CT AND MRI FINDINGS OF CARDIAC ECHINOCOCCOSIS

Fifteen patients (8 males and 7 females, 15-56 years old) with primary or secondary hydatid disease involving the heart were examined by radiography, CT and/or MRI. MRI was done with a 1.5 T machine (Picker) in 11 cases and a 0.5 T machine (Philips) in 4 cases using ECG-gated T1- and T2-weighted spin-echo pulse sequences. Transaxial sections were combined with at least one more plane (coronal and/or sagittal) and intermediate views if the need for further information was anticipated. In 4 patients primary cardiac echinococcal cysts were found, localised to the left ventricle/pericardium/interventricular septum in 2 cases and to the left atrium/pericardium and right atrium/pericardium in 1 case each. In 11 of 15 cases there was secondary involvement of the heart by echinococcal cysts primarily arising in the lung parenchyma (n = 6), mediastinum (n = 3) and by transdiaphragmatic extension from the liver and abdomen (n = 2). CT was superior to MRI in visualising calcifications. However, ECG-gated MRI of cardiac hydatid disease appears to be the method of choice for specific diagnosis and exact assessment of hydatid cysts and their correlation with cardiac structures.