Characterization of research trends and prospects on hepatic echinococcosis over the past forty years: a bibliometric analysis.

BACKGROUND: The distribution of hepatic echinococcosis (HE) is extensive, significantly impacting public health and economic development. Therefore, analyzing global collaboration networks and tracking developmental trends over the past four decades are crucial. This study aimed to demonstrate collaboration in the field of HE and explore key topics and future directions. MATERIALS AND METHODS: Bibliometric analyses were conducted using CiteSpace, Bibliometrix package of R, and VOSviewer software on HE-related studies from the Web of Science Core Collection published before 1 August 2023. RESULTS: This study identified 2605 records published in 196 journals by 9860 authors from 2607 institutes in 90 countries. Publications significantly notably increased in 2021. Developing countries like Turkey and China made notable contributions, while developed countries like the USA had higher average citation rates. The largest nodes in every cluster of the collaboration network were Hacettepe University, Tehran University, Xinjiang Medical University, Salford University, and the University of Pavia, and the top-producing authors were Wen H, Vuitton DA, Gottstein B, and Craig PS. Keyword co-occurrence analysis suggested that surgical techniques and novel drugs targeting combined immune checkpoints are the main therapeutic approaches in the future. CONCLUSION: Although developing countries had significantly contributed to publications on HE, the citation rate for individual articles from developed countries was significantly higher. Additionally, advancements in surgical techniques and novel drugs targeting combined immune checkpoints may emerge as the next research focus and developmental direction.

Vascular pathology in patients with alveolar echinococcosis: framework for assessment and clinical management - a retrospective case series.

OBJECTIVE: Alveolar echinococcosis (AE) is a parasitic liver disease with infiltrative growth similar to solid organ malignancies. Major vascular damage is frequent and often remains untreated until catastrophic events precipitate. Detailed clinical and radiological assessment is required to guide individualised treatment decisions. Standardised radiological reporting templates of malignancies with profiles resembling AE are candidates for adaptation. Our objectives are to describe vascular pathology in AE and establish a framework for structured evaluation as the basis for treatment decisions and monitoring. DESIGN: Retrospective case series. RESULTS: 69 patients (37.1%) had vascular involvement: portal vein (PV) 24.7%, hepatic vein (HV) 22.6% inferior vena cava (IVC) 13.4%. Significant stenosis/occlusion of vessels was present in 15.1% of PV, in 13.4% of HV and in 7.5% of IVC involvement. Vascular pathology needing specific treatment or monitoring was present in 8.6% of patients. The most frequent clinical presentation was high grade IVC stenosis or occlusion which was seen in 11 patients of the cohort. CONCLUSION: Advanced AE requires early multidisciplinary assessment to prevent progressive impairment of liver function due to vascular damage. The focus at first presentation is on complete evaluation of vascular (and biliary) involvement. The focus in non-resectable AE is on prevention of vascular (and biliary) complications while suppressing growth of AE lesions by benzimidazole treatment to improve the quality of life of patients. We developed a framework for standardised vascular assessment and follow-up of patients with AE to recognise and treat complications early.

Multidetector computed tomography assessment of venous invasion in hepatic alveolar echinococcosis.

PURPOSE: The objective of this study was to correlate multidetector computed tomography (MDCT) findings in hepatic alveolar echinococcosis (HAE) with intraoperative and postoperative histopathological results to identify reliable MDCT criteria for the diagnosis of HAE venous invasion. METHODS: A total of 136 HAE patients who underwent CT examination were included in this study. The lesion-vessel contact angle, irregular wall, lumen stenosis and occlusion were evaluated. RESULTS: A total of 614 veins were estimated. In total, 510 veins were invaded, and 104 veins were not. The invasion rate was 83.06%. In single CT findings, with a cutoff value of > 180° determined by receiver operating characteristic (ROC) curve analysis, the lesion-vessel contact angle performed the best (area under the ROC curve, AUC = 0.907, 95% confidence interval, 95% CI 0.872-0.941, p < 0.001), with a sensitivity, specificity and positive likelihood ratio (PLR) of 84.90%, 88.46%, and 7.35, respectively. Irregular wall and lumen stenosis showed the lowest diagnostic performance. Diagnostic performance was the highest when combining these criteria and signs (AUC = 0.932, 95% CI 0.905-0.960, p < 0.001). CONCLUSION: The lesion-vessel contact angle > 180° had the best sensitivity and specificity in the diagnosis of HAE venous invasion, and good interobserver agreement had been noted. The diagnostic performance of the lesion-vessel contact angle > 180° had been further improved with the addition of lumen occlusion accompanied by irregular wall or lumen stenosis.

