Innovation in hepatic alveolar echinococcosis imaging: best use of old tools, and necessary evaluation of new ones

Wenya Liu; Éric Delabrousse; Oleg Blagosklonov; Jing Wang; Hongchun Zeng; Yi Jiang; Jian Wang; Yongde Qin; Dominique Angèle Vuitton; Hao Wen

doi:10.1051/parasite/2014072

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Volume 21 (2014)

Parasite, 21 (2014) 74

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Innovation for the Management of Echinococcosis. Invited editors: Dominique A. Vuitton, Laurence Millon, Bruno Gottstein and Patrick Giraudoux

Open Access

Review

Table 1.

PNM classification of alveolar echinococcosis (according to WHO-IWGE, 2006).

PNM	Location and extension of the lesion
P	Hepatic localization of the parasite
P X	Primary parasite cannot be assessed
P 0	No detectable parasite in the liver
P 1	Peripheral lesions without proximal vascular and/or biliary involvement
P 2	Central lesions with proximal vascular and/or biliary involvement of one lobe^a
P 3	Central lesions with hilar, vascular, or biliary involvement of both lobes and/or with involvement of two hepatic veins
P 4	Any liver lesion with extension along the vessels^b and the biliary tree
N	Extrahepatic involvement of neighboring organs [diaphragm, lungs, pleura, pericardium, heart, gastric and duodenal wall, adrenal glands, peritoneum, retroperitoneum, parietal wall (muscles, skin, bone), pancreas, regional lymph nodes, liver ligaments, kidneys]
N X	Not evaluable
N 0	No regional involvement
N 1	Regional involvement of contiguous organs or tissues
M	The absence or presence of distant Metastasis [lungs, distant lymph nodes, spleen, CNS, orbital, bones, skin, muscle, kidneys, distant peritoneum, and retroperitoneum]
M X	Not completely evaluated
M 0	No metastasis^c
M 1	Metastasis

^a

For classification, the plane projecting between the bed of the gall bladder and the inferior vena cava divides the liver into two lobes.

^b

Vessels mean inferior vena cava, portal vein, and arteries.

^c

Chest X-ray and cerebral CT negative.

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