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| 1 | Proposal of an ultrasonographic classification for hepatic alveolar echinococcosis: Echinococcosis multilocularis Ulm classification-ultrasound显示文摘AIM: To establish an ultrasonographic classification based on a large sample of patients with confirmed hepatic alveolar echinococcosis(AE).METHODS: Clinical data and ultrasonography(US) findings of 185 patients(100 males; 85 females; mean age at diagnosis: 51.4 ± 17.6 years; mean age at time of US examination: 58.7 ± 18.2 years) were retrospectively reviewed with respect to the US morphology of hepatic AE lesions. The sonomorphological findings were grouped according to a five-part classification scheme.RESULTS: Application of the new classification resulted in the following distribution of sonomorphological patterns among the patients examined: hailstorm(54.1%); pseudocystic(13.5%); ossification(13.0%); hemangioma-like(8.1%); and metastasis-like(6.5%). Only 4.9% of lesions could not be assigned to a sonomorphological pattern.CONCLUSION: The sonomorphological classification proposed in the present study facilitates the diagnosis,interpretation and comparison of hepatic alveolar echinococcosis in routine practice and in the context of scientific studies. | Wolfgang Kratzer Beate Gruener Tanja EM Kaltenbach Sarina Ansari-Bitzenberger Peter Kern Michael Fuchs Richard A Mason Thomas FE Barth Mark M Haenle Andreas Hillenbrand Suemeyra Oeztuerk Tilmann Graeter | 2015 | World Journal of Gastroenterology2015，21，43： | 16 |
| 2 | Proposal of a computed tomography classification for hepatic alveolar echinococcosis显示文摘AIM: To establish a computed tomography(CT)-morphological classification for hepatic alveolar echinococcosis was the aim of the study. METHODS: The CT morphology of hepatic lesions in 228 patients with confirmed alveolar echinococcosis(AE) drawn from the Echinococcus Databank of the University Hospital of Ulm was reviewed retrospectively. For this reason, CT datasets of combined positron emission tomography(PET)-CT examinations were evaluated. The diagnosis of AE was made in patientswith unequivocal seropositivity; positive histological findings following diagnostic puncture or partial resection of the liver; and/or findings typical for AE at either ultrasonography, CT, magnetic resonance imaging or PET-CT. The CT-morphological findings were grouped into the new classification scheme.RESULTS: Within the classification a lesion was dedicated to one out of five 'primary morphologies' as well as to one out of six 'patterns of calcification'. 'primary morphology' and 'pattern of calcification' are primarily focussed on separately from each other and combined, whereas the 'primary morphology' V is not further characterized by a 'pattern of calcification'. Based on the five primary morphologies, further descriptive sub-criteria were appended to types Ⅰ-Ⅲ. An analysis of the calcification pattern in relation to the primary morphology revealed the exclusive association of the central calcification with type Ⅳ primary morphology. Similarly, certain calcification patterns exhibited a clear predominance for other primary morphologies, which underscores the delimitation of the individual primary morphological types from each other. These relationships in terms of calcification patterns extend into the primary morphological sub-criteria, demonstrating the clear subordination of those criteria.CONCLUSION: The proposed CT-morphological classification(EMUC-CT) is intended to facilitate the recognition and interpretation of lesions in hepatic alveolar echinococcosis. This could help to interpret different clinical courses better and shall assist in the context of scientific studies to improve the comparability of CT findings. | Tilmann Graeter Wolfgang Kratzer Suemeyra Oeztuerk Mark Martin Haenle Richard Andrew Mason Andreas Hillenbrand Thomas Kull Thomas F Barth Peter Kern Beate Gruener | 2016 | World Journal of Gastroenterology2016，22，13： | 10 |
| 3 | Hepatobiliary complications of alveolar echinococcosis: A long-term follow-up study显示文摘AIM:To determine the long-term hepatobiliary complications of alveolar echinococcosis(AE) and treatment options using interventional methods.METHODS:Included in the study were 35 patients with AE enrolled in the Echinococcus Multilocularis Data Bank of the University Hospital of Ulm.Patients underwent endoscopic intervention for treatment of hepatobiliary complications between 1979 and 2012.Patients' epidemiologic data, clinical symptoms, and indications for the intervention, the type of intervention and any additional procedures, hepatic laboratory parameters(pre- and post-intervention), medication and surgical treatment(pre- and post-intervention), as well as complications associated with the intervention and patients‘ subsequent clinical courses were analyzed.In order to compare patients with AE with and without history of intervention, data from an additional 322 patients with AE who had not experienced hepatobiliary complications and had not undergone endoscopic intervention were retrieved and analyzed.RESULTS:Included in the study were 22 male and 13 female patients whose average age at first diagnosis was 48.1 years and 52.7 years at the time of intervention.The average time elapsed between first diagnosis and onset of hepatobiliary complications was 3.7 years.The most common symptoms were jaundice, abdominal pains, and weight loss.Thenumber of interventions per patient ranged from one to ten.Endoscopic retrograde cholangiopancreatography(ERCP)was most frequently performed in combination with stent placement(82.9%),followed by percutaneous transhepatic cholangiodrainage(31.4%)and ERCP without stent placement(22.9%).In 14.3%of cases,magnetic resonance cholangiopancreatography was performed.A total of eight patients received a biliary stent.A comparison of biochemical hepatic function parameters at first diagnosis between patients who had or had not undergone intervention revealed that these were significantly elevated in six patients who had undergone intervention.Complications(cholangitis,pancreatitis)occurred in six patients during and in 12patients following the intervention.The average survival following onset of hepatobiliary complications was 8.8years.CONCLUSION:Hepatobiliary complications occur in about 10%of patients.A significant increase in hepatic transaminase concentrations facilitates the diagnosis.Interventional methods represent viable management options. | Tilmann Graeter Franziska Ehing Suemeyra Oeztuerk Richard Andrew Mason Mark Martin Haenle Wolfgang Kratzer Thomas Seufferlein Beate Gruener | 2015 | World Journal of Gastroenterology2015，21，16： | 6 |
| 4 | WHO classification of alveolar echinococcosis: Principles and application显示文摘 | Peter Kern Hao Wen Naoki Sato Dominique A. Vuitton Beate Gruener Yinmei Shao Eric Delabrousse Wolfgang Kratzer Solange Bresson-Hadni | 2005 | Parasitology International2005，，： | 2 |
| 5 | Long-term experience on surgical treatment of alveolar echinococcosis显示文摘 | Klaus Buttenschoen Daniela Carli Buttenschoen Beate Gruener Peter Kern Hans G. Beger Doris Henne-Bruns Stefan Reuter | 2009 | Langenbeck’s Archives of Surgery2009，，4： | 1 |
| 6 | Long-term experience on surgical treatment of alveolar echinococcosis显示文摘 | Klaus Buttenschoen Daniela Carli Buttenschoen Beate Gruener Peter Kern Hans G. Beger Doris Henne-Bruns Stefan Reuter | 2009 | Langenbeck’s Archives of Surgery2009，，4： | 1 |
| 7 | Long-term experience on surgical treatment of alveolar echinococcosis显示文摘 | Klaus Buttenschoen Daniela Carli Buttenschoen Beate Gruener Peter Kern Hans G. Beger Doris Henne-Bruns Stefan Reuter | 2009 | Langenbeck’s Archives of Surgery2009，，4： | 1 |
| 8 | Follow-up in hepatic alveolar echinococcosis under benzimidazole therapy using computed tomography显示文摘To the Editor:Alveolar echinococcosis(AE),caused by infection with Echinococcus multilocularis,is regarded as the most dangerous parasitic zoonosis in the temperate climate zones of the northern hemisphere,particularly across Central Europe and large parts of North-/Central Asia.Left untreated,AE has a very high mortality rate.The liver is the organ most commonly affected showing complex,often infiltrative lesions.When lesions cannot be resected in curative intention,long-term parasitostatic pharmacotherapy with benzimidazoles is indicated to inhibit further extension.[1] | Tilmann Graeter Rong Shi Hai-Hua Bao Wolfgang Kratzer Thomas F.E.Barth Andreas Hillenbrand Doris Henne-Bruns Julian Schmidberger Beate Gruener Wei-Xia Li 无 | 2020 | Chinese Medical Journal2020，，12： | 1 |
| 9 | Long-term experience on surgical treatment of alveolar echinococcosis显示文摘 | Klaus Buttenschoen Daniela Carli Buttenschoen Beate Gruener Peter Kern Hans G. Beger Doris Henne-Bruns Stefan Reuter | 2009 | Langenbeck’s Archives of Surgery2009，，4： | 1 |
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