Prevalence and Economic Significance of Hidatidosis in Cattle Slaughtered at an Abattoir in Konya, Turkey

Objective: This study was conducted to determine the period prevalence of hydatid cysts isolated from the livers of cattle slaughtered at a slaughterhouse in Konya. Methods: For this purpose, 49,545 cattle were slaughtered and examined for the presence of hydatid cysts in the liver. The study was conducted between June 01, 2018, and May 31, 2019. Results: The highest prevalence of hydatid cysts was observed in autumn 10.83% followed by spring 4.41%, winter 2.90%, and summer 2.66%, with an overall prevalence of 3.93%. Considering the month wise prevalence of hydatid cyst, the highest infection rate was detected in September (7.87%), June (7.16%) and August (7.14%), while the lowest prevalence was observed in February (2.72%) and January (2.83%). In gender-wise investigation, highest prevalence was observed in females (24.65%) during the summer and 18.45% inthe spring. In male animals, the infection rate was very low compared with females. However, the highest prevalence in males was observed throughout the year in autumn (2.36%) and the lowest prevalence in winter (1.68%). The highest prevalence was found among female cattle in heifers in winter (6.52%) and cows in summer (27.52%). Conclusion: The overall economic losses of 56,434 USD were estimated due to discarded hydatid cyst-infected livers during the study period. This study enlightens the prevalence and economic significance of hydatidosis in Konya.

Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel.

Therapy choices for cystic echinococcisis (CE) are stage-specific: surgical, minimally invasive, medical or observation without intervention. PAIR (percutaneous aspiration, instillation of a scolicide, and re-aspiration) has been considered the treatment of choice for uncomplicated echinococcal liver cysts. However, PAIR carries the risk of toxic cholangitis or hypernatremia and that the cyst frequently refills with bile after withdrawing the catheter. We treated a patient with a giant CE 1 liver cyst with puncture drainage (PD) under albendazole coverage. Drainage enabled us to monitor the morphology of protoscolices under praziquantel (PZQ) co-medication. Protoscolices degenerated within 5 days of PZQ 50 mg/kg/d. The cyst cavity solidified with no evidence of reactivation or secondary spread. Percutaneous treatments can replace surgery in a significant number or cases with hepatic CE. PD allows to assess microscopically the viability of protoscolices under co-medication with PZQ-albendazole and to avoid the instillation of topical scolicides.

Prevalence of Liver Hydatidosis and Its Economic Significance in Sheep Slaughtered in a Private Abattoir in Konya

Objective: This study aimed to determine the prevalence of liver hydatidosis in sheep slaughtered in a private slaughterhouse in Konya and to estimate the economic loss incurred because of the disease. Methods: The study was conducted over a period of 12 months between 1 June 2018 and 31 May 2019. Given that the aim of this investigation was to determine the prevalence of liver hydatidosis, only the livers of 41,002 sheep were examined for hydatid cysts. Results: The liver of 810 (1.97%) sheep was found to be infected with hydatid cysts during the study period. The infection rate was determined as 5.34% in animals older than one year of age and 1.68% in animals less than one year of age. Regardless of the age group, the highest infection rate was found in autumn (3.34%), while the lowest infection rate was seen in spring (0.84%). In the sheep, the highest infection rate was in December (17.2%), and in lambs, it was in June (2.9%). On the other hand, the lowest infection rate in sheep was observed in November (1.8%), while the lowest infection rate in lambs was found in April (0.7%). The total economic loss incurred due to the annihilated livers was estimated as 36,450 TL (6.417$). Regardless of the number of cysts and degree of infection, the infected livers were completely discarded. The economic loss incurred due to the discarded livers was estimated by considering the 2019 offal prices. Conclusion: Based on the data obtained from this study, it could be concluded that hydatidosis still exists in Konya as well as throughout Turkey and that it causes serious economic loss.

[Revolution CT hepatic perfusion imaging assessment of peripheral infiltration zone of hepatic alveolar echinococcosis].

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.

[Value of magnetic resonance imaging in assessment of iron deposition among patients with hepatic alveolar echinococcosis: a preliminary evaluation].

OBJECTIVE: To assess the value of MRI combined with serum ferritin analysis in measurement of hepatic iron deposition among patients with hepatic alveolar echinococcosis. METHODS: A total of 96 patients with definitive diagnosis of hepatic alveolar echinococcosis and 30 healthy volunteers were enrolled and underwent routine 1.5T MR scanning, and all laboratory examination data were captured. The liver-to-muscle signal intensity ratio, serum ferritin level and liver functions were analyzed. RESULTS: The liver-to-muscle signal intensity ratio was (1.95 ± 0.57) in patients with hepatic alveolar echinococcosis and (2.22 ± 0.28) in healthy volunteers (t = 2.022, P < 0.05), and the liver-to-muscle signal intensity ratio was negatively associated the serum ferritin level in patients with hepatic alveolar echinococcosis (rs = -0.446, P < 0.01). CONCLUSIONS: Abnormal iron deposition is detected in the liver of patients with hepatic alveolar echinococcosis, and serum ferritin level may be helpful for the identification of abnormal iron deposition in the liver of patients with hepatic alveolar echinococcosis. The liver-to-muscle signal intensity ratio measured by MRI may be a non-invasive approached used to assess the hepatic iron deposition in patients with hepatic alveolar echinococcosis.

Patients with cystic echinococcosis in the three national referral centers of Mongolia: A model for CE management assessment.

BACKGROUND: Mongolia is one of the endemic countries for cystic echinococcosis (CE), a zoonotic disease caused by the larval stage of Echinococcus granulosus. The goal of this study is to describe the current clinical management of CE in Mongolia, to capture the distribution of cyst stages of patients treated, and to contrast current practice with WHO-IWGE expert consensus. METHODS: Hospital records of CE patients treated between 2008 and 2015 at the three state hospitals and fulfilling the inclusion criterion 'discharge diagnosis CE' (ICD 10 code B.67.0-67.9) were reviewed. Demographical, geographical, clinical and ultrasonography (US) data were extracted and analyzed. The annual surgical incidence was estimated. The digital copies of US cyst images were independently staged by three international experts following the WHO CE cyst classification to determine the proportions of patients which ideally would have been assigned to the WHO recommended treatment modalities surgery, percutaneous, medical (benzimidazole) treatment and watch & wait. RESULTS: A total of 290 patient records fulfilled the inclusion criteria of the study. 45.7% of patients were below 15 years of age. 73.7% of CE cysts were located in abdominal organs, predominantly liver. US images of 84 patients were staged and assessed for interrater-agreement. The average raw agreement was 77.2%. Unweighted Kappa coefficient and weighted Kappa was 0.57 and 0.59, respectively. Mean proportions of images judged as stages CE1, CE2, CE3a, CE3b, CE4 and CL were 0.59, 0.01, 0.19, 0.08, 0.03 and 0.11, respectively. 40 cysts met the inclusion criteria of treatment modality analysis. The mean proportions of cases with a single cyst assigned to medical, percutaneous treatment, surgery and watch & wait were 52.5% (95% CI 42-65), 25.8% (95% CI 15-30), 5.1% (95% CI 0-10) and 3.3% (95% CI 0-10), respectively. 13.3% (95% CI 5-25) of cysts were staged as CL and therefore assigned to further diagnostic requirement. CONCLUSION: WHO CE cyst classification and WHO-IWGE expert consensus on clinical CE management is not implemented in Mongolia. This results in exclusively surgical treatment, an unnecessary high risk approach for the majority of patients who could receive medical, percutaneous treatment or observation (watch & wait). Introduction of WHO-IWGE expert consensus and training in ultrasound CE cyst staging would be highly beneficial for patients and the health care services.

Preliminary assessment of the diagnostic performances of a new rapid diagnostic test for the serodiagnosis of human cystic echinococcosis.

