LIVER ALVEOCOCCOSIS: ULTRASOUND AND MORPHOLOGICAL COMPARISONS

DOI: https://doi.org/10.29296/24999490-2020-01-09

Yu.A. Stepanova, O.I. Ashivkina, D.A. Ionkin, A.V. Glotov, V.A. Vishnevsky А.V. Vishnevsky National Medical Research Center of Surgery, B. Serpukhovskaya Str., 27, Moscow, 117997, Russian Federation Е-mail: [email protected]

Introduction. Alveococcosis is a parasitic disease associated with the formation of the liver tumor-like lesion. This parasitic tumor has infiltrative growth and the ability to metastasize, that is, it exhibits the properties of malignant tumors. The disease is asymptomatic for a long time, as a result of which the lesion is often revealed with a significant spread of the pathological process. All this requires a high-quality pre-operative diagnosis. Therefore, the assessment of the possibilities of constantly updated diagnostic imaging methods is relevant at the present time. The studies in which researchers estimate an insignificant number of clinical observations (from 5 to 17), using various echo-contrast substances (of both the last and previous generations) on the use of echo contrast ultrasound in the treatment of alveococcal lesions are currently rare. It should be noted that in the presented study, the data obtained with ultrasound echo contrasting are compared with the data of other radiological methods of research. Comparison of the echo contrasting data of alveococcal liver damage with morphological data is not noted in the literature. Objective to determine the possibilities of ultrasound with echo contrast enhancement in the assessment of alveococcal liver damage. Materials and methods. The study included 15 patients aged from 36 to 54 years (men – 6, women – 9), who were in A.V. Vishnevsky National Medical Research Center of Surgery with a diagnosis of liver alveococcosis. Ultrasound examination was performed for all patients (B-mode, duplex scanning, echocontrast enhancement). All patients were operated on, the lesions were morphologically verified as alveococcosis. Results. The analysis of the data obtained during echo contrasting of liver alveococcal lesions showed that additional information in comparison with ultrasound in B-mode and duplex scanning can be obtained by two parameters: evaluation of the lesion structure; the prevalence of the pathological process. At the same time, the characteristics of the echo contrast of the parasitic node during ultrasound investigation allow us to speak about the activity of the pathological process and the prognosis of the development of the disease. Conclusion. Our experience of using ultrasound echo contrast to assess the structure and prevalence of alveococcal liver damage has shown the effectiveness of this technique. It is advisable to accumulate experience of such studies in order to evaluate the data obtained on a more representative sample.
Keywords: 
liver alveococcosis, ultrasound, contrast-enhanced ultrasonography, research capabilities
Список литературы: 
  1. Al'perovich B.I. Al'veokokkoz i ego lechenie. M.: Meditsina, 1972; 272. [Alperovich B.I. Alveococcosis and its treatment. M.: Medicine, 1972; 272 (in Russian)]
  2. Zhuravlev V.A. Al'veokokkoz pecheni. Annaly hirurgicheskoj gepatologii. 1997; 2: 9–14. [Zhuravlev V.A. Alveococcosis of the liver. Annals of surgical hepatology. 1997; 2: 9–14 (in Russian)]
  3. Moro P., Schantz P.M. Echinococcosis: a review. Int J. Infect Dis. 2009; 13: 125–33. https://doi.org/10.1016/j.ijid.2008.03.037
  4. Vuitton D.A., Qian W., Hong-xia Z. Raoul F., Knapp J., Bresson-Hadni S., Wen H., Giraudoux P. A historical view of alveolar echinococcosis, 160 years after the discovery of the first case in humans: part 1. What have we learnt on the 156 distribution of the disease and on its parasitic agent? Chinese Medical J. 2011; 124 (18): 2943–53.
