To assess the diagnostic consistency between contrast-enhanced ultrasound (CEUS) and MRI for hepatic alveolar echinococcosis (HAE).

47 patients with HAE admitted to the Affiliated Hospital of Qinghai University from October 2019 to December 2020 were recruited. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 17 patients were male and 30 female, aged (36±2) years on average. All patients received CEUS and MRI within 1 week. The imaging features were analyzed to assess the biological activity of lesions. The consistency between the enhancement pattern by CEUS and vesicle-like structure by MRI in the diagnosis of biological activity of HAE was analyzed by Kappa test.

77 lesions were detected from 47 cases by CEUS. 62 lesions revealed peripheral enhancement including 19 lesions of hyperenhancement, 15 isoenhancement and 28 hypoenhancement. According to the revised MRI Kodama classification,1 lesion was classified as type 1, 20 lesions were type 2, 37 lesions were type 3, 17 lesions were type 4 and 2 lesions were types 5. 53 lesions with vesicle-like structures possessed biological activity were observed by MRI, and 62 lesions were detected by CEUS. The consistency between two imaging tools was high (κ=0.696, P<0.001).

CEUS and MRI yield high diagnostic consistency for the biological activity of HAE lesions. Compared with MRI, CEUS is more convenient, easy to operate and economical, and it can be utilized to effectively evaluate the biological activity of HAE lesions and monitor the changes of HAE during follow-up.