Rapid diagnostic tests for cystic echinococcosis (CE) are convenient to support ultrasound diagnosis in uncertain cases, especially in resource-limited settings. We found comparable diagnostic performances of the experimental Hyd Rapid Test and the commercial VIRapid HYDATIDOSIS Test, used in our diagnostic laboratory, using samples from well-characterized hepatic CE cases.

Robust phase-retrieval-based X-ray tomography for morphological assessment of early hepatic echinococcosis infection in rats.

Propagation-based phase-contrast computed micro-tomography (PPCT) dominates the non-destructive, three-dimensional inner-structure measurement in synchrotron-based biomedical research due to its simple experimental setup. To quantitatively visualize tiny density variations in soft tissues and organs closely related to early pathological morphology, an experimental study of synchrotron-based X-ray PPCT combined with generalized phase and attenuation duality (PAD) phase retrieval was implemented with the hepatic echinococcosis (HE) infection rat model at different stages. We quantitatively analyzed and evaluated the different pathological characterizations of hepatic echinococcosis during the development of this disease via our PAD-based PPCT and especially provided evidence that hepatic alveolar echinococcosis invades the liver tissue and spreads through blood flow systems with abundant blood supply in the early stage. Additionally, the infiltration of tiny vesicles in HE lesions can be clearly observed by our PAD-PPCT technique due to the striking contrast-to-noise ratio (CNR) and mass density resolution, which cannot be found by the medical imaging techniques, such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound, in hospitals. The results demonstrated that our PAD-PPCT technique has a great potential for indicating the subtle structural information of pathological changes in soft biomedical specimens, especially helpful for the research of early micro-morphology of diseases.

Simulating control of a focal wildlife outbreak of Echinococcus multilocularis.

The parasitic tapeworm Echinococcus multilocularis is the causative agent of alveolar echinococcosis, a serious zoonotic infection present in Europe that can be fatal. The United Kingdom currently has E. multilocularis free status but the possibility of introduction exists, most likely via an imported or returning dog or other deliberately introduced animal that has not had anthelmintic treatment. We have developed a model to predict the probability of successfully eliminating a focal outbreak of E. multilocularis using a programme of anthelmintic bait distribution. We investigated three different potential control programmes, each with 36 monthly campaigns commencing five, ten or 15 years after disease introduction over an area of 2827km2. We assumed equilibrium disease prevalence of 30%, 40% and 55% based on the range of values reported across Europe. However, for all of these scenarios, equilibrium had not been reached at five to 15 years after introduction and simulated local prevalence values were between 0.5% and 28%. We found that it is possible to eliminate the disease with a 38%-86% success rate if control is started five years after introduction, dropping to 0% to 56% if control is delayed until 15 years after introduction, depending upon the prevalence equilibrium. We have also estimated the costs involved in these programmes to be from €7 to €12 million (2013 prices).

Assessment of Vascularity in Hepatic Alveolar Echinococcosis: Comparison of Quantified Dual-Energy CT with Histopathologic Parameters.

