Hepatic alveolar echinococcosis: Comparative computed tomography study between two Chinese and two European centres

The main endemic areas for alveolar echinococcosis (AE) are in Central Europe and Western China, and in >98% of cases, AE manifests in the liver. The aim of this work was to compare European and Chinese patient groups for number, size, and computed tomography (CT) appearance of hepatic AE lesions. A total of 200 CT scans of patients with hepatic AE were evaluated by four blinded, experienced radiologists from two European (Besancon, Ulm) and two Chinese centres (Xining, Urumqi). In addition to noting the number, size, and localisation of the lesions, the radiologists evaluated morphological appearance using the Echinococcus multilocularis Ulm Classification - CT scheme. Chinese patients were younger than European patients (36.8 ± 13.2 vs. 63.5 ± 17.7; p < 0.0001) and had significantly larger lesions (120.4 ± 50.8 vs. 70.9 ± 39.8; p < 0.0001). The morphological appearance of the lesions on CT differed significantly between the two groups (p < 0.05), as did the number of lesions (2.6 ± 3.9 in European centres versus 3.8 ± 5.0 in Chinese centres; p = 0.0062). Patient age and AE-related morphological manifestations differ between Europe and China, but the reasons for the differences are unknown.