scholarly journals Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 634 ◽  
Author(s):  
Johannes Grimm ◽  
Annika Beck ◽  
Juliane Nell ◽  
Julian Schmidberger ◽  
Andreas Hillenbrand ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Peripheral Zone ◽  
Intermediate Stage ◽  
Border Zone ◽  
Hepatic Alveolar Echinococcosis ◽  
Progression Model ◽  
Type Iv ◽  
Laminated Layer

Alveolar echinococcosis (AE) is caused by the intermediate stage of Echinococcus multilocularis. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the Echinococcus multilocularis Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of Echinococcus multilocularis (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant.

scholarly journals Simple liver cysts and cystoid lesions in hepatic alveolar echinococcosis: a retrospective cohort study with Hounsfield analysis

Parasite ◽  
2019 ◽  
Vol 26 ◽  
pp. 54 ◽  
Author(s):  
Agata Engler ◽  
Rong Shi ◽  
Meinrad Beer ◽  
Julian Schmidberger ◽  
Wolfgang Kratzer ◽  
...  
Keyword(s):  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Morphological Characteristics ◽  
Hounsfield Unit ◽  
Type I ◽  
Hepatic Cysts ◽  
Hepatic Alveolar Echinococcosis ◽  
Type Iv ◽  
The Difference ◽  
The Individual

Background. Alveolar echinococcosis (AE) is a rare zoonosis caused by the larval stage of the tapeworm Echinococcus multilocularis. AE lesions affect the liver in more than 98% of cases. AE lesions have various morphological characteristics that are described in the Echinococcus multilocularis Ulm classification for computed tomography (EMUC-CT). One of these characteristics is a cystoid portion. The aim of the study was to compare the density of simple hepatic cysts with cystoid portions of AE lesions classified on the basis of the EMUC-CT. Results. Hounsfield Unit (HU) measurements of the cystoid portions of all EMUC-CT type I–IV AE lesions (n = 155) gave a mean of 21.8 ± 17.6, which was significantly different from that of 2.9 ± 4.5 for the simple hepatic cysts (p < 0.0001). The difference between each of the individual AE types and simple hepatic cysts was also significant. In addition, the HU values of the cystoid portions in types I, II and IIIa/b and simple cysts were each significantly different from type IV (p < 0.0001). The HU measurements in type IV presented by far the highest mean. Conclusions. The significantly higher density measured in the cystoid portions of hepatic AE lesions offers a good means of differentiation from simple hepatic cysts.

Hepatic Alveolar Echinococcosis

2021 ◽  
Author(s):  
Solange Bresson-Hadni ◽  
Laurent Spahr ◽  
François Chappuis
Keyword(s):  
Access To Care ◽  
Surgical Resection ◽  
Larval Stage ◽  
Echinococcus Multilocularis ◽  
Gold Standard ◽  
Diagnostic Procedure ◽  
Alveolar Echinococcosis ◽  
Opportunistic Infections ◽  
First Line ◽  
Hepatic Alveolar Echinococcosis

AbstractHepatic alveolar echinococcosis (HAE) is a rare but severe zoonosis caused by the pseudotumoral intrahepatic development of the larval stage of the tapeworm Echinococcus multilocularis. HAE is present only in the Northern Hemisphere, predominantly in China. Currently, there is a significant resurgence of cases in historically endemic areas associated with emergence of HAE in countries not previously concerned. Today, in European countries, HAE is often discovered by chance; however, clinicians should be made aware of opportunistic infections that progressively emerged recently as a result of therapeutic or pathological immunosuppression. Ultrasonography is the key first-line diagnostic procedure, with specific serology providing confirmation in 95% of the cases. Albendazole, only parasitostatic, is the mainstay for treatment. Surgical resection, if feasible, is the gold standard for treatment, and more patients are currently eligible for this option because of an earlier diagnosis. The prognosis has considerably improved but remains poor in countries where access to care is less favorable.

scholarly journals Follow-up in hepatic alveolar echinococcosis under benzimidazole therapy using computed tomography

