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Objective: To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease., Methods: Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People's Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed., Results: Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was -28 to -84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient's cyst was complicated with infection and it invaded the abdominal wall., Conclusions: The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

Objective: To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters., Methods: Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups., Results: The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different ( F = 24.579, 8.343, 20.535 and 21.843, all P <0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients ( F = 2.621, P > 0.05) ., Conclusions: The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.

Objective: To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis., Methods: A total of 100 patients with hepatic cystic echinococcosis were given triple-phase abdominal CT scan, and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed., Results: The compression displacement, half-globular, no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordance with the real situation under the surgical sight. However, four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments., Conclusions: The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.