4. OVERVIEW
LAYERS:
Hydatid Cyst has three layers:
The outer layer (pericyst):
• The host tissue reaction.
• Form a rigid protective layer a few millimeters thick.
5. OVERVIEW
LAYERS:
The middle laminated membrane:
• Resembles the white (albumen) of a hard-boiled egg
and is easily ruptured.
• This membrane is acellular and is about 2 mm thick.
• It permits the passage of nutrients but is impervious to
bacteria.
• Disruption of the laminated membrane predisposes to
infection.
6. OVERVIEW
LAYERS:
The inner germinal (or germinative) layer:
Thin and translucent.
Scolices, the infectious embryonic tapeworms, develop
from an outpouching of this layer So known as the
brood capsule.
The thickness of these layers depends on the tissue in
which the cyst is located.
thick in the liver,
less developed in muscle,
absent in bone,
Sometimes visible in the brain.
7. 4 Types:
Type I: Simple cyst with no internal architecture:
• Appear as a well-defined anechoic mass with or without hydatid sand
and septa. Unilocular cysts are considered to be an initial stage in the
development of the parasite.
• Rolling the patient during evaluation disperses the sand, creating small
echogenic foci, or “falling snowflakes”.
Radiological Findings:
8. Type II: Cyst with Daughter Cyst(s) and Matrix
• Daughter cysts are seen inside the mother cyst. Floating membranes or
vesicles can also be seen in the cyst.
Radiological Findings:
9. Type II: Cyst with Daughter Cyst(s) and Matrix
• Daughter cysts are seen inside the mother cyst. Floating membranes or
vesicles can also be seen in the cyst.
Radiological Findings:
10. Type III: Calcified Cyst
• Dead cysts with total calcification.
Radiological Findings:
11. Type IV: Complicated HC
• HC complications include rupture and superinfection.
Radiological Findings:
12. Type IV: Complicated HC
• HC complications include rupture and superinfection.
Radiological Findings:
13. • Previously surgical operation was the only
accepted treatment for hydatid liver cysts.
• Recently percutaneous management has
become more preferable because of its low
morbidity rate and lower cost.
Treatment Options:
14. • According to Gharbi's classification;
• Type 1 cyst (pure fluid collection) and
• Type 2 cyst (fluid collection with a split wall)
Are better benefit from PAIR techniques.
• Whereas type 3 cysts (fluid collection with
daughter cysts) and type 4 cysts
(heterogeneous echo pattern) do benefit to a
lesser extend.
Treatment Options:
15. • To prevent a possible leak, a path through
the liver parenchyma is preferred for the
puncture of the cyst.
• Albendazole may be injected intracystically
as it sterilizes the cyst cavity and affects
scolices as well.
Treatment Options:
16. • After percutaneous drainage, patients receive
albendazole.
• Follow up preferred by ULTRASOUND
monthly in the first year then every 6 months
later on.
Treatment Options:
