Magnetic resonance imaging as an adjunct to computed tomography in the diagnosis of pulmonary Hydatid cysts

Abstract

Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentiating it from its mimics. The aim of this study is to assess the findings of pulmonary hydatid cysts on CT and MRI and the additional contribution of MRI in doubtful cases. Materials and Methods: This is a retrospective study of 90 patients with suspected hydatid cysts. CT and MRI findings were noted and role of MRI in diagnosing hydatid cysts and its mimics was studied. Descriptive statistics for CT findings and sensitivity and specificity of MRI were calculated using surgery or histopathology as gold standard. Results: Of the 90 patients with suspected pulmonary hydatid cysts, there were 52 true-positive and 7 false-positive cases on CT. Commonest CT finding was unilocular thick-walled cyst. In the 26 patients who had additional MRI, based on T2-weighted hypointense rim or folded membranes, accurate preoperative differentiation of 14 patients with hydatid cysts from 10 patients with alternate diagnosis was possible. There was one false-positive and one false-negative case on MRI. Conclusion: Although hydatid cyst can be diagnosed on CT on most occasions, sometimes there are challenges with certain mimics and atypical appearances. T2-weighted MRI can act as a problem solving tool to conclusively diagnose hydatid cyst or suggest an alternate diagnosis.

Keywords

Computed tomography - hydatid - magnetic resonance imaging - pulmonary

Publikationsverlauf

Artikel online veröffentlicht:
26. Juli 2021

• References

• 1 Singh N, Srinivas R, Bal A, Aggarwal AN. Lung carcinoma mimicking hydatid cyst: A case report and review of the literature. Med Oncol 2009; 26: 424-8
• 2 Kilinç O, Döskaya M, Sakar A, Yorgancioğlu A, Halilçolar H, Caner A. et al. Three atypical pulmonary hydatidosis lesions mimicking bronchial cancer from Turkey. New Microbiol 2009; 32: 229-33
• 3 Kabiri el H, Al Bouzidi A, Kabiri M. Askin tumor mimicking a hydatid cyst of the lung in children: Case report. Pan Afr Med J 2014; 17: 131
• 4 Manson-Bahr PE, Apted FI. Manson's Tropical Diseases. London: Bailiere Tindall 1982; p: 245-7
• 5 Beggs I. The radiology of hydatid disease. AJR Am J Roentgenol 1985; 145: 639-48
• 6 Gottstein B, Reichen J. Hydatid lung disease (echinococcosis/hydatidosis). Clin Chest Med 2002; 23: 397-408
• 7 Haliloglu M, Saatci I, Akhan O, Ozmen MN, Besim A. Spectrum of imaging findings in pediatric hydatid disease. AJR Am J Roentgenol 1997; 169: 1627-31
• 8 Solak H, Yeniterzi M, Yüksek T, Anil N, Göktoğan T, Ceran S. et al. The hydatid cyst of the lung in children and results of surgical treatment. Thorac Cardiovasc Surg 1990; 38: 45-7
• 9 Akgul Ozmen C, Onat S. Computed tomography (CT) findings of pulmonary hydatid cysts in children and the factors related to cyst rupture. Med Sci Monit 2017; 23: 3679-86
• 10 Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease: Radiologic and pathologic features and complications. Radiographics 2000; 20: 795-817
• 11 Jerray M, Benzarti M, Garrouche A, Klabi N, Hayouni A. Hydatid disease of the lungs. Study of 386 cases. Am Rev Respir Dis 1992; 146: 185-9
• 12 Kervancioglu R, Bayram M, Elbeyli L. CT findings in pulmonary hydatid disease. Acta Radiol 1999; 40: 510-4
• 13 Zhang Q, Huang TM, Li BZ, Li ZL, Liao KX. Misdiagnosis of pulmonary hydatid cyst rupture: Report of 38 cases. Zhonghua Jie He He Hu Xi Za Zhi 2003; 26: 474-6
• 14 Sinner WN.Von. Radiographic, CT and MRI spectrum of hydatid disease of the chest: A pictorial essay. Eur Radiol 1993; 3: 62-70
• 15 Kayhan S, Sahin U, Turut H, Yurdakul C. An unusual radiological presentation of a pulmonary hydatid cyst in a child. J Clin Imaging Sci 2013; 3: 20
• 16 Poyrazoglu H, Tor F, Avsar MK, Bayraktar I, Ulus T. An unusual approach to a ruptured hydatid cyst case which had been treated with a wrong diagnosis. Indian J Thorac Cardiovasc Surg 2008; 24: 22-3
• 17 Singh S, Gibikote SV. Magnetic resonance imaging signal characteristics in hydatid cysts. Australas Radiol 2001; 45: 128-33
• 18 Kalovidouris A, Gouliamos A, Vlachos L, Papadopoulos A, Voros D, Pentea S. et al. MRI of abdominal hydatid disease. Abdom Imaging 1994; 19: 489-94
• 19 Marani SA, Canossi GC, Nicoli FA, Alberti GP, Monni SG, Casolo PM. et al. Hydatid disease: MR imaging study. Radiology 1990; 175: 701-6
• 20 von Sinner WN, Rifai A, te Strake L, Sieck J. Magnetic resonance imaging of thoracic hydatid disease. Correlation with clinical findings, radiography, ultrasonography, CT and pathology. Acta Radiol 1990; 31: 59-62
• 21 Inan N, Arslan A, Akansel G, Anik Y, Sarisoy HT, Ciftci E. et al. Diffusion-weighted imaging in the differential diagnosis of simple and hydatid cysts of the liver. AJR Am J Roentgenol 2007; 189: 1031-6
• 22 Oruç E, Yıldırım N, Topal NB, Kılıçturgay S, Akgöz S, Savcı G. et al The role of diffusion-weighted MRI in the classification of liver hydatid cysts and differentiation of simple cysts and abscesses from hydatid cysts. Diagn Interv Radiol 2010; 16: 279-87
• 23 Jayakumar PN, Srikanth SG, Chandrashekar HS, Kovoor JM, Shankar SK, Anandh B. et al. Pyruvate: An in vivo marker of cestodal infestation of the human brain on proton MR spectroscopy. J Magn Reson Imaging 2003; 18: 675-80
• 24 García-Díez AI, Ros Mendoza LH, Villacampa VM, Cózar M, Fuertes MI. MRI evaluation of soft tissue hydatid disease. Eur Radiol 2000; 10: 462-6