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Hepatic hydatid cysts: sonographic follow-up after percutaneous sonographically guided aspiration
H M Salama1, N H Ahmed, N el Deeb
1Tropical Medicine Department, Faculty of Medicine, Cairo University, Kasr El Aini, Egypt.
Purpose:
We studied the sonographic appearances of hepatic hydatid cysts and used sonography to follow up these cysts after sonographically guided aspiration using the PAIR technique.
Methods:
Included in this study were 362 patients with 558 hepatic hydatid cysts. Initial sonographic examination revealed 510 noncomposite cysts and 48 composite cysts (18 rosette and 30 honeycomb pattern). Noncomposite hydatid cysts (510 cysts) were aspirated and treated with scolicidal agents using the PAIR technique. Sonographic follow-up was done for up to 5 years after aspiration.
Results:
There was immediate detachment of the germinal layer in all cysts during aspiration. There were no serious complications. Sonographic follow-up after 1 month and 1 year revealed complete cyst collapse in 326 cysts (64%) and 449 cysts (88%), respectively. Repeat ultrasound scanning showed a continued decrease in the sizes of all remaining cysts. Organized lesions (pseudosolid pattern) were detected in only 26 cases after up to 5 years of follow-up.
Conclusions:
The most common sonographic appearance of hepatic hydatid cysts among Egyptians is noncomposite, anechoic cysts. The PAIR technique is a safe, effective, and inexpensive therapeutic modality.