title: Echinococcosis of the liver.
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.
authors.affiliation: Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Benedikt V
authors.initials: BV
authors.lastname: Czermak
authors.forename: Okan
authors.initials: O
authors.lastname: Akhan
authors.forename: Renate
authors.initials: R
authors.lastname: Hiemetzberger
authors.forename: Bettina
authors.initials: B
authors.lastname: Zelger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Michael
authors.initials: M
authors.lastname: Rieger
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000469:parasitology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods