Grading of liver lesions caused by Echinococcus granulosus


The availability of different therapeutic alternatives in hydatid liver disease necessitates a comprehensive classification system in order to evaluate indications and monitor results. We have proposed a new scheme in which lesions are graded 1–5 according to the morphology of the cyst and the presence of findings in favour of cyst rupture. Ultrasound (US), CT and cholangiographic findings in 214 hydatid liver lesions in 152 patients who underwent surgery within 15 days of their radiological examinations were evaluated retrospectively. Results of the radiological classification were correlated with surgical data. We found that purely cystic unilocular lesions never ruptured, that dilatation of biliary canaliculi around a lesion with a complex morphological appearance is a non-specific finding and that there was no reliable radiological sign for a simple biliary communication. US, CT and cholangiography were reliable in diagnosing intra-biliary and direct ruptures. We conclude that the proposed grading scheme could be useful in monitoring the results of different therapeutic modalities for hydatid disease of the liver and, with the accumulation of further data, could be helpful in allocating patients to therapeutic alternatives.

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Correspondence to: I. Rozanes

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Rozanes, I., Acunas, B., Celik, L. et al. Grading of liver lesions caused by Echinococcus granulosus. Eur. Radiol. 3, 429–433 (1993).

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Key words

  • Echinococcosis
  • Liver, cysts
  • Liver, echinococcosis parasites