  5. Zajtsev I.S. Povtornye operatsii pri al'veokokkoze. Diss. … kand. med. nauk. Tomsk, 2015; 157. [Zaitsev I.S. Repeated operations for alveococcosis. Diss. ... cand. med. scien. Tomsk, 2015; 157 (in Russian)]
  6. McManus D.P., Zhang W., Li J., Bartley P.B. Echinococcosis. Lancet. 2003; 362: 1295–304. https://doi.org/10.1016/S0140-6736(03)14573-4
  7. Gottstein B., Dai W.J., Walker M., Stettler M., Müller N., Hemphill A. An intact laminated layer is important for the establishment of secondary Echinococcus multilocularis infection. Parasitology Research. 2002; 88: 822–8.
  8. Miguet J.P., Bresson-Hadni S., Vuitton D. Echinococcosis of the liver. In: McIntyre N., Benhamou J.P., Bircher J. eds. Textbook of clinical hepatology. Oxford: Oxford University Press, 1989; 721.
  9. Merzlikin N.V., Brazhnikova N.A., Al'perovich B.I., Tshaj V.F. Klinicheskaja hirurgija. Uchebnik dlja meditsinskih vuzov. V 2-h tomah. T.2. Tomsk: Sibirskij gosudarstvennyj meditsinskij universitet, 2008; 432. [Merzlikin N.V., Brazhnikova N.A., Alperovich B.I., Tskhay V.F. Clinical surgery. Textbook for medical schools. In 2 volumes. V.2. – Tomsk: Siberian State Medical University, 2008; 432 (in Russian)]
  10. Kern P. Clinical features and treatment of alveolar echinococcosis. Curr Opin Infect Dis. 2010; 23: 505–12. https://doi.org/10.1097/QCO.0b013e32833d7516
  11. Zagajnov V.E., Kiselev N.M., Gorohov G.G., Vasenin S.A., Bel'skij V.A., Shalapuda V.I., Ryhtik P.I. Sovremennye metody hirurgicheskogo lechenija rasprostranennogo al'veokokkoza pecheni. Annaly hirurgicheskoj gepatologii. 2016; 21 (1): 44–52. https://doi.org/10.16931/1995-5464.2016144-52 [Zagaynov V.E., Kiselev N.M., Gorokhov G.G., Vasenin S.A., Belskiy V.A., Shalapuda V.I., Rykhtik P.I. Modern methods of surgical treatment of diffuse liver alveococcosis. Annaly khirurgicheskoy gepatologii. 2016; 21 (1): 44–52 (in Russian)]
  12. Gerasimov T.I. Kuznetsova V.N. Al'veokokkoz pecheni: kliniko-morfologicheskij analiz autopsijnogo sluchaja i voprosy differentsial'noj diagnostiki. Ul'janovskij mediko-biologicheskij zhurnal. 2013; 1: 97–103. [Gerasimov T.I., Kuznetsova V.N., Alveococcosis of the liver: a clinical and morphological analysis of an autopsy case and differential diagnosis issues. Ulyanovsk Biomedical J. 2013; 1: 97–103 (in Russian)]
  13. Ashivkina O.I., Stepanova Ju.A. Al'veokokkoz pecheni: vozmozhnosti luchevyh metodov diagnostiki. Meditsinskaja vizualizatsija. 2015; 5: 9–19. [Ashivkina O.I., Stepanova Yu.A. Alveococcosis of the liver: the possibility of radiation diagnostic methods. Medical imaging. 2015; 5: 9–19 (in Russian)]
  14. Surov E.A. Hirurgicheskoe lechenie al'veokokkoza pecheni s porazheniem magistral'nyh sosudov. Diss. ... kand. med. nauk. Bishkek, 2017; 123. [Surov E.A. Surgical treatment of alveococcosis of the liver with damage to the great vessels. Diss. ... cand. med. scies. Bishkek, 2017; 123 (in Russian)]
  15. Bulakçi M., Kartal M.G., Yilmaz S., Yilmaz E., Yilmaz R., Şahin D., Aşik M., Erol O.B. Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update. Diagnostic and interventional radiology. 2016; 22 (3): 247–56. https://doi.org/10.5152/dir.2015.15456
  16. Liu W., Delabrousse É., Blagosklonov O., Wang J., Zeng H., Jiang Y., Wang J., Qin Y., Vuitton D.A., Wen H. Innovation in hepatic alveolar echinococcosis imaging: best use of old tools, and necessary evaluation of new ones. Parasite. 2014; 21: 74. https://doi.org/10.1051/parasite/2014072
  17. Coşkun A., Oztürk M., Karahan O.I., Erdogan N., Işin S., Güleç M. Alveolar Echinococcosis of the Liver: Correlative Color Doppler US, CT, and MRI Study. Acta Radiologica. 2004; 45: 492–8.
