Hydatid Disease in Different Organs, A Pictorial Review

Congress:

ECR 2019

Poster Number:

C-1176

Type:

Educational Exhibit

Keywords:

Parasites, Diagnostic procedure, Ultrasound, MR, CT, Liver, Extremities, Abdomen

Authors:

A. Al-Taie, Z. AHMED, Z. Jaleel; Doha/QA

DOI:

10.26044/ecr2019/C-1176

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1176

Fig. 1: Ultrasound reveals intramuscular complex cystic lesion in the anterolateral...

Fig. 2: Baseline US and CECT (A, B) are showing hepatic hydatid cyst with wall...

Fig. 14: CT scan of the abdomen coronal (A) and axial (B) sections demonstrate a cystic...

Fig. 4: Ultrasound of the abdomen (A, B) demonstrates multiple cysts in the liver,...

Learning objectives

Demonstrate in a case-based review a diversity of cases withhydatiddisease with different organs involvement. Illustrate the diagnostic imaging appearances ofhydatiddisease in different diagnostic modalities. Summarize the Imaging findings ofHydatiddisease.

Background

*Hydatiddisease (HD) is a worldwide parasitic infection endemic in many parts of the world. *It is caused by genusEchinococcus. *It affects human in two forms: 1. Cystic echinococcosis caused by the tapewormsEchinococcus granulosus. 2. Alveolar echinococcosis, caused byEchinococcus multilocularis. *Definitive hosts are carnivores (e.g. dogs, foxes, cats), and the intermediate hosts are mainly sheep, pigs and cattle.Humans are accidental hosts, and the infection occurs by ingesting food contaminated withEchinococcuseggs. *Hydatid cyst layers: The outer pericyst: Composed of inflammatory tissue of host origin. The middle exocyst:...

Findings and procedure details

1. Plain Radiograph: Rim-like calcification in soft tissues and abdominal viscera. Fairly homogenous opacity with or without calcification in Lungs. 2. Ultrasound: First ultrasound classificationdeveloped by Gharbi et al. in 1981 consists of five stages: Stage 1: Homogeneously hypoechogeniccysticthin-walled lesion. Stage 2: Septatedcysticlesion. Stage 3: Cysticlesion with daughter lesions and floating membranes. Stage 4: Pseudo-tumor lesion. Stage 5: Calcified or partially calcified lesion (inactivecyst). 3. CT scan: The cysts demonstrate fluid attenuation (0 - 30 HU). The daughter vesicles usually contain fluid with a lower...

Conclusion

Radiologists should be familiar with typical and atypical findings ofhydatiddisease in different diagnostic modalities and exclude possible complications when relevant. HD should be included in the differential diagnosis ofcysticlesions in the endemic areas.

Personal information

Dr. Zeyad Tareq Jaleel Emergency radiologist. M.B.Ch.B, CABMS-RAD. Hamad Medical Corporation. Doha, Qatar. Email:[email protected] Dr. Alaa Abdulsattar Al-Taie Associate Consultant Musculoskeletal Radiologist. M.B.Ch.B, CABMS-RAD, Musculoskeletal Radiology Clinical Fellowship. Hamad Medical Corporation. Doha, Qatar. Email:[email protected] Dr. Zahoor Ahmed Associate Consultant Emergency Radiology, MBBS, MD. Hamad Medical Corporation. Doha, Qatar. Email: [email protected]

References

1- Pinar Polat, et al. Hydatid Disease from Head to Toe. Available at https://pubs.rsna.org/doi/pdf/10.1148/rg.232025704, (accessed 10 December, 2018). 2- Imad S Dandan, et al. Hydatid CystsClinical Presentation Updated. Available at https://emedicine.medscape.com/article/178648-clinical, (accessed 12 December, 2018). 3- Gharbi HA, et al. Ultrasound examination of the hydatic liver. Radiology. 1981 May; 139(2):459-63. PubMed PMID: 7220891 Available at https://ncbi.nlm.nih.gov/pubmed/7220891, (accessed 10 December, 2018). 4- Nagihan Inan, er al. Diffusion-Weighted Imaging in the Differential Diagnosis of Simple and Hydatid Cysts of the Liver. Available at https://www.ajronline.org/doi/10.2214/AJR.07.2251, (accessed 12 December,...