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SCIENTIFIC EXHIBIT - Continuing Medical Education

Hydatid Disease: Radiologic and Pathologic Features and Complications

(CME available in print version and on RSNA Link)
Published Online:May 1 2000https://doi.org/10.1148/radiographics.20.3.g00ma06795

Abstract

Hydatid disease primarily affects the liver and typically demonstrates characteristic imaging findings. However, there are many potential local complications (eg, intrahepatic complications, exophytic growth, transdiaphragmatic thoracic involvement, perforation into hollow viscera, peritoneal seeding, biliary communication, portal vein involvement, abdominal wall invasion). Furthermore, secondary involvement due to hematogenous dissemination may be seen in almost any anatomic location (eg, lung, kidney, spleen, bone, brain). Ultrasonography (US) is particularly useful for the detection of cystic membranes, septa, and hydatid sand. Computed tomography (CT) best demonstrates cyst wall calcification and cyst infection. CT and magnetic resonance (MR) imaging may demonstrate cyst wall defects as well as the passage of contents through a defect. Chest radiography, US, CT, and MR imaging are all useful in depicting transdiaphragmatic migration of hydatid disease. CT is the modality of choice in peritoneal seeding. US and CT demonstrate rupture in most cases that involve wide communication. Indirect signs of biliary communication include increased echogenicity at US and fluid levels and signal intensity changes at MR imaging. CT allows precise assessment of osseous lesions, whereas MR imaging is superior in demonstrating neural involvement. Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt, accurate diagnosis.

