Endemic exposure + cystic liver lesion, suspected hydatid disease
Recommended: MRI Abdomen (or CT Abdomen with contrast) is the preferred imaging study for endemic exposure + cystic liver lesion, suspected hydatid disease. Echinococcus granulosus most common; calcified rim, daughter cysts inside mother cyst pathognomonic.
Recommended study
MRI Abdomen (or CT Abdomen with contrast)
Echinococcus granulosus most common; calcified rim, daughter cysts inside mother cyst pathognomonic. Endemic in Mediterranean, Middle East, S. America, central Asia.
If the default doesn't apply
Serologic confirmation
Echinococcus IgG serology
No contrast
Watch-outs
Anaphylaxis from cyst rupture
DO NOT do random percutaneous biopsy of suspicious cysts — risk of anaphylaxis and dissemination. PAIR (puncture-aspirate-inject-reaspirate) by experienced operator.
Pearls
- Gharbi / WHO classification (CE1-CE5) guides management.
- Water lily sign: detached membranes floating within cyst.
- Albendazole + PAIR or surgery for active disease.