Diagnosis of Abdominal Hydatid Cyst Disease: The Role of Ultrasound and Ultrasound-Guided Fine Needle Aspiration Cytology

Objective: To retrospectively analyze the role of ultrasound (US) imaging and US-guided fine needle aspiration cytology in the diagnosis and management of abdominal hydatid cyst disease (HCD). Subjects and Methods: The medical records of 55 diagnosed cases of HCD seen between January 1986 and December 2000 at Mubarak Al-Kabeer Hospital and Al-Amiri Hospital in Kuwait were reviewed for demographic and clinical data, including radiology and serology. The US findings of the patients were classified into four types as follows: type I: single or multiple well-defined cysts, with or without detached or collapsed wall and with or without echogenic contents; type II: single or multiple cysts with peripheral cysts, with or without echogenic contents; type III: solid or semisolid lesions, and type IV: cysts with calcified walls. Results: The overall accuracy of US in the diagnosis of HCD was 80% (44/55 cases). US examination was suggestive of HCD type I, 16/19 (84%), type II, 21/23 (91%), type III, 3/8 (38%), and type IV, 4/5 (80%). For the 11 remaining undiagnosed cases, US was useful for localizing the lesions for US-guided fine needle aspiration cytology. It established the diagnosis in all the 11 cases, without precipitating complications. Conclusion: US alone was valuable for diagnosing and localizing HCD in the abdomen except for solid-type lesions. USguided fine needle aspiration cytology was useful in localizing and establishing the diagnosis of HCD in the cases where US alone was ineffective.