Echinococcosis CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]


CT scan is often used to diagnose cystic echinococcosis.

CT Scan

Both MRI and CT scan may be used to diagnose cystic echinococcosis. MRI is usually preferred over CT scan when diagnosing cystic echinococcosis since MRI gives better visualization of cystic areas within the tissue.[1][2][3]

Abdominal CT scan

The most important features that is associated with hepatic hydatic cysts in CT scan are:

  • Fluid density cyst, with frequent peripheral focal areas of calcification
    • Indicates no active infection if completely circumferential
  • Septation and daughter cysts
  • The water-lily sign
    • Indicates a cyst with floating, undulating membrane, caused by a detached endocyst
  • Hyperdense internal septa
    • Representing a spoke wheel pattern within a cyst
  • Fluid with variable attenuation depending on the amount of proteinaceous debris
  • Dilated intrahepatic bile duct
    • Due to compression or rupture of cyst into bile ducts

Chest CT scan

Chest CT scan features include:[4][5][2][6]

  • Multiple or solitary cystic lesion (most common)
  • Cysts with diameter of 1-20 cm
  • Unilateral or bilateral cysts
  • Predominantly found in the lower lobes

Radiographic and CT features may differ in complicated and uncomplicated cysts:

  • Uncomplicated cysts are characterized by:
    • Round or oval masses with well-defined borders
    • Enhancement after contrast injection
    • Hypodense content relative to the capsule
  • Complicated cysts may show:
    • Meniscus sign or air crescent sign
    • Cumbo sign or onion peel sign
    • Water-lily sign
    • Consolidation adjacent to the cyst (ruptured cyst)
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  1. Sréter T, Széll Z, Egyed Z, Varga I (2003). "Echinococcus multilocularis: an emerging pathogen in Hungary and Central Eastern Europe?". Emerging Infect. Dis. 9 (3): 384–6. doi:10.3201/eid0903.020320. PMC 2958538. PMID 12643838.
  2. 2.0 2.1 Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000). "Hydatid disease: radiologic and pathologic features and complications". Radiographics. 20 (3): 795–817. doi:10.1148/radiographics.20.3.g00ma06795. PMID 10835129.
  3. Himsworth CG, Jenkins E, Hill JE, Nsungu M, Ndao M, Andrew Thompson RC, Covacin C, Ash A, Wagner BA, McConnell A, Leighton FA, Skinner S (2010). "Emergence of sylvatic Echinococcus granulosus as a parasitic zoonosis of public health concern in an indigenous community in Canada". Am. J. Trop. Med. Hyg. 82 (4): 643–5. doi:10.4269/ajtmh.2010.09-0686. PMC 2844548. PMID 20348513.
  4. Gottstein B, Reichen J (2002). "Hydatid lung disease (echinococcosis/hydatidosis)". Clin. Chest Med. 23 (2): 397–408, ix. PMID 12092034.
  5. Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A (2003). "Hydatid disease from head to toe". Radiographics. 23 (2): 475–94, quiz 536–7. doi:10.1148/rg.232025704. PMID 12640161.
  6. Ozdemir N, Akal M, Kutlay H, Yavuzer S (1994). "Chest wall echinococcosis". Chest. 105 (4): 1277–9. PMID 8162770.

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