  18. Holin A.V., Amanbaeva G.T., Kakishov U.K. Diagnosticheskie vozmozhnosti RKT i MRT v raspoznavanii al'veokokkoza i ehinokokkoza pecheni. Vestnik KRSU. 2015; 15(7): 164–9. [Kholin, A.V., Amanbaeva, G.T., Kakishov, U.K. Diagnostic capabilities of CT and MRI in recognition of alveococcosis and liver echinococcosis. Bulletin of KRSU. 2015; 15 (7): 164–9 (in Russian)]
  19. Cheremisinov O.V. Vozmozhnosti rentgenovskoj i magnitno-rezonansnoj tomografii v diagnostike al'veokokkoza pecheni. Meditsinskaja vizualizatsija. 2003; 4: 46–52. [Cheremisinov O.V. Possibilities of X-ray and magnetic resonance imaging in the diagnosis of liver alveococcosis. Medical imaging. 2003; 4: 46–52 (in Russian)]
  20. Aliev M.A., Bajmahanov B.B., Narshanov B.A. Opyt hirurgicheskogo lechenija al'veoljarnogo ehinokokkoza pecheni. Annaly hirurgicheskoj gepatologii. 2006; 3: 179–80. [Aliyev M.A., Baymahanov B.B., Narshanov B.A. Experience in surgical treatment of alveolar liver echinococcosis. Annals of surgical hepatology. 2006; 3: 179–80 (in Russian)]
  21. Stepanova Ju.A., Ionkin D.A., Ashivkina O.I., Zhavoronkova O.I., Chzhao A.V., Vishnevskij V.A. Al'veokokkoz pecheni: vozmozhnosti ul'trazvukovogo issledovanija na etapah kombinirovannogo hirurgicheskogo lechenija. Doktor.Ru. 2016; 1 (118): 74–9. [Stepanova Yu.A., Ionkin D.A., Ashkivkina O.I., Zhavoronkova O.I., Zhao A.V., Vishnevsky V.A. Alveococcosis of the liver: the possibilities of ultrasound at the stages of combined surgical treatment. Doctor.Ru. 2016; 1 (118): 74–9 (in Russian)]
  22. Ehrhardt A.R., Reuter S., Buck A.K., Haenle M.M., Mason R.A., Gabelmann A., Kern P., Kratzer W. Assessment of disease activity in alveolar echinococcosis: a comparison of contrastenhanced ultrasound, three-phase helical CT and 18F fluoroxyglucose positron-emission tomography. Abdominal Imaging. 2007; 32: 730–6.
  23. Caoduro C., Porot C., Vuitton D.A., Bresson-Hadni S., Grenouillet F., Richou C., Boulahdour H., Blagosklonov O. The role of delayed 18F-FDG PET imaging in the follow-up of patients with alveolar echinococcosis. J. of Nuclear Medicine 2013; 54: 358–63.
  24. Suzuki Y., Fujimoto Y., Hosoki Y., Suzuki M., Inoue M., Sakurai S., Ohtake T., Ohhira M., Saito H., Kohgo Y. Usefulness of contrast-enhanced wide-band Doppler ultrasonography to diagnose alveolar echinococcosis of the liver and evaluate the effect of the treatment. European J. of Radiology. 2003; 48: 305–11.
  25. Kratzer W., Reuter S., Hirschbuehl K., Ehrhardt A.R., Mason R.A., Haenle M.M., Kern P., Gabelmann A. Comparison of contrast-enhanced power Doppler ultrasound (Levovist) and computed tomography in alveolar echinococcosis. Abdominal Imaging. 2005; 30: 286–90.
