Animals ; China ; Echinococcosis ; diagnosis ; Humans ; Malaria ; diagnosis ; Schistosomiasis ; diagnosis

Aged ; Brain ; parasitology ; Echinococcosis, Hepatic ; diagnosis ; etiology ; therapy ; Echinococcosis, Pulmonary ; diagnosis ; etiology ; therapy ; Female ; Humans ; Lymphoma, T-Cell ; complications

Adult ; Bone Diseases ; diagnosis ; pathology ; surgery ; Echinococcosis ; diagnosis ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged

Echinococcosis ; diagnosis ; surgery ; Female ; Hernia, Diaphragmatic ; diagnosis ; surgery ; Humans ; Middle Aged ; Surgical Mesh

Echinococcosis ; diagnosis ; Humans ; Male ; Middle Aged ; Spinal Cord Diseases ; diagnosis ; Spine ; pathology

OBJECTIVE: More than 70% of hepatic alveolar echinococcosis (HAE) are inoperable. Thus, long-term, or even life-long, pharmacological treatment with benzimidazoles is necessary. For effective treatment, it is of great importance to employ imaging techniques to detect and monitor the non-resectable parasitic viability. Therefore, this study aimed to evaluate diffusion-weighted imaging (DWI) in assessing the viability of HAE in comparison to 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography, combined with computed tomography (PET/CT). MATERIALS AND METHODS: Positron emission tomography, computed tomography and DWI (b-values: 0, 800 s/mm2) were retrospectively analysed in eight patients with clinically-verified HAE to, generate the apparent diffusion coefficient (ADC) map. The activity of HAE lesions in both techniques were determined independently by two radiologists according to the following standard: (+), marked focally or perilesionally increased FDG uptake/high signal intensity; (−), a hepatic defect without FDG uptake/no high signal intensity. Every lesion's maximum standardized uptake value (SUV(max)) on the PET/CT images and mean ADC values on the parametric ADC maps were measured respectively. Results of PET/CT and DWI were compared on a per-lesion-basis. Pearson's correlation coefficient was assessed for statistical analysis. RESULTS: A total of 14 HAE lesions were detected. Eight lesions (diameter 3–15 cm) showed perilesional hyper-signal intensity on DWI. This was visualised on PET/CT as increased FDG uptake. They mainly existed in the lesion's border with normal liver parenchyma. Five lesions (diameter < 2 cm) were detected as nodular hyperintensity on DWI and a ‘hot spot’ on PET/CT in the same distribution. One patient, who had received oral drug therapy for three years showed significantly decreased perilesional hyperintensity on the DWI and a hepatic defect without any FDG uptake on PET/CT. Pearson's correlation coefficient indicated a significant inverse correlation of the ADC and the SUV(max) (r = −0.67, p < 0.001). CONCLUSION: Diffusion-weighted imaging is capable of offering information on visually detecting the HAE lesions' viability and may be useful for routine application in the initial diagnosis of HAE.
Benzimidazoles ; Diagnosis ; Diffusion ; Drug Therapy ; Echinococcosis ; Echinococcosis, Hepatic ; Electrons ; Humans ; Liver ; Magnetic Resonance Imaging ; Parasites ; Positron-Emission Tomography and Computed Tomography ; Positron-Emission Tomography ; Retrospective Studies

PURPOSE: The purpose of this study is to find some points that may help the differential diagnosis of ring lesions in magnetic resonance (MR) imaging of the liver through recognition of the characteristics of the morphology and the signal intensities of the ring lesions. MATERIALS AND METHODS: T1- and T2-weighted axial spin-echo images and gadolinium-enhanced Tl-weighted images were obtained with a 1.0 T superconducting MR imager. We reviewed the MR findings of 23 hepatic ring lesions which were confirmed as hepatocellular carcinomas (13), metastases (4), liver abscesses (4), hydatid cyst (1), and hematoma (1). RESULTS: There were 19 single rings and 4 double rings (all the cases were liver abscesses) on Tl-weighted images, and 8 single rings and 14 double rings on T2-weighted images. The signal intensity of the ring was low in hepatocellular carcinoma on Tl-weighted images and in hydatid cyst on T2-weighted images. It was high on Tl-weighted images in subacute hemaroma. Target lesion as an inner high-signal-intensity ring surrounded by a high-signal-intensity ring on T2-weighted images was seen in metatasis, liver abscess, and hepatocellular carcinoma. CONCLUSION: It is helpful to recognize the chracteristics of morphology and signal intensities of the ring lesions in the differential diagnosis of hepatic focal lesions.
Carcinoma, Hepatocellular ; Diagnosis, Differential ; Echinococcosis ; Hematoma ; Liver Abscess ; Liver* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis

