Schuhbaur J, Schweizer M, Philipp J, Schmidberger J, Schlingeloff P, Kratzer W. Long-term follow-up of liver alveolar echinococcosis using echinococcosis multilocularis ultrasound classification. World J Gastroenterol 2021; 27(40): 6939-6950 [PMID: 34790016 DOI: 10.3748/wjg.v27.i40.6939]
Corresponding Author of This Article
Wolfgang Kratzer, MD, Professor, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89081, Germany. wolfgang.kratzer@uniklinik-ulm.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 28, 2021; 27(40): 6939-6950 Published online Oct 28, 2021. doi: 10.3748/wjg.v27.i40.6939
Long-term follow-up of liver alveolar echinococcosis using echinococcosis multilocularis ultrasound classification
Jasmin Schuhbaur, Melissa Schweizer, Jana Philipp, Julian Schmidberger, Patrycja Schlingeloff, Wolfgang Kratzer
Jasmin Schuhbaur, Melissa Schweizer, Jana Philipp, Julian Schmidberger, Patrycja Schlingeloff, Wolfgang Kratzer, Department of Internal Medicine I, University Hospital Ulm, Ulm 89081, Germany
Author contributions: Kratzer W and Schuhbaur J planned and designed the study; The data were evaluated by Kratzer W and Schuhbaur J; all authors were involved in the interpretation of the results; Kratzer W, Schuhbaur J, Schmidberger J, Schlingeloff P, Schweizer M and Philipp J prepared the first draft; the statistical analysis was performed by Schmidberger J and Schlingeloff P; all authors read, amended, and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the local ethics committee and conducted in accordance with the Declaration of Helsinki (ref. No. 166/13). Because of its retrospective design and pseudonymised evaluation of imaging, no ethics approval was necessary. All data were analysed anonymously.
Informed consent statement: Because of retrospective and anonymous character of this study, the need for informed consent was waived by the institutional review board.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request (wolfgang.kratzer@uniklinik-ulm.de).
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wolfgang Kratzer, MD, Professor, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89081, Germany. wolfgang.kratzer@uniklinik-ulm.de
Received: July 20, 2021 Peer-review started: July 20, 2021 First decision: August 19, 2021 Revised: September 1, 2021 Accepted: September 22, 2021 Article in press: September 22, 2021 Published online: October 28, 2021 Processing time: 98 Days and 21.7 Hours
ARTICLE HIGHLIGHTS
Research background
Alveolar echinococcosis (AE) is a human parasitosis caused by Echinococcus multilocularis.
Research motivation
Early diagnosis of AE is important to initiate prompt therapy and improve patient prognosis. Abdominal ultrasonography is the most common primary imaging modality and allows for classification of hepatic lesion morphology.
Research objectives
We address the question of whether (and how) the sonomorphology of individual AE lesions can change over time.
Research methods
In our preliminary retrospective longitudinal study, based on data from the national echinococcosis database in Germany, we evaluated clinical and ultrasound (US) imaging data for 59 patients according to AE case definition of confirmed (n = 26) or probable (n = 33) AE. The AE reference lesion was the largest hepatic AE lesion at the time of the first US examination. We used the Echinococcosis Multilocularis Ulm Classification (EMUC)-US to classify the sonomorphologic pattern.
Research results
The study included 59 patients, 38 (64.5%) women and 21 (35.6%) men. The mean median age at initial diagnosis was 59.9 ± 16.9 years. At the time of initial US, 42.4% (25/59) had a hailstorm pattern, 16.9% (10/59) had a pseudohemangioma-like pattern, 15.3% (9/59) had a pseudocystic pattern, and 25.4% (15/59) had a metastasis-like pattern. Although the sonomorphologic pattern remained unchanged in 84.7% (50/59) of the AE reference lesions, 15.3% (9/59) showed a pattern change over time. A change in pattern was seen exclusively for AE lesions initially classified as hemangioma-like or pseudocystic.
Research conclusions
The sonomorphology of hepatic AE lesions may change over time, particularly hemangioma-like and pseudocystic patterns.
Research perspectives
Further research should clarify whether the patterns evolve and change according to a sonomorphological evolution.
