Imaging of pulmonary hydatid cyst in children

Purpose. We present the various imaging features of pediatric pulmonary hydatidosis based upon a series of 232 cases. The importance of chest radiographs and thoraco-abdominal ultrasound is emphasized. Patients and Methods. A retrospective study of 232 children with pulmonary hydatidosis is presented. The 232 cases (130 boys and 102 girls, age range: 18 months to 14 years) were studied between January 1982 and December 2001. Chest radiographs were available in all cases, chest ultrasound in 156 cases and abdominal ultrasound in 212 cases. CT was only performed in 40 cases. Surgery was performed for all patients. Diagnosis was confirmed with serology tests and/or pathological study of resected cysts. Result. The total number of pulmonary cysts detected on chest radiographs was 344. The right lung was more frequently affected than the left (208 lesions). A simple cyst was the most commonly observed lesion (220 cysts). Complicated forms were noted in 118 cases. 180 cysts were observed at ultrasound. A simple cyst presenting as an anechoic mass was noted in 140 cases. In 38 cases, the lesion was heterogeneous. In two lesions endocystic germinal membranes were detected. CT visualized 50 lesions. Thirty three lesions were complicated with endocystic floating or collapsed membranes. Bronchiectasis was observed in seven cases. Conclusion. Chest radiographs and thoraco-abdominal ultrasound are very useful for the diagnosis of pulmonary hydatidosis and evaluation of lesion extension. CT is useful for diagnosis of atypical or complicated lesions and to detect bronchiectasis.