Publication Details
Abstract
The objective of the present study was to assess the diagnostic efficiency of prevailing instrumental and laboratory techniques in hepatic hydatid and to construct a developed, step-by-step diagnostic algorithm for both hospital-based practices as well as seroepidemiological examinations in endemic areas.
A retrospective and prospective analysis was carried out among 282 patients with hepatic echinococcosis. We compared performance of serological tests (latex agglutination reaction, indirect hemagglutination), ultrasonography, radionuclide liver scanning, angiography and CT. Furthermore, a mass ultrasound screening study was conducted among rural dwellers in northern Uzbekistan.
Ultrasonography showed a high sensitivity (97.8%) and specificity (93.5%), whereas CT had the best diagnostic accuracy (sensitivity 99.1%, specificity 98.8%). The combined application of US and CT improved the diagnosis accuracy up to 99%. Early-stage disease was detected with a marked reduction of the complication rate by mass screening. The introduction of a staged diagnostic strategy decreased postoperative mortality rates from 4.4% to 1% and the occurrence of peripheral complications from 23.3% to 6.0%.
This case supports a structured, algorithmic diagnostic approach that includes common imaging technologies as well as more advanced techniques, and underscores the role of population-level US screening in endemic areas.
The proposed algorithm facilitates early diagnosis, better surgical management and decreased mortality especially in rural health care systems.
The limitations of the study are its regional nature and retrospective aspects, and more large-scale multicenter studies are encouraged.