Abstract: Objective The aim of this study was to explore the clinical value of 256-slice CT scan in differentiating hepatic echinococcosis from hepatic cysts. Methods 77 patients with hepatic echinococcosis and 34 patients with hepatic cysts were enrolled in our hospital between April 2017 and November 2020, and all underwent CT scan. Serum anti-cystic fluid antigen antibody (anti-EgCF antibody), anti-cephalomere antigen antibody (anti-EgP antibody), anti-cyst fluid semi-purified antigen antibody (anti-EgB antibody) and anti-echinococcus multilocularis antibody (anti-Em2 antibody) were detected by ELISA. Results Before surgery, the blood eosinophil count in patients with hepatic echinococcosis was (0.3±0.1)×10⁹/L, significantly higher than [(0.1±0.1)×10⁹/L, P<0.05] in patients with hepatic cysts; serum anti-EgCF and anti-EgB positive rates in patients with hepatic echinococcosis were 85.3% and 61.8%, significantly higher than (31.2% and 0.0%, respectively, P<0.05) in patients with hepatic cysts; the CT scan showed hepatic round, round-like or lobulated cysts with calcified cyst walls in patients with hepatic echinococcosis, significantly different to that in patients with hepatic cysts; out of the 111 patients, the CT scan misdiagnosed hepatic echinococcosis as hepatic cysts in 3 cases(2.7%), as hepatic metastasis in 1 case (1.0%), and misdiagnosed hepatic cysts as hepatic echinococcosis in 2 cases (1.8%). Conclusion The 256-slice CT examination can display the characteristic imaging of hepatic echinococcosis lesions, which can help differentiating hepatic echinococcosis from hepatic cysts, and provide a reliable imaging evidence for management of patients with hepatic cysts.

Key words: Hepatic echinococcosis, Hepatic cyst, X-ray computed tomography, Diagnosis