[Cerebral hydatid disease: imaging features]

Area of Science:

• Neurology
• Radiology
• Infectious Diseases

Background:

• Cerebral hydatid cysts (HC) are uncommon intracranial space-occupying lesions, even in endemic regions.
• Diagnosis typically relies on characteristic computed tomography (CT) findings.

Purpose of the Study:

• To evaluate the diagnostic value of magnetic resonance imaging (MRI) compared to CT for cerebral hydatid disease.
• To assess MRI's utility in characterizing atypical or complicated HC and aiding surgical planning.

Main Methods:

• Retrospective review of CT scans (n=25) and MRI scans (n=4, including diffusion and spectroscopy in one) from 25 patients with pathologically confirmed cerebral hydatid disease.
• Analysis of lesion characteristics, including location, size, number, and appearance on imaging.

Main Results:

• Most HC were supratentorial, solitary, unilocular, and appeared as well-defined cystic lesions with significant mass effect.
• CT diagnosed HC in most cases (22/25), but MRI provided more precise details on cyst capsule, signal characteristics, and enhancement patterns.
• Complicated or infected cysts showed surrounding edema and rim enhancement, which were better delineated by MRI.

Conclusions:

• While CT is effective for diagnosing typical cerebral hydatid disease, MRI, especially with advanced sequences like diffusion and spectroscopy, is more valuable for characterizing complex or atypical cysts.
• MRI enhances the understanding of cyst details, aiding in accurate diagnosis and improving surgical planning for cerebral hydatid disease.