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.	張寬, 王會蘋, 黃山等.肝泡狀棘球蚴病的CT診斷.實用放射學雜志, 2011, 27(7):1117-1119.
6.	魯厚文.肝臟泡狀棘球蚴病的CT診斷探討.影像診斷與介入放射學, 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.	任偉新, 肖湘生, 溫浩.肝泡狀棘球蚴病的影像學診斷及治療進展.中國介入影像與治療學, 2007, 4(4):314-317.
9.	張亞飛, 陸宏偉, 吉鴻等.肝包蟲病治療的研究進展.中國普外基礎與臨床雜志, 2015, 22(2):162-165.
10.	張洋, 樊海寧.肝泡型包蟲病的治療進展.臨床外科雜志, 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.	吐爾干艾力, 溫浩, 邵英梅.肝泡狀棘球蚴術前可根治性切除的綜合評估.肝膽外科雜志, 2006, 14(2):154-156.
20.	亞力坤·依明, 古蘭拜爾·玉蘇甫. MSCT對肝泡狀棘球蚴病的診斷價值.放射學實踐, 2011, 26(1):59-61.
21.	蔣鐵民.晚期的肝泡狀棘球蚴病的手術方式探討.新疆:新疆醫科大學, 2010.
22.	戴季蓬, 邵英梅, 溫浩等.肝包蟲病的診斷與治療進展.中華肝膽外科雜志, 2011, 17(5):432-433.
23.	溫浩, 劉文亞, 邵英梅等.包蟲病影像診斷技術和手術治療進展.國際醫學寄生蟲病雜志, 2009, 36(5):299-306.
24.	劉文亞, 樓儉茹, 邢艷等.肝臟泡狀棘球蚴病的多層螺旋CT影像特征.中華放射學雜志, 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. 張寬, 王會蘋, 黃山等.肝泡狀棘球蚴病的CT診斷.實用放射學雜志, 2011, 27(7):1117-1119.
6. 魯厚文.肝臟泡狀棘球蚴病的CT診斷探討.影像診斷與介入放射學, 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. 任偉新, 肖湘生, 溫浩.肝泡狀棘球蚴病的影像學診斷及治療進展.中國介入影像與治療學, 2007, 4(4):314-317.
9. 張亞飛, 陸宏偉, 吉鴻等.肝包蟲病治療的研究進展.中國普外基礎與臨床雜志, 2015, 22(2):162-165.
10. 張洋, 樊海寧.肝泡型包蟲病的治療進展.臨床外科雜志, 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. 吐爾干艾力, 溫浩, 邵英梅.肝泡狀棘球蚴術前可根治性切除的綜合評估.肝膽外科雜志, 2006, 14(2):154-156.
20. 亞力坤·依明, 古蘭拜爾·玉蘇甫. MSCT對肝泡狀棘球蚴病的診斷價值.放射學實踐, 2011, 26(1):59-61.
21. 蔣鐵民.晚期的肝泡狀棘球蚴病的手術方式探討.新疆:新疆醫科大學, 2010.
22. 戴季蓬, 邵英梅, 溫浩等.肝包蟲病的診斷與治療進展.中華肝膽外科雜志, 2011, 17(5):432-433.
23. 溫浩, 劉文亞, 邵英梅等.包蟲病影像診斷技術和手術治療進展.國際醫學寄生蟲病雜志, 2009, 36(5):299-306.
24. 劉文亞, 樓儉茹, 邢艷等.肝臟泡狀棘球蚴病的多層螺旋CT影像特征.中華放射學雜志, 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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