  26. Ehrhardt A.R., Reuter S., Buck A.K., Haenle M.M., Mason R.A., Gabelmann A., Kern P., Kratzer W. Assessment of disease activity in alveolar echinococcosis: a comparison of contrastenhanced ultrasound, three-phase helical CT and 18F fluoroxyglucose positron-emission tomography. Abdominal Imaging. 2007; 32: 730–6.
  27. Tao S., Qin Z., Hao W., Yongquan L., Lanhui Y., Lei Y. Usefulness of gray-scale contrast-enhanced ultrasonography in diagnosing hepatic alveolar echinococcosis. Ultrasound in Medicine and Biology. 2011; 37: 1024–8.
  28. SonoVue International non-proprietary name: sulfur hexafluoride. Assessment report. Ed. Committee for Medicinal Products for Human Use (CHMP). UK: EMA, 2014; 1–33.
  29. Sonov'ju. Nauchnaja monografija. Dinamicheskoe kontrastnoe usilenie v rezhime real'nogo vremeni. M.: Bracco Imaging, 2013; 48. [SonoVue. Scientific monograph. Dynamic contrast enhancement in real time. M.: Bracco Imaging, 2013; 48 (in Russian)]
  30. Didier D., Weiler S., Rohmer P., Lassegue A., Deschamps J.P., Vuitton D., Miguet J.P., Weill F. Hepatic alveolar echinococcosis: correlative US and CT study. Radiology. 1985; 86: 154–79.
  31. Bresson-Hadni S., Liance M., Meyer J.P., Houin R., Bresson J.L., Vuitton D.A. Cellular immunity in experimental Echinococcus multilocularis infection. II. Sequential and comparative phenotypic study of the periparasitic mononuclear cells in resistant and sensitive mice. Clinical and Experimental Immunology. 1990; 82: 378–83.
  32. Gottstein B., Dai W.J., Walker M., Stettler M., Müller N., Hemphill A. An intact laminated layer is important for the establishment of secondary Echinococcus multilocularis infection. Parasitology Research. 2002; 88: 822–8.
  33. Rodicheva N.S. Vzaimosvjaz' biologicheskogo sostojanija al'veokokka s kliniko-morfologicheskimi projavlenijami al'veokokkoza. Diss. … kand. med nauk. Tomsk, 1996; 133. [Rodicheva N.S. The relationship of the biological state of alveococcus with the clinical and morphological manifestations of alveococcosis. Diss. ... cand. med. scien. Tomsk, 1996; 133 (in Russian)]
  34. Golovina A.A. O soderzhanii gialuronidazy v lichinkah al'veoljarnogo ehinokokka pecheni cheloveka. Trudy Novosibirsk. med. in-ta. Novosibirsk, 1961; 36: 33. [Golovina A.A. On the content of hyaluronidase in the larvae of the alveolar echinococcus human liver. Works Novosibirsk. Med. Inst. Novosibirsk, 1961; 36: 33 (in Russian)]
  35. Wang J., Lin R., Zhang W., Li L., Gottstein B., Blagosklonov O., Lü G., Zhang C., Lu X., Vuitton D.A., Wen H. Transcriptional profiles of cytokine/chemokine factors of immune cellhoming to the parasitic lesions: a comprehensive one-year course study in the liver of E. multilocularis-infected mice. PLoS One. 2014; 17: e91638.
  36. Guerret S., Vuitton D.A., Liance M., Pater C., Carbillet J.P. Echinococcus multilocularis: relationship between susceptibility/resistance and liver fibrogenesis in experimental mice. Parasitology Research. 1998; 84: 657–67.
  37. Vasilevich A.P., Kondratenko G.G., Karman A.D. Diagnostika i hirurgicheskoe lechenie parazitarnyh zabolevanij uchebno-metodicheskoe posobie. Minsk: BGMU, 2017; 85. [Vasilevich A.P., Kondratenko G.G., Karman A.D. Diagnosis and surgical treatment of parasitic diseases is an educational tool. Minsk: Belarusian State Medical University, 2017; 85 (in Russian)]