BACKGROUNDHuman cystic echinococcosis (CE) is a parasitic zoonosis of major public health importance throughout the world. CE is endemic throughout central Asia including northwestern China. In China, CE has been reported in 21 provinces, autonomous regions and municipalities, covering approximately 87% of China's territories. It is most common in the pastoral and semi-pastoral western provinces and regions. This study aimed to reveal the natural history, curative effect and possible re-infection risk factors of human CE through long termed follow-up of treated and untreated CE cases in Hobukesar, Xingjiang, China.

METHODSFollow-up studies on CE were performed twice in Hobukesar from August 2005 to October 2008, after an initial mass screening performed in 1995 and 1996. Ultrasound scan was the primary diagnostic method.

RESULTSAmong 24 patients with confirmed CE, 22 were treated (surgery in 19 and chemotherapy in three). Two recurrent cases and one re-infection case were subsequently found during follow-up. The CE type of one of the recurrent cases reverted from CE4 to CE3, as classified using World Health Organization (WHO) guidelines.

CONCLUSIONSUltrasound was required to differentiate primary, recurrent and re-infection cases during epidemiological investigation and follow-up of CE. Most patients did not change their habits, which may be one possible cause of reinfection. One recurrent case suggested that, despite initial suggestion from the WHO Informal Working Group on Echinococcosis, CE4-type cysts are not inactive.

China ; epidemiology ; Data Collection ; Echinococcosis ; diagnosis ; epidemiology ; therapy ; Follow-Up Studies ; Humans

BACKGROUNDAlveolar echinococcosis located in the adrenal gland can be considered a rare and aggressive infestation that radiologically and macroscopically mimics a malignant neoplasm. Its pathogenesis is poorly understood. This paper describes its clinical and radiological aspects and discusses its proper management.

METHODSThe records of two patients with adrenal gland alveolar echinococcosis who were diagnosed and treated in our center in 2009 were evaluated.

RESULTSNeither patient showed any signs of recurrence following radical surgical treatment and postoperative oral anthelmintic therapy.

CONCLUSIONRadical surgery can be a feasible, effective management option that results in a good prospective outcome.

Adrenal Glands ; pathology ; surgery ; Echinococcosis, Hepatic ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged

PURPOSE: Cystic lesions of the liver are highly variable in respect to appearance and therapeutic approach. However, without cystectomy and hepatic resection, the patient is at risk for recurrent enlargement, infection, or progression of an unrecognized malignant neoplasm. The goal of this study was to discern the safest and most effective method, with special emphasis on a suitable therapeutic technique for various cystic lesions of the liver. METHODS: We reviwed the cystectomy and hepatic resection and outcome of patients with hepatic cysts from November, 1987 to April, 2000 at the Hanyang University Hospital. A retrospective study of 19 patients with various cystic lesions of the liver was performed. RESULTS: There were 8 simple cysts, 2 polycystic liver disease, 2 biliary cystadenoma, 4 biliary cystadenocarcinoma, 2 hydatid cysts, and 1 traumatic cyst. In examining the 6 cystectomies, 13 hepatic resections. (4 right lobectomies, 4 left lobectomies, 5 minor hepatic resections), there were no postoperative deaths in this series. Four patients (21.1%) developed operative complications. During the mean follow- up time of 78.2 months, symptomatic relief was complete and permanent in all of patients except the 1 biliary cystadenocarcinoma 1 of the 4 patients with biliary cystadenocarcinoma died of tumor recurrence (5.3%) approximately 27 months after hepatic resection. CONCLUSION: Cystectomy and hepatic resection is a more curative treatment for cystic lesions of the liver than other treatments. We recommend complete cystectomy and hepatic resection as the preferred therapy, particularly when the cyst is large, a malignancy cannot be ruled out, and a proper diagnosis is not confirmed.
Cystadenocarcinoma ; Cystadenoma ; Cystectomy* ; Diagnosis ; Echinococcosis ; Humans ; Liver Diseases ; Liver* ; Recurrence ; Retrospective Studies