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Echinococcosis of the liver

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Abstract

Echinococcosis, also known as hydatid disease, is an infection of larval stage animal tapeworm, Echinococcus. The larvae reside in the liver and lungs, producing multiloculated fluid-filled cysts. Imaging findings of Echinococcosis caused by E. granulosus are single, unilocular cyst or multiseptated cysts, showing “wheel-like”, “rosette-like” or “honeycomb-like” appearances. There may be “snow-flakes” sign, reflecting free floating protoscoleces (hydatid-sand) within the cyst cavity. Degenerating cysts show wavy or serpentine bands or floating membranes representing detached or ruptured membranes. Degenerated cysts show heterogeneous, solid-looking pseudotumor that may show “ball of wool sign”. Dead cysts show calcified cyst wall. Echinococcosis caused by E. multilocularis produces multilocular alveolar cysts with exogeneous proliferation, progressively invading the liver parenchyma and other tissues of the body. Imaging findings are ill-defined infiltrating lesions of the liver parenchyma, consisting of multiple small clustered cystic and solid components. On sonography, lesions are heterogeneous with indistinct margins, showing “hailstorm appearance” or “vesicular or alveolar appearance”. CT and MR imaging displays multiple, irregular, ill-defined lesions. Multiple small round cysts with solid components are frequent. Large lesions show “geographical map” appearance. Calcifications are very frequent, appearing as peripheral calcification or punctuate scattered calcific foci. Invasion into the bile ducts, portal vein or hepatic vein may occur. Direct spread of infected tissue may result in cysts in the peritoneal cavity, kidneys, adrenal gland or bones.

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Authors and Affiliations

  1. Department of Radiology, Medical University Innsbruck, Innsbruck, Austria

    Benedikt V. Czermak, Werner Jaschke & Michael Rieger

  2. Department of Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey

    Okan Akhan

  3. Department of Cardiology, Medical University Innsbruck, Innsbruck, Austria

    Renate Hiemetzberger

  4. Department of Pathology, Medical University, Innsbruck, Austria

    Bettina Zelger

  5. Department of Gastroenterology, Medical University Innsbruck, Innsbruck, Austria

    Wolfgang Vogel

  6. Department of Pathology, Kon Kuk University, School of Medicine, Choongju, South Korea

    Sang Yoon Kim

  7. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, South Korea

    Jae Hoon Lim

Authors
  1. Benedikt V. Czermak
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  2. Okan Akhan
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  3. Renate Hiemetzberger
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  4. Bettina Zelger
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  5. Wolfgang Vogel
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  6. Werner Jaschke
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  7. Michael Rieger
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  8. Sang Yoon Kim
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  9. Jae Hoon Lim
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Correspondence to Jae Hoon Lim.

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Czermak, B.V., Akhan, O., Hiemetzberger, R. et al. Echinococcosis of the liver. Abdom Imaging 33, 133–143 (2008). https://doi.org/10.1007/s00261-007-9331-0

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  • DOI: https://doi.org/10.1007/s00261-007-9331-0

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