PURPOSE: To investigate whether dual-energy computer tomography(DECT) could determine the angiographic vascularity of alveolar echinococcosis lesions by comparing the quantitative iodine concentration (IC) with the microvascular density (MVD). MATERIAL AND METHODS: Twenty-five patients (16 men, 9 women; mean age, 40.9 ± 13.8 years) with confirmed hepatic alveolar echinococcosis (HAE) underwent DECT of the abdomen, consisting of arterial phase (AP), portal venous phase (PVP), and delayed phase (DP) scanning, in dual-source mode (100 kV/140 kV). Image data were processed with a DECT software algorithm that was designed for the evaluation of iodine distribution in the different layers (marginal zone, solid and cystic) of the lesions. The CT patterns of HAE lesions were classified into three types: solid type, pseudocystic type and 'geographic map' (mixed) type. The IC measurements in different layers and different types of lesions were statistically compared. MVD was examined using CD34 immunohistochemical staining of the resected HAE tissue and scored based on the percentage of positively stained cells and their intensity. Pearson's correlation analysis was used to evaluate the potential correlation between DECT parameters and MVD. RESULTS: A total of 27 HAE lesions were evaluated, of which 9 were solid type, 3 were pseudocystic type and 15 were mixed type. The mean lesion size was 100.7 ± 47.3 mm. There was a significant difference in the IC measurements between different layers of HAE lesions during each scan phase (p < 0.001). The IC in the marginal zone was significantly higher than in the solid and cystic components in AP (2.15 mg/mL vs. 0.17 or 0.01 mg/mL), PVP (3.08 mg/mL vs. 0.1 or 0.02 mg/mL), and DP (2.93 mg/mL vs. 0.04 or 0.02 mg/mL). No significant difference was found among the different CT patterns of HAE lesions. Positive expression of CD34 in the marginal zones surrounding HAE lesions was found in 92.5% (25/27) of lesions, of which 18.5% (5/27) were strongly positive, 62.7% (17/27) were moderately positive, and 11.1% (3/27) were weakly positive. In contrast, 7.4% (2/27) of the lesions were negative for CD34. There was a positive correlation between IC measurements and MVD in the marginal zone of HAE lesions (r = 0.73, p < 0.05). CONCLUSIONS: The DECT quantitative iodine concentration was significantly correlated with MVD in the marginal zones surrounding HAE lesions. Dual-energy CT using a quantitative analytic methodology can be used to evaluate the vascularity of AE.

Detecting nested clusters of human alveolar echinococcosis.

Recent changes in the epidemiology of alveolar echinococcosis (AE) in Eurasia have led to increasing concerns about the risk of human AE and the need for a thorough evaluation of the epidemiological situation. The aim of this study was to explore the use of a National Register to detect complex distribution patterns on several scales. The data were human AE cases from the FrancEchino register, diagnosed in France from 1982 to 2011. We used the Kulldorff spatial scan analysis to detect non-random locations of cases. We proposed an exploratory method that was based on the successive detection of nested clusters inside each of the statistically significant larger clusters. This method revealed at least 4 levels of disease clusters during the study period. The spatial variations of cluster location over time were also shown. We conclude that National Human AE registers, although not exempted from epidemiological biases, are currently the best way to achieve an accurate representation of human AE distribution on various scales. Finally, we confirm the multi-scale clustered distribution of human AE, and we hypothesize that our study may be a reasonable starting point from which to conduct additional research and explore the processes that underlie such distributions.

Subcutaneous infection model facilitates treatment assessment of secondary Alveolar echinococcosis in mice.

Alveolar echinococcosis (AE) in humans is a parasitic disease characterized by severe damage to the liver and occasionally other organs. AE is caused by infection with the metacestode (larval) stage of the fox tapeworm Echinococcus multilocularis, usually infecting small rodents as natural intermediate hosts. Conventionally, human AE is chemotherapeutically treated with mebendazole or albendazole. There is, however still the need for improved chemotherapeutical options. Primary in vivo studies on drugs of interest are commonly performed in small laboratory animals such as mice and Mongolian jirds, and in most cases, a secondary infection model is used, whereby E. multilocularis metacestodes are directly injected into the peritoneal cavity or into the liver. Disadvantages of this methodological approach include risk of injury to organs during the inoculation and, most notably, a limitation in the macroscopic (visible) assessment of treatment efficacy. Thus, in order to monitor the efficacy of chemotherapeutical treatment, animals have to be euthanized and the parasite tissue dissected. In the present study, mice were infected with E. multilocularis metacestodes through the subcutaneous route and were then subjected to chemotherapy employing albendazole. Serological responses to infection were comparatively assessed in mice infected by the conventional intraperitoneal route. We demonstrate that the subcutaneous infection model for secondary AE facilitates the assessment of the progress of infection and drug treatment in the live animal.

A new and simple score for predicting cystobiliary fistula in patients with hepatic hydatid cysts.

