Multi-Slice Spiral CT in The Diagnosis and Resectability Evaluation of Hepatic Alveolar Echinococcosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHUANGYu ¹ , YUXin ¹ , ZHANGJing ¹ , XIEMeng-yu ¹ , LIXian-zhong ² , LIWei ³ ,  WUBing ¹

1. Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Ganzi Tibetan Autonomous Prefecture Hospital, Ganzi 626000, Sichuan Province, China;
3. Ganzi Tibetan Autonomous Prefecture CDC, Ganzi 626000, Sichuan Province, China;

Corresponding author：

WUBing, Email: bingwu69@163.com

Keywords：

Alveolar echinococcosis; Tomography, X-ray computed; Liver

DOI：

10.7507/1007-9424.20160030

Video：

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Objective To assess the value of multi-slice spiral CT (MSCT) in the diagnosis and resectability judgement of hepatic alveolar echinococcosis (HAE). Methods The CT findings of 28 patients who were confirmed HAE by surgical pathological examination were retrospectively analyzed. Comparative analysis were made between the CT findings and surgical pathology. Results Altogether 45 lesions in hepatic were detected. Lesions mainly revealed an infiltrating tumor-like hepatic mass with irregular margins and heterogeneous contents with varied attenuation, including scattered hyper-attenuating calcifications and hypo-attenuating areas corresponding to necrosis, no substantial enhancement, however, the fibro-inflammatory component surrounding the parasitic tissue was enhanced faintly in the delayed phase, and clearly demarcated from surrounding parenchyma. MSCT angiography (CTA) depicted signs of infiltration of hepatic vessels such as pushed, compression, displacement, stenosis, encasement and interruption. Compared with findings of operation, the sensitivity and specificity value of MSCT for evaluating the hepatic artery system disorders were 67%, 97%; and for portal venous system were 83%, 93%; and for hepatic venous system were 84%, 91%; while for inferior vena cava were 85%, 100%. Twelve cases which were evaluated as resectable by MSCT were in accordance with surgical findings. In the rest 16 patients which were judged as non-resectable by MSCT, only 2 patients were radical treatment through partial excision, repair and reconstruction for the involvement of large vessels and bile ducts. Conclusion MSCT is accuracy in the diagnosis and assessment of vessels complication of HAE. It has an important value to evaluate the resectability of HAE and the planning of treatment.

Citation： ZHUANGYu, YUXin, ZHANGJing, XIEMeng-yu, LIXian-zhong, LIWei, WUBing. Multi-Slice Spiral CT in The Diagnosis and Resectability Evaluation of Hepatic Alveolar Echinococcosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(1): 104-108. doi: 10.7507/1007-9424.20160030 Copy

1.	Vuitton DA, Zhou H, Bresson-Hadni S, et al. Epidemiology of alveolar echinococcosis with particular reference to China and Europe. Parasitology, 2003, 127 Suppl:S87-S107.
2.	Li TY, Chen XW, Zhen R, et al. Widespread co-endemicity of human cystic and alveolar echinococcosis on the eastern Tibetan Plateau, northwest Sichuan/southeast Qinghai, China. Acta Trop, 2010, 113(3):248-256.
3.	Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococ-cosis:Clinical and therapeutic aspects. World J Gastroenterol, 2012, 18(13):1448-1458.
4.	Becce F, Pomoni A, Uldry E, et al. Alveolar echinococcosis of the liver:Diffusion-weighted MRI findings and potential role in lesion characterisation. Eur J Radiol, 2014, 83(4):625-631.
5.	张宽, 王会苹, 黄山等.肝泡状棘球蚴病的CT诊断.实用放射学杂志, 2011, 27(7):1117-1119.
6.	鲁厚文.肝脏泡状棘球蚴病的CT诊断探讨.影像诊断与介入放射学, 2008, 17(1):16-18.
7.	Yapici O, Erturk SM, Ulusay M, et al. Hepatic alveolar echinococ-cosis:a diagnostic challenge. JBR-BTR, 2011, 94(1):21-23.
8.	任伟新, 肖湘生, 温浩.肝泡状棘球蚴病的影像学诊断及治疗进展.中国介入影像与治疗学, 2007, 4(4):314-317.
9.	张亚飞, 陆宏伟, 吉鸿等.肝包虫病治疗的研究进展.中国普外基础与临床杂志, 2015, 22(2):162-165.
10.	张洋, 樊海宁.肝泡型包虫病的治疗进展.临床外科杂志, 2014, 22(7):533-535.
11.	Marrone G, Crino' F, Caruso S, et al. Multidisciplinary imaging of liver hydatidosis. World J Gastroenterol, 2012, 18(13):1438-1447.
12.	Czermak BV, Akhan O, Hiemetzberger R, et al. Echinococ cosis of the liver. Abdom Imaging, 2008, 33(2):133-143.
13.	Kantarci M, Bayraktutan U, Karabulut N, et al. Alveolar echinococ-cosis:spectrum of findings at cross-sectional imaging. Radiographics, 2012, 32(7):2053-2070.
14.	Liu W, Delabrousse É, Blagosklonov O, et al. Innovation in hepatic alveolar echinococcosis imaging:best use of old tools, and necessary evaluation of new ones. Parasite, 2014, 21:74.
15.	Farrokh D, Zandi B, Pezeshki Rad M, et al. Hepatic Alveolar Echino-coccosis. Arch Iran Med, 2015, 18(3):199-202.
16.	Buttenschoen K, Carli Buttenschoen D, Gruener B, et al. Long-term experience on surgical treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(4):689-698.
17.	Kern P, Wen H, Sato N, et al. WHO classification of alveolar echino-coccosis:principles and application. Parasitol Int, 2006, 55 Suppl:S283-S287.
18.	Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1):1-16.
19.	吐尔干艾力, 温浩, 邵英梅.肝泡状棘球蚴术前可根治性切除的综合评估.肝胆外科杂志, 2006, 14(2):154-156.
20.	亚力坤·依明, 古兰拜尔·玉苏甫. MSCT对肝泡状棘球蚴病的诊断价值.放射学实践, 2011, 26(1):59-61.
21.	蒋铁民.晚期的肝泡状棘球蚴病的手术方式探讨.新疆:新疆医科大学, 2010.
22.	戴季蓬, 邵英梅, 温浩等.肝包虫病的诊断与治疗进展.中华肝胆外科杂志, 2011, 17(5):432-433.
23.	温浩, 刘文亚, 邵英梅等.包虫病影像诊断技术和手术治疗进展.国际医学寄生虫病杂志, 2009, 36(5):299-306.
24.	刘文亚, 楼俭茹, 邢艳等.肝脏泡状棘球蚴病的多层螺旋CT影像特征.中华放射学杂志, 2005, 39(8):860-863.
25.	Koch S, Bresson-Hadni S, Miguet JP, et al. Experience of liver trans-plantation for incurable alveolar echinococcosis:a 45-case European collaborative report. Transplantation, 2003, 75(6)):856-863.

