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Cardiac Hydatid Disease: CT and MRI Findings

¹ Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Millet Caddesi, Capa, Istanbul, 34390 Turkey.
² Department of Pediatric Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —52-year-old woman with hydatid cyst in left ventricular apex. See also Figure S1C, cine loop, in supplemental data online. Static image from four-chamber cardiac MRI examination performed with cine true fast imaging with steady-state precession shows hydatid cyst (arrow) with hypointense ring-shaped thick wall in left ventricular apex.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —52-year-old woman with hydatid cyst in left ventricular apex. See also Figure S1C, cine loop, in supplemental data online. Static image from four-chamber cardiac MRI examination performed with cine true fast imaging with steady-state precession shows left ventricular hydatid cyst (arrow) and two huge cysts in liver (asterisks).

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. Short-axis HASTE dark-blood MR image (A) and static image from cine true fast imaging with steady-state precession (FISP) MRI examination (B) show hydatid cyst (asterisk) originating from interventricular septum and growing into right ventricular cavity.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. Short-axis HASTE dark-blood MR image (A) and static image from cine true fast imaging with steady-state precession (FISP) MRI examination (B) show hydatid cyst (asterisk) originating from interventricular septum and growing into right ventricular cavity.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. Static image from right-sided two-chamber cine true FISP MRI examination shows multiloculated cyst (arrowhead) in pericardium and right ventricular cyst (asterisk).

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. HASTE dark-blood MR image 1 month after C, when patient experienced acute precordial pain, reveals that cyst in right ventricle had multiple curvilinear areas of low signal intensity indicating germinative membrane (arrow) and intense pericardial effusion (arrowheads).

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. Static images from cine true FISP MRI examination show multiple curvilinear areas of low signal intensity within pericardial effusion (arrowheads) and pericardial thickening attributable to pericarditis due to rupture of multiloculated cyst in pericardium.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2F —12-year-old girl with complicated pericarditis due to right ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in supplemental data online. Static images from cine true FISP MRI examination show multiple curvilinear areas of low signal intensity within pericardial effusion (arrowheads) and pericardial thickening attributable to pericarditis due to rupture of multiloculated cyst in pericardium.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —32-year-old man with left ventricular hydatid cyst. Static image from four-chamber cine true fast imaging with steady-state precession MRI examination shows subepicardial left ventricular cyst (arrow).

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —32-year-old man with left ventricular hydatid cyst. Static image from four-chamber cine true fast imaging with steady-state precession MRI examination shows subepicardial hydatid cyst (arrow) with large base (arrowheads) originating from cardiac apex.

View larger version (157K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —82-year-old woman with hepatic hydatid cyst. Heart has been secondarily affected by cyst. Static image from cine true fast imaging with steady-state precession coronal MRI examination shows large multiloculated hydatid cyst (arrow) originating from liver and growing toward right hemithorax.

View larger version (144K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —82-year-old woman with hepatic hydatid cyst. Heart has been secondarily affected by cyst. Static images from four-chamber (B) and short-axis (C) cine true fast imaging with steady-state precession MRI examinations show marked narrowing of right atrial chamber (asterisk) due to compression of hydatid cyst. Hydatid cyst (arrow, C) in liver contains germinative membrane. rv = right ventricle, lv = left ventricle, la = left atrium.

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —82-year-old woman with hepatic hydatid cyst. Heart has been secondarily affected by cyst. Static images from four-chamber (B) and short-axis (C) cine true fast imaging with steady-state precession MRI examinations show marked narrowing of right atrial chamber (asterisk) due to compression of hydatid cyst. Hydatid cyst (arrow, C) in liver contains germinative membrane. rv = right ventricle, lv = left ventricle, la = left atrium.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —31-year-old woman with hydatid cyst in right pulmonary artery. Contrast-enhanced CT image obtained with mediastinal window settings shows small cyst within right pulmonary artery (arrow).

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —31-year-old woman with hydatid cyst in right pulmonary artery. Control CT image obtained 7 months after A shows enlargement of lesion (arrow) within right pulmonary artery. Another cyst is present in pulmonary trunk (arrowhead).

View larger version (76K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —31-year-old woman with hydatid cyst in right pulmonary artery. CT scans 6 months after B show bilateral massive right (C) and left (D) pulmonary artery embolisms (arrow) due to rupture of pulmonary artery hydatid cysts. Patient had dyspnea and hemoptysis.

View larger version (73K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —31-year-old woman with hydatid cyst in right pulmonary artery. CT scans 6 months after B show bilateral massive right (C) and left (D) pulmonary artery embolisms (arrow) due to rupture of pulmonary artery hydatid cysts. Patient had dyspnea and hemoptysis.

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —5-year-old girl with pericardial and hepatic hydatid cysts. Contrast-enhanced CT image shows low-attenuation pericardial hydatid cyst (arrow).

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —5-year-old girl with pericardial and hepatic hydatid cysts. Contrast-enhanced CT image shows three hydatid lesions in liver.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —47-year-old woman with multiple pericardial hydatid cysts. Contrast-enhanced CT images show three low-attenuation pericardial hydatid cysts (arrows).

View larger version (97K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —47-year-old woman with multiple pericardial hydatid cysts. Contrast-enhanced CT images show three low-attenuation pericardial hydatid cysts (arrows).

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —47-year-old woman with multiple pericardial hydatid cysts. Contrast-enhanced CT images 3 years after A and B show three different pericardial hydatid cysts (arrows).

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7D —47-year-old woman with multiple pericardial hydatid cysts. Contrast-enhanced CT images 3 years after A and B show three different pericardial hydatid cysts (arrows).

View larger version (95K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —1-year-old woman with esophageal carcinoma and incidentally detected left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental data online. Contrast-enhanced CT image obtained to evaluate esophageal carcinoma (asterisk) shows cystic lesion with small calcification in inferior wall of left ventricle (arrow).

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —1-year-old woman with esophageal carcinoma and incidentally detected left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental data online. Static short-axis (B) and sagittal (C) images from cine true fast imaging with steady-state precession MRI examination show hypointense ring-shaped thick-walled hydatid cyst (arrow) in inferior wall of left ventricle and esophageal carcinoma (asterisk, C).

View larger version (92K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8C —1-year-old woman with esophageal carcinoma and incidentally detected left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental data online. Static short-axis (B) and sagittal (C) images from cine true fast imaging with steady-state precession MRI examination show hypointense ring-shaped thick-walled hydatid cyst (arrow) in inferior wall of left ventricle and esophageal carcinoma (asterisk, C).

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —45-year-old man with left ventricular hydatid cyst. See also Figure S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo T1-weighted MR image shows large hypointense intracavitary left ventricular hydatid cyst (arrowheads).

View larger version (123K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —45-year-old man with left ventricular hydatid cyst. See also Figure S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo T2-weighted MR image (B) and static image from cine true fast imaging with steady-state precession short-axis MRI examination (C) show hyperintense cyst (arrowheads) that includes multiple daughter cysts.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9C —45-year-old man with left ventricular hydatid cyst. See also Figure S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo T2-weighted MR image (B) and static image from cine true fast imaging with steady-state precession short-axis MRI examination (C) show hyperintense cyst (arrowheads) that includes multiple daughter cysts.

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