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

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

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

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

An undifferentiated (embryonal) liver sarcoma (ULS) originates from a primitive mesenchymal cell, with a predilection for childhood and very rare occurrence in adults. We report a case of a ULS that was incidentally found in a 53-year-old female. Our case was initially interpreted as a large hydatid cyst, which was later suspected to be a neoplastic lesion because its size was increasing and a solid portion was newly detected after shrinkage of the cyst following drainage. The patient underwent successful right hepatic lobectomy with complete resection, and is currently disease-free without adjuvant therapy. Although it is difficult to diagnose a hepatic cyst as a ULS due to its rare occurrence in adulthood and lack of specific findings, its possibility should be considered, especially when its size is increasing, because early diagnosis and curative resection are necessary for a favorable outcome.
Adult ; Drainage ; Early Diagnosis ; Echinococcosis ; Female ; Humans ; Liver ; Middle Aged ; Sarcoma

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

Adult ; Benzimidazoles ; therapeutic use ; Echinococcosis, Pulmonary ; diagnosis ; drug therapy ; Female ; Humans

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