Diagnosis of liver infestation by alveolar echinococcosis (AE) is based on serologic, sonographic and computed tomography (CT) findings. Experience with magnetic resonance imaging (MRI) demonstrates that features of this disease are limited. CT and MRI findings of 14 cases with hepatic AE were compared in this report. We have described the MRI appearance of hepatic AE, which exhibits variable signal intensities on T1- and T2-weighted images. Fibrous and parasitic tissue showed low signal both on T1- and, generally, on T2-weighted images. In a few cases, a high signal on T2-weighted images may be observed, due either to central necrotic zones or to small peripheral cyst. MRI than by CT was more easily identified central necrosis. However, MRI seemed to be less effective than CT in allowing us to reach a positive diagnosis, due to its inability to show microcalcifications. In addition, MRI may not reveal small lesions. In most cases, T1-weighted images revealed more clearly than CT did the margins of the lesions and the hepatic extension, especially to hepatic veins, vena cava and perihepatic spaces. (C) 2003 Elsevier Inc. All rights reserved.