Polat Pinar, Kantarci Mecit, Alper Fatih, Suma Selami, Koruyucu Melike Bedel, Okur Adnan
Department of Radiology, Faculty of Medicine, Atatürk University, Armagan Apt 4/7, Erzurum, Turkey.
Radiographics. 2003 Mar-Apr;23(2):475-94; quiz 536-7. doi: 10.1148/rg.232025704.
Hydatid disease (HD) is a unique parasitic disease that is endemic in many parts of the world. HD can occur almost anywhere in the body and demonstrates a variety of imaging features that vary according to growth stage, associated complications, and affected tissue. Radiologic findings range from purely cystic lesions to a completely solid appearance. Calcification is more common in HD of the liver, spleen, and kidney. HD can become quite large in compressible organs. Hydatid cysts (HCs) can be solitary or multiple. Chest radiography, ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, and even urography can depict HCs. The imaging method used depends on the involved organ and the growth stage of the cyst. US most clearly demonstrates the hydatid sands in purely cystic lesions, as well as floating membranes, daughter cysts, and vesicles. CT is best for detecting calcification and revealing the internal cystic structure posterior to calcification. MR imaging is especially helpful in detecting HCs of the central nervous system. Radiologic and serologic findings can generally help establish the diagnosis of HD, but an HC in an unusual location with atypical imaging findings may complicate the differential diagnosis. Nevertheless, familiarity with imaging findings, especially in patients living in endemic regions, is advantageous in this context.
包虫病(HD)是一种独特的寄生虫病,在世界许多地区呈地方性流行。HD几乎可发生于身体的任何部位,并表现出多种影像学特征,这些特征会因生长阶段、相关并发症及受累组织的不同而有所变化。影像学表现从单纯的囊性病变到完全实性外观不等。钙化在肝、脾和肾的包虫病中更为常见。在可压缩器官中,包虫囊肿(HCs)可长得相当大。HCs可为单发或多发。胸部X线摄影、超声检查(US)、计算机断层扫描(CT)、磁共振成像(MR),甚至尿路造影都可显示HCs。所采用的成像方法取决于受累器官及囊肿的生长阶段。US最能清晰显示单纯囊性病变中的包虫砂,以及漂浮的膜、子囊和小泡。CT最适合检测钙化并显示钙化后方的内部囊性结构。MR成像对检测中枢神经系统的HCs特别有帮助。影像学和血清学检查结果通常有助于确立HD的诊断,但位于不寻常部位且具有非典型影像学表现的HC可能会使鉴别诊断复杂化。然而,熟悉影像学表现,尤其是对生活在流行地区的患者而言,在这种情况下是有益的。