Long-term follow-up of liver alveolar echinococcosis using echinococcosis multilocularis ultrasound classification

Figure 1 Flowchart illustrating case selection, including inclusion and exclusion criteria starting from the patient collective of the alveolar echinococcosis database in Germany. AE: Alveolar echinococcosis.

Figure 2 Echinococcosis Multilocularis Ulm Classification-ultrasound.

Figure 3 Diameter of hepatic alveolar echinococcosis reference lesion sorted by sonomorphological pattern analogous to Echinococcosis Multilocularis Ulm Classification-ultrasound classification.

Figure 4 Hepatic alveolar echinococcosis reference lesion in segment II with pseudocystic pattern. A: Initially sharply delineated with individual centrally echo-rich portions; B: Through the disease course, more blurred delineation and increase of centrally echo-rich portions. The ultrasound images shown are from the current patient collective.

Figure 5 Hepatic alveolar echinococcosis reference lesions (arrow) in segment II/IVa/VIII (patient 1) and segment II/III (patient 2), respectively. A and C: initially classified as pseudocystic pattern (patient 1: A, patient 2: C); B and D: In the course of each case loss of the centrally echo-poor, liquid-impressive zone and increasing calcification structures, indicating a change in sonomorphology with a transition to a hailstorm pattern (patient 1: B; patient 2: D). The ultrasound images shown are from the current patient collective.

Figure 6 Predominant sonomorphological pattern of alveolar echinococcosis reference lesion subdivided according to Echinococcosis Multilocularis Ulm Classification-ultrasound classification, ultrasound 1 to ultrasound 7. US: Ultrasound.

Figure 7 Potential pattern change over time.