{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T17:39:51Z","timestamp":1788802791042,"version":"build-2803163510"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Ultrasound"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n              <jats:title>Purpose<\/jats:title>\n              <jats:p>Hepatic alveolar echinococcosis (HAE) of the metastasis-like pattern, according to the Echinococcus Ulm classification, is usually discovered as an incidental finding, and the diagnostic differentiation from \u201ctrue metastases\u201d is difficult. The aim of this study was to investigate whether lesions of the \u201cmetastasis-like pattern\u201d in HAE show a typical contrast behavior that can be used for differentiation from metastasis in malignancies.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Methods<\/jats:title>\n              <jats:p>This prospective clinical study included 11 patients with histologically confirmed HAE of the metastasis-like pattern (7 female and 4 male; mean age, 57.1\u00a0years; mean disease duration, 59.5\u00a0months), who had been examined by B-scan sonography and CEUS, from the National Echinococcosis Registry Germany.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Results<\/jats:title>\n              <jats:p>On contrast-enhanced sonography, 11\/11 reference lesions showed annular rim enhancement in the arterial and portal venous phases. Throughout the entire 4-min study period, none of the reference lesions showed central contrast enhancement\u2014i.e., all exhibited a complete \u201cblack hole sign\u201d. A small central scar was seen in 81.8% of cases.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusion<\/jats:title>\n              <jats:p>In clinically unremarkable patients with incidentally detected metastasis-like lesions of the liver, contrast-enhanced sonographic detection of rim enhancement without central contrast uptake (black hole sign) should be considered evidence supporting a diagnosis of hepatic alveolar echinococcosis with a rare metastasis-like pattern. This can help to differentiate HAE from metastases, especially in high-endemic areas.<\/jats:p>\n            <\/jats:sec>","DOI":"10.1007\/s40477-022-00688-x","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T18:06:49Z","timestamp":1653156409000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Contrast-enhanced ultrasound (CEUS) in patients with metastasis-like hepatic alveolar echinococcosis: a cohort study"],"prefix":"10.1007","author":[{"given":"Melissa","family":"Schweizer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Schmidberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrycja","family":"Schlingeloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Kratzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"688_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","volume":"114","author":"E Brunetti","year":"2010","unstructured":"Brunetti E, Kern P, Vuitton; Writing Panel for the WHO-IWGE (2010) Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. 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