Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Radiology, Gaoping District People's Hospital, Nanchong 637100, Sichuan Province, China.
World J Gastroenterol. 2024 Oct 7;30(37):4115-4131. doi: 10.3748/wjg.v30.i37.4115.
Echinococcosis is a zoonotic disease caused by parasites belonging to the genus that primarily affect the liver. The western plateau and pastoral areas of China are high-risk regions for hepatic cystic echinococcosis and hepatic alveolar echinococcosis (HAE). The high late mortality rate associated with HAE underscores the critical need for early diagnosis to improve cure rates and mitigate the disease burden in endemic areas. Currently, the World Health Organization recommends ultrasonography as the preferred initial screening method for hepatic echinococcosis. However, distinguishing between specific types of lesions, such as those of hepatic cystic echinococcosis and HAE, and other focal liver lesions is challenging. To address this issue, contrast-enhanced ultrasound is recommended as a tool to differentiate solid and cysto-solid hepatic echinococcosis from other focal liver lesions, significantly enhancing diagnostic accuracy. In this comprehensive review, we discuss the progression of hepatic echinococcosis and detail the imaging features of various types of echinococcosis using conventional, contrast-enhanced, and intraoperative ultrasound techniques. Our objective is to provide robust imaging evidence and guidance for early diagnosis, clinical decision making, and postoperative follow-up in regions with high disease prevalence.
包虫病是一种由寄生虫引起的人畜共患疾病，主要影响肝脏。中国的西部高原和牧区是肝囊型包虫病和肝泡型包虫病（HAE）的高风险地区。HAE 相关的高晚期死亡率突出表明，迫切需要早期诊断，以提高治愈率并减轻流行地区的疾病负担。目前，世界卫生组织建议超声检查作为肝包虫病的首选初始筛查方法。然而，区分特定类型的病变（如肝囊型包虫病和 HAE）与其他局灶性肝病变具有挑战性。为了解决这个问题，建议使用对比增强超声作为区分实性和囊实混合性肝包虫病与其他局灶性肝病变的工具，显著提高诊断准确性。在这篇全面的综述中，我们讨论了肝包虫病的进展，并详细描述了使用常规、对比增强和术中超声技术的各种包虫病的影像学特征。我们的目标是为高疾病流行地区的早期诊断、临床决策和术后随访提供有力的影像学证据和指导。