References

  • 1 Pumarola A, Rodriguez-Torres A, García-Rodriguez JA, Piédrola-Angulo G. Microbiología y parasitología médica 2nd ed. Barcelona, Spain: Salvat, 1990.
    Google Scholar
  • 2 King CH. Cestodes (tapeworms) In: Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. 4th ed. New York, NY: Churchill Livingstone, 1995; 2544-2553.
    Google Scholar
  • 3 Beggs I. The radiology of hydatid disease. AJR Am J Roentgenol 1985; 145:639-648.
    Medline Google Scholar
  • 4 Lewall DB. Hydatid disease: biology, pathology, imaging and classification. Clin Radiol 1998; 52:863-874.
    Google Scholar
  • 5 von Sinner WN. New diagnostic sign in hydatid disease: radiography, ultrasound, CT and MRI correlated to pathology. Eur J Radiol 1990; 12:150-159.
    Google Scholar
  • 6 Moguillanski SJ, Gimenez CR, Villavicencio RL. Radiología de la hidatidosis abdominal. In: Stoopen ME, Kimura K, Ros PR, eds. Radiología e imagen diagnóstica y terapeútica: abdomen. Vol 2. Philadelphia, Pa: Lippincott Williams & Wilkins, 1999; 47-72.
    Google Scholar
  • 7 Gharbi HA, Hassine W, Brauner MW, Dupuch KD. Ultrasound examination of the hydatic liver. Radiology 1981; 139:459-463.
    Google Scholar
  • 8 Lewall DB, McCorkell SJ. Hepatic echinococcal cyst: sonographic appearance and classification. Radiology 1985; 155:773-775.
    Google Scholar
  • 9 Marti-Bonmati L, Menor Serrano F. Complications of hepatic hydatid cysts: ultrasound, computed tomography, and magnetic resonance diagnosis. Gastrointest Radiol 1990; 15:119-125.
    Medline Google Scholar
  • 10 Bezzi M, Teggi A, De Rosa F, et al. Abdominal hydatid disease: US findings during medical treatment. Radiology 1987; 162:91-95.
    Google Scholar
  • 11 Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol 1986; 146:391-394.
    Medline Google Scholar
  • 12 el Hajjam M, Essadki O, Chikhaoui N, Kadiri R. Ultrasound signs of pseudoneoplastic forms of hepatic hydatid cysts: a prospective analysis of 50 cases. Ann Radiol (Paris) 1996; 39:172-181.
    Medline Google Scholar
  • 13 de Diego J, Lecumberri FJ, Franquet T, Ostiz S. Computed tomography in hepatic echinococcosis. AJR Am J Roentgenol 1982; 139:699-702.
    Medline Google Scholar
  • 14 Scherer V, Weinzierl M, Sturm R, et al. Computed tomography in hydatid disease of the liver: a report on 13 cases. J Comput Assist Tomogr 1978; 2:612-617.
    Medline Google Scholar
  • 15 Davolio SA, Canossi GC, Nicoli FA, et al. Hydatid disease: MR imaging study. Radiology 1990; 175:701-706.
    Google Scholar
  • 16 Méndez JV, Arrazola J, López J, et al. Fat-fluid level in hepatic hydatid cyst: a new sign of rupture into the biliary tree? AJR Am J Roentgenol 1996; 167:91-94.
    Medline Google Scholar
  • 17 Hernandez J, Martín MF, Ferreirós J, et al. Lesiones quísticas, parasitarias e inflamatorias del hígado. Monogr Diagn Imaging 1992; 3:51-70.
    Google Scholar
  • 18 Gómez R, Moreno E, Loinaz C, et al. Diaphragmatic or transdiaphragmatic thoracic involvement in hepatic hydatid disease: surgical trends and classification. World J Surg 1995; 19:714-719.
    Medline Google Scholar
  • 19 Domjan JM, Tung KT, Johnson C. Bare area abscess: imaging findings and potential communication with the mediastinum. Br J Radiol 1997; 70:754-757.
    Medline Google Scholar
  • 20 Jain R, Dawhney S, Berry M. Hydatid disease: CT demonstration and follow-up of a cystogastric fistula. AJR Am J Roentgenol 1992; 158:212.
    Google Scholar
  • 21 Karavias DD, Vagianos CE, Kakkos SK, et al. Peritoneal echinococcosis. World J Surg 1996; 20:337-340.
    Medline Google Scholar
  • 22 Ulualp KM, Aydemir I, Senturk H, et al. Management of intrabiliary rupture of hydatid cyst of the liver. World J Surg 1995; 19:720-724.
    Medline Google Scholar
  • 23 Khaldi F, Braham N, Ben Chehida F, et al. Hepatic hydatidosis and portal hypertension in children: is it the Budd-Chiari syndrome? Ann Pediatr (Paris) 1993; 40:631-634.
    Medline Google Scholar
  • 24 Gil-Egea MJ, Alameda F, Girvent M, Riera R, Sitges-Serra A. Hydatid cyst in the hepatic hilum causing a cavernous transformation in the portal vein. Gastroenterol Hepatol 1998; 21:227-229.
    Medline Google Scholar
  • 25 Odev K, Kilinc M, Arslan A, et al. Renal hydatidosis cyst and the evaluation of their radiologic images. Eur Urol 1996; 30:40-49.
    Medline Google Scholar
  • 26 Jerray M, Benzarti M, Garrouche A, et al. Hydatid disease of the lungs. Am Rev Respir Dis 1992; 146:185-189.
    Medline Google Scholar
  • 27 von Sinner WN, Linjawi T, al Watban JA. Mediastinal hydatid disease: report of three cases. J Can Assoc Radiol 1990; 41:79-82.
    Google Scholar
  • 28 Dogan R, Yüksel M, Cetin G, et al. Surgical treatment of hydatid cysts of the lung: report on 1055 patients. Thorax 1989; 44:192-199.
    Medline Google Scholar
  • 29 Balikian JP, Mudarris FF. Hydatid disease of the lungs: a roentgenologic study of 50 cases. AJR Am J Roentgenol 1974; 122:692-707.
    Google Scholar
  • 30 Hirzalla MO, Samara N, Ateyat B, et al. Recurrent hydatid pulmonary emboli. Am Rev Respir Dis 1989; 140:1082-1085.
    Medline Google Scholar
  • 31 von Sinner WN, Hellström M, Kagevi I, Norlen BJ. Hydatid disease of the urinary tract. J Urol 1993; 149:577-580.
    Medline Google Scholar
  • 32 Torricelli P, Martinelli C, Biagini R, et al. Radiographic and computed tomographic findings in hydatid disease of bone. Skeletal Radiol 1990; 19:>435-439.
    Medline Google Scholar
  • 33 Franquet T, Montes M, Lecumberri FJ, et al. Hydatid disease of the spleen: imaging findings in nine patients. AJR Am J Roentgenol 1990; 154:525-528.
    Medline Google Scholar
  • 34 von Sinner WN, Stridbeck H. Hydatid disease of the spleen: ultrasonography, CT and MR imaging. Acta Radiologica 1992; 33:459-461.
    Medline Google Scholar
  • 35 Islekel S, Ersahin Y, Zileli M, et al. Spinal hydatid disease. Spinal Cord 1998; 36:166-170.
    Medline Google Scholar
  • 36 Ögüt AG, Kanberoglu K, Altug A, Cokyüksel O. CT and MRI in hydatid disease of cervical vertebrae. Neuroradiology 1992; 34:430-432.
    Medline Google Scholar
  • 37 Braithwaite PA, Lees RF. Vertebral hydatid disease: radiological assessment. Radiology 1981; 140:763-766.
    Google Scholar
  • 38 Tekkök IH, Benli K. Primary spinal extradural hydatid disease: report of a case with magnetic resonance characteristics and pathological correlation. Neurosurgery 1993; 3:320-323.
    Google Scholar
  • 39 Nurchi G, Floris F, Montaldo C, et al. Multiple cerebral hydatid disease: case report with magnetic resonance imaging study. Neurosurgery 1992; 30:436-438.
    Medline Google Scholar
  • 40 Yekeler I, Koçak H, Aydin NE, et al. A case of cardiac hydatid cyst localized in the lungs bilaterally and on anterior wall of right ventricle. J Thorac Cardiovasc Surg 1993; 41:261-263.
    Google Scholar
  • 41 Ergun R, Okten AI, Yuksel M, et al. Orbital hydatid cyst: report of four cases. Neurosurg Rev 1997; 20:33-37.
    Medline Google Scholar
  • 42 Gunalp I, Gunduz K. Cystic lesions of the orbit. Int Ophthalmol 1996–97; 20:273-277.
    Medline Google Scholar
  • 43 Karnak I, Ciftci AO, Tanyel FC. Hydatid cyst: an unusual etiology for a cystic lesion of the posterior mediastinum. J Pediatr Surg 1998; 33:759-760.
    Medline Google Scholar
  • 44 Casero RD, Gomez Costas M, Menso E. An unusual case of hydatid disease: localization to the gluteus muscle. Clin Infect Dis 1996; 23:295-296.
    Google Scholar
  • 45 Pochini M, Maggiulli G, Nardi D, et al. Cisti da echinococco primaria del muscolo coracobrachiale: caso clinico. Minerva Chir 1994; 49:603-606.
    Medline Google Scholar
  • 46 Schoretsanitis G, de Bree E, Melissas J, Tsiftsis D. Primary hydatid cyst of the adrenal gland. Scand J Urol Nephrol 1998; 32:51-53.
    Medline Google Scholar
  • 47 Bashour TT, Alali ARK, Mason DT, Saalouke M. Echinococcosis of the heart: clinical and echocardiographic features in 19 patients. Am Heart J 1996; 132:1028-1030.
    Medline Google Scholar

Article History

Published in print: May 2000