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WHO-IWGE classification of cystic echinococcosis

Last revised by Henry Knipe ◉ on 14 Nov 2024

Citation, DOI, disclosures and article data

Citation:

Venkatesh M, Knipe H, Deng F, et al. WHO-IWGE classification of cystic echinococcosis. Reference article, Radiopaedia.org (Accessed on 14 Jan 2025) https://doi.org/10.53347/rID-26148

DOI:

https://doi.org/10.53347/rID-26148

Permalink:

https://radiopaedia.org/articles/26148

rID:

26148

Article created:

2 Dec 2013, Manchikanti Venkatesh

Disclosures:

At the time the article was created Manchikanti Venkatesh had no recorded disclosures.

View Manchikanti Venkatesh's current disclosures

Last revised:

14 Nov 2024, Henry Knipe ◉

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Micro-X Ltd, Shareholder (past)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Henry Knipe's current disclosures

Revisions:

28 times, by 20 contributors - see full revision history and disclosures

Systems:

Hepatobiliary

Sections:

Classifications

Tags:

hydatid cyst, hepatic

Synonyms:

WHO classification of hepatic hydatid cysts
2001 World Health Organization classification of hepatic hydatid cysts
2001 WHO classification of hepatic hydatid cysts
World Health Organization Informal Working Group on Echinococcosis classification
WHO-IWGE classification
World Health Organization 2001 classification of hydatid liver cysts

The World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification of cystic echinococcosis is used to assess the stage hepatic hydatid cysts on ultrasound. It is useful in deciding the appropriate management depending on the stage of the cyst.

Usage

This classification, the latest updated version published in 2010 ³, is currently (c. 2022) in wide use along with the Gharbi classification. The WHO-IGWE is very similar to the Gharbi classification, as Gharbi was involved in its development ^3,5,6.

Classification

CE 1 (active stage)
- unilocular anechoic cyst with double line sign ⁴
- fine internal echoes represent "hydatid sand" (fluid and protoscolices originating from a ruptured vesicle), which may only be visible after patient repositioning ²
CE 2 (active stage)
- cyst with multiple internal septations
  - septa represent walls of daughter cyst(s) ²
  - described as multivesicular, rosette, or honeycomb appearance ⁴
CE 3 (transitional stage: the evolving appearance of daughter cyst(s) within the encompassing parent cyst
- 3A: daughter cysts have detached laminated membranes (water lily sign) ⁴
- 3B: daughter cysts within a solid matrix ⁴
CE 4 (inactive/degenerative)
- cyst with heterogeneous hypoechoic and hyperechoic contents ⁴ (ball of wool sign)
- absence of daughter cysts ⁴
CE 5 (inactive/degenerative)
- solid and calcified wall ⁴

NB, "CE" = cystic echinococcosis.

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