BACKGROUND: Hepatic hydatid cysts are common disorders in Turkey. Although most patients are treated by percutaneous drainage, some cases require operative intervention. Biliary fistula is a major complication of hydatid cyst operations. The purpose of this study is to identify preoperative predictors of cystobiliary fistula (CBF) and to develop a scoring system for this disorder. METHODS: Overall, 135 patients with hepatic hydatid cysts were included in this study. The following variables were analyzed as potential predictors of CBF: Age, gender, findings on physical examination, complete blood cell count, liver function tests, and ultrasonographic features of the cysts (type, diameter, number, and localization). RESULTS: CBF was detected in 33 of 135 patients. Univariate analyses showed significant differences in cyst diameter, levels of alkaline phosphatase (ALP) and direct bilirubin, platelet count, and white blood cell (WBC) count between patients with and without CBF. On multivariate analyses, WBC count > 9,000/mm(3) (odds ratio [OR], 4.5), direct bilirubin level > 0.7 mg/dL (OR, 2.76), cyst diameter > 8.2 cm (OR, 5.48), and ALP level > 120 U/L (OR, 3.82) were significant and independent predictors of CBG. One point was given for the presence of each of these factors to develop a new score. The resulting area under the receiver operator characteristic curve was 0.803 (95% confidence interval, 0.726-0.866). CONCLUSION: Preoperative detection and management of CBF are important issues in the treatment of hydatid cysts of the liver. Developing a scoring system based on routinely measured laboratory and radiologic factors will help the clinician to manage patients with hepatic hydatid cysts. External studies are needed to validate this new scoring system in routine clinical practice.

Assessment of the accuracy of preoperative imaging methods in the diagnosis of hepatic single-chamber echinococcosis.

UNLABELLED: Echinococcosis is an infectious disease, caused by larval stages of cestode species of the genus Echinococcus. The course of the disease is determined on the basis of the location and larval size. In 80-95% of cases echinococcosis is located in the liver and lungs, rarely in the brain. Symptoms are usually uncharacteristic for an uncomplicated disease. The diagnosis of echinococcosis is based on imaging and immunodiagnostic tests. The aim of the study was to assess the accuracy of preoperative imaging methods in the diagnosis of hepatic single- chamber echinococcosis. MATERIAL AND METHODS: Amongst the 110 patients with hepatic cysts diagnosed during the period between 2000 and 2009, a group of 30 subjects with suspicion of single-chamber echinococcosis (ultrasound and CT) was isolated. The imaging methods visualized structures typical for hydatid cysts: the mother cyst with satellite cysts called " honeycomb appearance", cysts with calcified walls and compartments, and endocyst separation called "water lily-sign". The study group comprised 22 female and 8 male patients with an average age of 52±16.2 years. The histopathological examination of the excised cyst verified the diagnosis. RESULTS: Single-chamber echinococcosis was finally recognized in 19 cases, while in the 11 remaining cases the parasitic disease was excluded. The sensitivity of imaging methods was estimated at 73.7%, specificity - 88.9%, negative predictive value - 61.5%, positive predictive value - 93.3%, Youden`s factor - 0.626, and Φ index - 0.586. CONCLUSIONS: In conclusion, the presence of an unilocular cyst with an uniform anechoic content can be a simple cyst or single-chamber echinococcus cyst. The typical, characteristic image of a hydatid cyst, such as the "water lily-sign" is rarely observed during imaging examinations. It has also been shown that cystic calcification, observed during ultrasonography and computed tomography was evidence of the parasitic character of the lesion.

Assessment of early hepatic echinococcus multilocularis infection in rats with real-time contrast-enhanced ultrasonography.

The aim of this study was to demonstrate characteristic imaging and accurate evaluation of blood perfusion in early stage of hepatic alveolar echinococcosis (HAE) by contrast-enhanced ultrasonography (CEUS). The early stage of experimentally induced secondary HAE in 45 rats was studied. Thirty-six HAE lesions in 33 rats, confirmed by pathologic examination, were examined by ultrasound (US), color Doppler flow imaging (CDFI) and then CEUS. Thirty-three lesions were found in 30 rats by US, and 30 lesions were detected in 27 rats by CEUS. The sensitivity of US and CEUS was 92% (95% CI 76%-98%) and 82% (95% CI 65%-93%), respectively. US imaging characteristics were categorized into four types: hyperechoic spot (type 1, 45.5%, 15/33), granular hyperechoic spots (type 2, 12.1%, 4/33), hyperechoic lesion (type 3, 30.3%, 10/33) and mixed pattern (type 4, 12.1%, 4/33). CDFI failed to detect blood flow signals in any lesions. CEUS results for 30 lesions showed ring enhancement in the peripheral area during the arterial phase and no filling effect in either the portal or the delayed phase (46.7%, 14/30); ring enhancement combined with central septa enhancement during the arterial phase and portal venous phase (46.7, 14/30), and no enhancement (6.6%, 2/30). The enhanced area, confirmed by pathologic examination, was an inflammatory reaction belt surrounding the lesion. The results of this study suggest that US, with high sensitivity, can be used as a screening method for early HAE lesions in the animal model, while CEUS can be used for displaying the peripheral blood perfusion and vesicle structure.

