{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:27:48Z","timestamp":1774531668974,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["KA 4356\/3-1"],"award-info":[{"award-number":["KA 4356\/3-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["KR 5204\/1-2"],"award-info":[{"award-number":["KR 5204\/1-2"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"State of Baden-W\u00fcrttemberg","award":["14-(33)-8402.43\/419 E"],"award-info":[{"award-number":["14-(33)-8402.43\/419 E"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Alveolar echinococcosis (AE) is caused by the intermediate stage of Echinococcus multilocularis. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the Echinococcus multilocularis Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of Echinococcus multilocularis (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant.<\/jats:p>","DOI":"10.3390\/pathogens9080634","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T10:45:17Z","timestamp":1596537917000},"page":"634","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5115-9033","authenticated-orcid":false,"given":"Johannes","family":"Grimm","sequence":"first","affiliation":[{"name":"Institute of Pathology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Beck","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliane","family":"Nell","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Schmidberger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Hillenbrand","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambros J.","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Dezs\u00e9nyi","sequence":"additional","affiliation":[{"name":"Department of Infectiology, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meinrad","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kern","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Henne-Bruns","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplantation Surgery, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Kratzer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Moller","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas FE","family":"Barth","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6669-3741","authenticated-orcid":false,"given":"Beate","family":"Gruener","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tilmann","family":"Graeter","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"ref_1","unstructured":"Eckert, J., Gemmell, M.A., Meslin, F., and Pawlowski, Z.S. 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