016] [Indexed: 12/19/2022]
Abstract
Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Ilhan
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Suleyman Bademler
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Erdem Yilmaz
- Department of Radiology, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Adem Bayraktar
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Murat Asik
- Department of Radiology, Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Recep Guloglu
- Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Rolle AM, Soboslay PT, Reischl G, Hoffmann WH, Pichler BJ, Wiehr S. Evaluation of the Metabolic Activity of Echinococcus multilocularis in Rodents Using Positron Emission Tomography Tracers. Mol Imaging Biol 2016; 17:512-20. [PMID: 25561014 DOI: 10.1007/s11307-014-0815-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE 2-Deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) has been used as a standard clinical positron emission tomography (PET) tracer for the follow-up of the rare but life-threatening parasitic disease alveolar echinococcosis (AE). Given that the disease is endemic in many countries in the northern hemisphere and the diagnosis is still challenging, the aim of our study was to evaluate further clinically relevant PET tracers as possible diagnostic tools for AE in vitro and in vivo. PROCEDURES Various clinically used PET tracers were evaluated in vitro and assessed in an in vivo AE animal model based on PET/magnetic resonance (MR) measurements. RESULTS In vitro binding assays displayed high uptake of [(18)F]FDG in a cell suspension of E. multilocularis tissue, whereas 3'-deoxy-3'-[(18)F]fluorothymidine ([(18)F]FLT) and [(11)C]choline were found to be taken up strongly by E. multilocularis vesicles. [(18)F]FDG and [(18)F]FLT displayed an elevated uptake in vivo, which appeared as several foci throughout the parasite tissue as opposed to [(18)F]fluoro-azomycinarabinofuranoside ([(18)F]FAZA) and [(11)C]choline. CONCLUSIONS Our data clearly demonstrate that the clinically applied PET tracer [(18)F]FDG is useful for the diagnosis and disease staging of AE but also has drawbacks in the assessment of currently inactive or metabolically weak parasitic lesions. The different tested PET tracers do not show the potential for the replacement or supplementation of current diagnostic strategies. Hence, there is still the need for novel diagnostic tools.
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Affiliation(s)
- Anna-Maria Rolle
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University, Röntgenweg 13, 72076, Tübingen, Germany
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Mueller J, Stojkovic M, Berger AK, Rosenberger KD, Schlett CL, Kauczor HU, Junghanss T, Weber TF. How to not miss alveolar echinococcosis in hepatic lesions suspicious for cholangiocellular carcinoma. Abdom Radiol (NY) 2016; 41:221-30. [PMID: 26867903 DOI: 10.1007/s00261-015-0561-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Hepatic alveolar echinococcosis (AE) resembles intrahepatic cholangiocarcinoma (ICC) on radiological imaging. The purpose of this study was to identify criteria to discriminate AE from ICC with CT and MR Imaging. METHODS One hundred and sixteen imaging studies of 94 patients (CT n = 65; MRI n = 51) diagnosed with AE (n = 55) or ICC (n = 39) were retrospectively reviewed by two blinded radiologists for lesion features including enhancement pattern and matrix composition. A consensus read was conducted in cases of disagreement. Uni- and multivariate logistic regression with bootstrapping were used for analysis. RESULTS Using CT, no or septal enhancement and calcification yielded the highest values of sensitivity/specificity (90.9%/90.6% and 81.8%/96.9%) for AE. Using MRI, no or septal enhancement and cystic components achieved the highest sensitivity/specificity (90.9%/100.0% and 84.8%/66.7%) for AE. Multivariate logistic regression identified the following strong independent predictors for AE: for MRI, no or septal enhancement (odds ratio [OR] 322.4; p < 0.001); for CT, no or septal enhancement and calcification (OR 35.9 and 42.5; p < 0.001 and p < 0.01, respectively). No or septal enhancement and calcification demonstrated the highest interreader agreement (>90%). CONCLUSION Enhancement characteristics and matrix calcifications offer the strongest discriminating potential between AE and ICC with a high sensitivity, specificity, and interreader agreement.
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