Prevalence and financial effects of hydatidosis in cattle slaughtered in Birre-Sheleko and Dangila Abattoirs, Northwestern Ethiopia.

A cross-sectional survey of bovine hydatidosis was carried out on local zebu cattle slaughtered at Birre-Sheleko and Dangila Abattoirs from August 2007 to July 2008 to determine the prevalence and to estimate financial loss caused by the disease. Postmortem examination, hydatid cyst characterization and direct and indirect financial loss estimations were conducted. Out of the total of 521 animals examined (255 Birre-Sheleko and 266 Dangila), 79 (15.2%) were found harbouring one or more hydatid cyst. The prevalence of the disease between the two abattoirs was not significantly different (P > 0.05). The result obtained from postmortem examination indicated that a total of 112 visceral organs were found harbouring one or more hydatid cysts. The involvement of lung, liver, spleen and kidney was found to be 70.5%, 21.4%, 6.3% and 1.8% respectively. From the total of 224 cysts counted, 147 (65.6%), 29 (12.9%), 3 (1.3%) and 45 (20.1%) were small, medium, large and calcified cysts respectively, and 114 (50.9%) and 65 (29%) were sterile and fertile cysts respectively. Viability rate of 47.7%, all from the lungs, and higher liver calcification rate were observed. The annual financial loss from organ condemnation and carcass weight loss due to bovine hydatidosis at Birre-Sheleko and Dangila abattoirs were estimated to be $18911.6.

An abattoir-based study on the prevalence and economic losses due to cystic echinococcosis in slaughtered herbivores in Ahwaz, south-western Iran.

A 10-year (1998-2008) retrospective study was carried out to investigate the prevalence and long-term trend of hydatid disease in slaughtered herbivores in the large complex abattoir of Ahwaz (the capital of Khuzestan province, south-western Iran). A total of 3,583,417 animals including 2,815,982 sheep, 427,790 goats and 339,645 cattle were inspected macroscopically for hydatid cysts in the 10-year period, and overall 155,555 (4.24%) livers and 228,172 (6.37%) lungs were condemned. Cystic echinococcosis (CE) was responsible for 36.08% and 48.04% of total liver and lung condemnations, respectively. The prevalence of pulmonary hydatid disease in sheep, goats and cattle was 2.22, 5.43 and 6.99%, respectively; on the other hand, the prevalence of hepatic hydatid disease for those animals was 1.26, 2.57 and 2.80%, respectively. Data showed an overall downward long-term trend for CE in all livestock slaughtered during the study period (P < 0.01). Lung condemnation due to CE was significantly more common than liver condemnation for each animal separately (P < 0.001). The prevalence of liver and lung hydatidosis in sheep was significantly lower than that in other livestock (P < 0.001). The prevalence of hydatid disease recovered from the sheep, cattle and goats varied in different seasons, but there was no statistical difference between various seasons. The odds ratio of lung and liver condemnations due to hydatidosis showed a slightly different pattern in some years; however, the overall declining trend was still observed. The total annual economic loss incurred due to hydatidosis in all ruminants slaughtered at Ahwaz municipal abattoir was estimated to be US$459,659.6, based on the market prices in the year 2008. This number corresponds to a loss of US$300,620.4 for cattle, US$123,490.0 for sheep and US$35,549.2 for goats. The current results provide baseline data for the future monitoring of this potentially important disease in the region, and also suggest that a thorough investigation leading to a disease control strategy is required to reduce the economic and public health consequences of CE.