Zidi A, Ben Miled-Mrad K, Hantous-Zannad S, Fathallah B, Mestiri I, Baccouche I, Djilani H
Service d'Imagerie Médicale, Hôpital Abderrahmane Mami, Ariana - 2080 - Tunisie.
J Radiol. 2007 Jan;88(1 Pt 1):59-64. doi: 10.1016/s0221-0363(07)89790-3.
To describe the CT findings of ruptured pulmonary hydatid cyst (HC) and to establish a progressive CT staging.
CT scans of 41 patients with pulmonary hydatid cyst complicated by rupture in the bronchi were retrospectively reviewed. We also reviewed the findings in the literature on the rupture of pulmonary hydatid cysts and the Lewall and McCorkell classification and proposed a more detailed staging related to the progression of HC. The Lewall and McCorkell communicating rupture is manifested by a tear of the endocyst with a discharge of the cyst's contents via the bronchioles that were incorporated in the pericyst: -Stage I: signet ring sign; -State II: crescent sign and inverse crescent sign; -Stage III: air bubble sign and honeycomb; Stage IV: air-water level, double arch sin, water lily sign, serpiginous aspect, regular air-water level; -Stage V: dry cyst sign, ball of wool aspect, small bell image, pseudotumoral aspect; -Stage VI: sequela image, residual cavity, and cicatricial image.
Seventy-three complicated pulmonary hydatid cysts were included in the analysis and were distributed as follows: stage I (16%), stage II (12.7%), stage III (42.8%), stage IV, double arch sign (2.7%), water lily sign (10%), serpiginous aspect (8.2%), regular air-water level (5.4%), stage V, ball of wool aspect (6.8%), small bell image (15%), pseudotumoral aspect (4%), stage VI, residual cavity (4%) and cicatricial image (2.7%).
Our staging offers more details than the Lewall and McCorkell general classification. Moreover, this staging takes into consideration both the natural evolution of the HC and the particularities of the pulmonary location.
描述破裂性肺包虫囊肿（HC）的CT表现，并建立一个渐进性CT分期。
回顾性分析41例合并支气管破裂的肺包虫囊肿患者的CT扫描结果。我们还回顾了有关肺包虫囊肿破裂的文献以及Lewall和McCorkell分类，并提出了一个与HC进展相关的更详细的分期。Lewall和McCorkell交通性破裂表现为内囊撕裂，囊肿内容物经并入包囊周围的细支气管排出：- Ⅰ期：印戒征；- Ⅱ期：新月征和反新月征；- Ⅲ期：气泡征和蜂窝征；Ⅳ期：气液平面、双弓征、睡莲征、匐行征、规则气液平面；- Ⅴ期：干囊肿征、羊毛球征、小钟形影像、假肿瘤样表现；- Ⅵ期：后遗症影像、残留空洞和瘢痕影像。
73个合并症的肺包虫囊肿纳入分析，分布如下：Ⅰ期（16%），Ⅱ期（12.7%），Ⅲ期（42.8%），Ⅳ期，双弓征（2.7%），睡莲征（10%），匐行征（8.2%），规则气液平面（5.4%），Ⅴ期，羊毛球征（6.8%），小钟形影像（15%），假肿瘤样表现（4%），Ⅵ期，残留空洞（4%）和瘢痕影像（2.7%）。
我们的分期比Lewall和McCorkell的一般分类提供了更多细节。此外，该分期同时考虑了HC的自然演变和肺部位置的特殊性。
