Hepatic echinococcosis: difficulties in diagnosis at the early stages of progression and with complications (literature review)

Abstract

To demonstrate the possible difficulties in the diagnosis of hepatic echinococcosis, that a specialist in ultrasound diagnostics and a radiologist may encounter in everyday practice, russian and foreign literature as well as our own experience have been reviewed. With high accuracy and specificity of ultrasonography in the differential diagnosis of echinococcal cysts, incorrect interpretation is possible in the presence of mural hemorrhages and (or) hemorrhagic clots in a nonparasitic cyst, which aren’t also visible in ultrasonography and can imitate elements of the chitinous membrane. The degree of prevalence of the process, the exclusion of damage to the lungs and other organs of the abdominal cavity are important. In such cases CT scan is the most convenient and accurate diagnostic method due to its high spatial and temporal resolution, standardization and availability. In the most difficult cases the capabilities of MRI are used in the comparison of diffusion-weighted images and apparent diffusion coefficient, which also makes it possible to diagnose cystic neoplasms. Ultrasonography is a diagnostic technology that is still the most commonly used to differentiate cavity structures; however, all dubious clinical observations should be further examined by using CT or MRI.