1. Vuitton DA, Zhou H, Bresson-Hadni S, et al. Epidemiology of alveolar echinococcosis with particular reference to China and Europe. Parasitology, 2003, 127 Suppl:S87-S107.
2. Li TY, Chen XW, Zhen R, et al. Widespread co-endemicity of human cystic and alveolar echinococcosis on the eastern Tibetan Plateau, northwest Sichuan/southeast Qinghai, China. Acta Trop, 2010, 113(3):248-256.
3. Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococ-cosis:Clinical and therapeutic aspects. World J Gastroenterol, 2012, 18(13):1448-1458.
4. Becce F, Pomoni A, Uldry E, et al. Alveolar echinococcosis of the liver:Diffusion-weighted MRI findings and potential role in lesion characterisation. Eur J Radiol, 2014, 83(4):625-631.
5. 张宽, 王会苹, 黄山等.肝泡状棘球蚴病的CT诊断.实用放射学杂志, 2011, 27(7):1117-1119.
6. 鲁厚文.肝脏泡状棘球蚴病的CT诊断探讨.影像诊断与介入放射学, 2008, 17(1):16-18.
7. Yapici O, Erturk SM, Ulusay M, et al. Hepatic alveolar echinococ-cosis:a diagnostic challenge. JBR-BTR, 2011, 94(1):21-23.
8. 任伟新, 肖湘生, 温浩.肝泡状棘球蚴病的影像学诊断及治疗进展.中国介入影像与治疗学, 2007, 4(4):314-317.
9. 张亚飞, 陆宏伟, 吉鸿等.肝包虫病治疗的研究进展.中国普外基础与临床杂志, 2015, 22(2):162-165.
10. 张洋, 樊海宁.肝泡型包虫病的治疗进展.临床外科杂志, 2014, 22(7):533-535.
11. Marrone G, Crino' F, Caruso S, et al. Multidisciplinary imaging of liver hydatidosis. World J Gastroenterol, 2012, 18(13):1438-1447.
12. Czermak BV, Akhan O, Hiemetzberger R, et al. Echinococ cosis of the liver. Abdom Imaging, 2008, 33(2):133-143.
13. Kantarci M, Bayraktutan U, Karabulut N, et al. Alveolar echinococ-cosis:spectrum of findings at cross-sectional imaging. Radiographics, 2012, 32(7):2053-2070.
14. Liu W, Delabrousse É, Blagosklonov O, et al. Innovation in hepatic alveolar echinococcosis imaging:best use of old tools, and necessary evaluation of new ones. Parasite, 2014, 21:74.
15. Farrokh D, Zandi B, Pezeshki Rad M, et al. Hepatic Alveolar Echino-coccosis. Arch Iran Med, 2015, 18(3):199-202.
16. Buttenschoen K, Carli Buttenschoen D, Gruener B, et al. Long-term experience on surgical treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(4):689-698.
17. Kern P, Wen H, Sato N, et al. WHO classification of alveolar echino-coccosis:principles and application. Parasitol Int, 2006, 55 Suppl:S283-S287.
18. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1):1-16.
19. 吐尔干艾力, 温浩, 邵英梅.肝泡状棘球蚴术前可根治性切除的综合评估.肝胆外科杂志, 2006, 14(2):154-156.
20. 亚力坤·依明, 古兰拜尔·玉苏甫. MSCT对肝泡状棘球蚴病的诊断价值.放射学实践, 2011, 26(1):59-61.
21. 蒋铁民.晚期的肝泡状棘球蚴病的手术方式探讨.新疆:新疆医科大学, 2010.
22. 戴季蓬, 邵英梅, 温浩等.肝包虫病的诊断与治疗进展.中华肝胆外科杂志, 2011, 17(5):432-433.
23. 温浩, 刘文亚, 邵英梅等.包虫病影像诊断技术和手术治疗进展.国际医学寄生虫病杂志, 2009, 36(5):299-306.
24. 刘文亚, 楼俭茹, 邢艳等.肝脏泡状棘球蚴病的多层螺旋CT影像特征.中华放射学杂志, 2005, 39(8):860-863.
25. Koch S, Bresson-Hadni S, Miguet JP, et al. Experience of liver trans-plantation for incurable alveolar echinococcosis:a 45-case European collaborative report. Transplantation, 2003, 75(6)):856-863.

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Multi-Slice Spiral CT in The Diagnosis and Resectability Evaluation of Hepatic Alveolar Echinococcosis

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