Evaluation of vascular invasion in hepatic alveolar echinococcosis using computed tomography: An observational study

Objective: Alveolar echinococcosis (AE) is a severe, chronic parasitic disease predominantly affecting the liver. Surgical intervention is the only definitive treatment, but vascular invasion significantly increases surgical risks. This study aimed to identify factors associated with vascular invasion in hepatic AE to improve diagnosis and surgical planning. Methods: A retrospective analysis of 70 patients with newly diagnosed hepatic AE was conducted using contrast enhanced computed tomography (CT). Factors including sex, age, number and size of foci, lesion volume, and the morphologic type of lesions (based on the Alveolar Echinococcosis Ulm Classification, AEUC) were evaluated for their association with blood vessel invasion. Statistical analyses included cross-tabulations and symmetric measures, with significance assessed at p < 0.05. Results: Among the variables analyzed, the number of foci and the size of the largest focus were identified as significant predictors of vascular invasion, with Cramer's V values of 0.404 (p=0.022) and 0.630 (p=0.066), respectively. Other factors, including sex, age, lesion volume, and AEUC morphological type, showed weaker or statistically insignificant associations with vascular involvement. Conclusion: The invasion of parasitic nodules into large blood vessels in patients with first diagnosed hepatic AE does not depend directly on sex, age, type of focus according to AEUC. It can be stated that with a high probability invasion of pathologic focus into the vascular wall is associated with an increase in the volume of liver lesion. The most significant predictors of invasion into large vessels are the number of foci and the size of the largest foci.