Current status of diagnosis and treatment of hepatic echinococcosis

Table 1 The Gharbi classification of hydatid cysts

Type	Characteristics
I	Unilocular cyst, wall and internal echogonicities
II	Cyst with detached membrane (water-lily sign)
III	Multivesicular, multiseptated cyst, daughter cyst (honeycomb pattern)
IV	Hererogeneous cyst, no daughter vesicules
V	Cyst with partially or completely calcified wall

Table 2 The World Health Organization classification of hydatid cysts

WHO stage	Characteristics	Activity
CE1	Uniloculer, anechoic cyst with double line sign	Active
CE2	Multiseptated “rosette-like”“honeycomb patern” cyst	Active
CE3a	Cyst with detached membrane (water-lily sign)	Transitional
CE3b	Daughter cysts in solid matrix	Transitional
CE4	Hererogeneous cyst, no daughter vesicules	Inactive
CE5	Solid matrix with calcified wall	Inactive

WHO: World Health Organization.

Table 3 PNM classification of Echinococcus multilocularis[146]

P	Hepatic localization of the metacestode
Px	Primary lesion unable to be assessed
P0	No detectable hepatic lesion
P1	Peripheral lesion without biliary or proximal vascular involvement
P2	Central lesions with biliary or proximal vascular involvement of one lobe
P3	Central lesions with biliary or proximal vascular involvement of both lobes or two hepatic veins or both
P4	Any lesion with extension along the portal vein, inferior vena cava or hepatic arteries
N	Extra-hepatic involvement of neighbouring organs
Nx	Not evaluable
N0	No regional involvement
N1	Involvement of neighboring organs or tissues
M	Absence or presence of distant metastasis
Mx	Not completely assessed
M0	No metastasis on chest radiograph and computer tomography brain scan
M1	Metastasis present