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Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 533-535
Imaging appereances of hydatid cyst


Department of Radiodiagnosis, V S Hospital, Ellisbridge, Ahmedabad- 380016, India

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Date of Submission10-May-2006
Date of Acceptance10-Aug-2006
 

Keywords: Hydatid Cyst Of Liver, E. Granulosus

How to cite this article:
Shah D S, Parikh H, Shah B, Banuprakash S, Shah J. Imaging appereances of hydatid cyst. Indian J Radiol Imaging 2006;16:533-5

How to cite this URL:
Shah D S, Parikh H, Shah B, Banuprakash S, Shah J. Imaging appereances of hydatid cyst. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Aug 24];16:533-5. Available from: http://www.ijri.org/text.asp?2006/16/4/533/32262

   Introduction Top


Hydatid disease is one of the common diseases in tropical countries. It primarily affects the liver and shows typical imaging findings. However clinical presentations vary widely and are mostly nonspecific. Thus imaging plays an important role in diagnosis of HYDATID disease. The motive of this assay is to describe the imaging appearances of HYDATID disease and Recognize the most frequent complications associated with hepatic hydatid disease.


   Discussion Top


Hydatid disease is a worldwide zoonosis produced by the larval stage of the Echinococcus tapeworm. The two main types of hydatid disease are caused by E. granulosus and E multilocularis.

Human beings are accidental hosts and acquire infection by infesting ova from fomites, contaminated water or direct contact with dogs. Embryos from duodenum pass through mucosa to reach liver through portal venous system where they form hydatid cysts.

Hydatid disease involves liver primarily. Other sites include lungs, spleen, kidneys [Figure - 1],[Figure - 2] Bones [Figure - 7], CNS and rarely orbit and heart (pericardium) [Figure - 2]. Peritoneal hydatid results from rupture of hepatic or splenic hydatid [Figure - 3].

The right lobe is the most frequently involved portion of the liver [Figure - 5]. Imaging findings in hepatic hydatid disease depend on the stage of cyst growth (ie, whether the cyst is unilocular, contains daughter vesicles, contains daughter cysts, is partially calcified, or is completely calcified [dead]).

Cyst calcification usually occurs in the cyst wall, although internal calcification in the matrix may also be seen. US demonstrate a hyperechoic contour with a cone-shaped acoustic shadow. When the cyst wall is heavily calcified, only the anterior portion of the wall is visualized and appears as a thick arch with a posterior concavity. As stated earlier, partial calcification of the cyst does not always indicate the death of the parasite [Figure - 2] nevertheless, densely calcified cysts may be assumed to be inactive.

Multivesicular cysts manifest as well-defined fluid collections in a honeycomb pattern with multiple septa representing the walls of the daughter cysts1 [Figure - 6]. Daughter cysts appear as cysts within a cyst. When daughter cysts are separated by the hydatid matrix (a material with mixed echogenicity), they demonstrate a "spoke wheel" pattern2 [Figure - 7]. The matrix represents hydatid fluid containing membranes of broken daughter vesicles, scolices, and hydatid sand. Membranes may appear within the matrix as serpentine linear structures, a finding that is highly specific for hydatid disease3 (WATER LILY SIGN).

CT may display the same findings as US. Cyst fluid usually demonstrates water attenuation (3-30 HU). Calcification of the cyst wall or internal septa is easily detected at CT [Figure - 7]. A hydatid cyst typically demonstrates a high-attenuation wall at unenhanced CT even without calcification. Detachment of the laminated membrane from the pericyst can be visualized as linear areas of increased attenuation within the cyst 4 [Figure - 8]. Daughter vesicles manifest as round structures located peripherally within the mother cyst [Figure - 1][5].

 
   References Top

1.Lewall DB, McCorkell SJ. Hepatic echinococcal cyst: sonographic appearance and classification. Radiology 1985; 155:773-775.  Back to cited text no. 1  [PUBMED]  
2.Bezzi M, Teggi A, De Rosa F, et al. Abdominal hydatid disease: US findings during medical treatment. Radiology 1987; 162:91-95.  Back to cited text no. 2  [PUBMED]  
3.Bezzi M, Teggi A, De Rosa F, et al. Abdominal hydatid disease: US findings during medical treatment. Radiology 1987; 162:91-95.  Back to cited text no. 3  [PUBMED]  
4.Odev K, Kilinc M, Arslan A, et al. Renal hydatidosis cyst and the evaluation of their radiologic images. Eur Urol 1996; 30:40-49.   Back to cited text no. 4    
5.WHO Informal Working Group: International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 2003 Feb; 85(2): 253-61.  Back to cited text no. 5    

Top
Correspondence Address:
D S Shah
15, Amrakunj Society, B/h Nehrunagar, S. M. Road, Ambawadi, Ahmedabad-380015, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32262

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7], [Figure - 8]

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