2020 ◽  
Vol 133 (12) ◽  
pp. 1507-1509
Author(s):  
Tilmann Graeter ◽  
Rong Shi ◽  
Hai-Hua Bao ◽  
Wolfgang Kratzer ◽  
Thomas F.E. Barth ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Alveolar Echinococcosis ◽  
Hepatic Alveolar Echinococcosis

Experimental infection of larval Echinococcus multilocularis in the rodent brain as a model for cerebral alveolar echinococcosis

1998 ◽  
Vol 72 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Y. Sato ◽  
M. Nakao ◽  
K. Nakaya ◽  
A. Ito
Keyword(s):  
Experimental Infection ◽  
Echinococcus Multilocularis ◽  
Post Infection ◽  
Alveolar Echinococcosis ◽  
Third Ventricle ◽  
Left Lung ◽  
Cranial Cavity ◽  
Rodent Brain ◽  
Laminated Layer ◽  
The Brain

AbstractExperimental infection of larval Echinococcus multilocularis in the rodent brain was attempted to establish a murine model for cerebral alveolar echinococcosis. Balb/c mice and jirds were injected intracranially with 10% of a homogenated hydatid cyst mass. Small cystic larvae were observed macroscopically in the cranial cavity 1, 2 and 5 months post-infection in both mice and jirds. Some larval cysts from both rodents contained mature or immature protoscoleces. In mice, the laminated layer was found in the lateral ventricle 2 months post-infection but without protoscoleces. At five months post-infection, larger larval cysts were found in the cranial cavity of a mouse, which also demonstrated partial palsy of the legs. A laminated layer with mature protoscoleces was observed in the third ventricle and the mouse also harboured, in the left lung, a larval cyst containing protoscoleces surrounded by lymphocytes. Jirds were also found to be infected with metacestodes in the cranial cavity, but neither unusual behaviour nor establishment of cysts inside the brain was observed in jirds during the course of infection.

scholarly journals A CT-Based Radiomics Nomogram To Predict The Biological Activity of Hepatic Alveolar Echinococcosis

2021 ◽  
Author(s):  
Jian Wang ◽  
Tieliang Zhang ◽  
Yi Jiang ◽  
Yafei Zhao ◽  
Wenyao Xu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Biological Activity ◽  
Alveolar Echinococcosis ◽  
Model Performance ◽  
K Nearest Neighbors ◽  
Hepatic Alveolar Echinococcosis ◽  
Positron Emission ◽  
Pet Ct ◽  
Combined Models ◽  
Selection Operator

Abstract BackgroundThis study aims to establish a computed tomography (CT) - based radiomics nomogram to predict the biological activity of hepatic alveolar echinococcosis (HAE).MethodsA total of 174 HAE patients (139 for training, 35 for test) were enrolled whose CT and positron emission tomography-computed tomography (PET/CT) examinations were performed before surgery, and the biological activity was evaluated according to the PET/CT. Radiomic features were extracted from CT images, based on which radiomic scores (Rad-score) were calculated with the least absolute shrinkage and selection operator logistic regression. Three radiomics models (K-Nearest Neighbors, Logical regression, and Multilayer Perceptron), including only radiomic features and a radiomics nomogram, comprised of demographics, clinical indexes, and radiomic features were constructed respectively to predict the biological activity of HAE. The model performance was evaluated by area under curve (AUC), decision curve, and calibration curve.Results30 features in total were selected as optimal radiomic features and considered as input to calculate the Rad-score. There were no significant differences in the predictive efficacy between the combined models and the radiomics models from the perspective of the decision curve. The radiomics models was unparalleled, with an AUC of 0.952 (95%CI=0.902~0.981, P<0.0001) and 0.800 (95%CI=0.631~0.916, P<0.0020) in the training and testing cohort, respectively.ConclusionThe radiomics nomogram model showed great potential in identifying HAE biological activity.

scholarly journals Proposal of a computed tomography classification for hepatic alveolar echinococcosis

2016 ◽  
Vol 22 (13) ◽  
pp. 3621 ◽  
Author(s):  
Tilmann Graeter ◽  
Wolfgang Kratzer ◽  
Suemeyra Oeztuerk ◽  
Mark Martin Haenle ◽  
Richard Andrew Mason ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Alveolar Echinococcosis ◽  
Hepatic Alveolar Echinococcosis
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