Unilocular hepatic echinococcal cysts: sonography and computed tomography findings

Area of Science:

• Radiology
• Parasitology
• Hepatology

Background:

• Unilocular hepatic echinococcal cysts (HEC) present diagnostic challenges in endemic regions, often mimicking simple cysts, especially with negative serology.
• Accurate radiological differentiation is crucial for timely diagnosis and management of HEC.

Purpose of the Study:

• To identify and describe distinctive imaging features of unilocular hepatic echinococcal cysts (HEC) using ultrasound (US) and computed tomography (CT).
• To improve the radiological diagnosis of HEC in patients with negative serological results.

Main Methods:

• Retrospective analysis of sonographic and CT findings in 21 patients with proven unilocular HEC.
• Review of 28 liver examinations, including 14 US and 14 CT studies.

Main Results:

• Seven key imaging features aiding HEC diagnosis were identified in 66.6% of patients.
• The most frequent findings included hydatid sand and focal/segmental cyst wall thickening (29.2% each).
• Other identified features were coexistent cysts in spleen/lungs (16.6%), pericystic biliary dilatation (8.3%), and lobar atrophy/hypertrophy (8.3%).

Conclusions:

• Specific ancillary imaging signs can suggest hepatic echinococcal cysts (HEC) in approximately two-thirds of patients.
• These findings are valuable for diagnosing HEC when serological tests are inconclusive or negative.