Niron E A, Ozer H
Br J Radiol. 1981 Apr;54(640):335-8. doi: 10.1259/0007-1285-54-640-335.
They grey scale ultrasound features of liver hydatid disease have been evaluated on 65 surgically proven cysts in 38 patients. The majority of cysts showed the well-known ultrasound pattern of simple cysts. However, a minority of lesions were either multicystic or gave the appearance of a cyst within a cyst. Occasionally cysts showed a feature which we have called "the ultrasonographic water lily sign". Hydatid sand was also occasionally seen in the most dependent portion of hydatid cysts. We have noted that if a hydatid cyst becomes secondarily infected these typical ultrasound patterns are lost and the ultrasound diagnosis may then become more difficult.