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Percutaneous Treatment of Liver Hydatid Cysts: Comparison of Direct Injection of Albendazole and Hypertonic Saline Solution

Yahya Paksoy¹, Kemal Ödev¹, Mustafa ahin², Ahmet Arslan³ and Osman Koç¹

¹ Department of Radiology, Selcuk University, Meram School of Medicine, Konya, Turkey.
² Department of General Surgery, Selcuk University, Meram School of Medicine, Konya, Turkey.
³ Department of Medical Biology and Genetics, Gaziantep University, School of Medicine, Gaziantep, Turkey.

View larger version (88K): [in a new window]   Fig. 1A —50-year-old woman with hydatid cyst. This patient was in group 2. Sonogram shows liver cyst with pure fluid collection during instillation of scolicidal solution. Needle tip is seen in cystic lesion.

View larger version (95K): [in a new window]   Fig. 1B —50-year-old woman with hydatid cyst. This patient was in group 2. One month after percutaneous treatment, sonogram shows that endocyst is collapsed and no longer appears anechoic.

View larger version (91K): [in a new window]   Fig. 1C —50-year-old woman with hydatid cyst. This patient was in group 2. At end of study, sonogram shows that cystic cavity is obliterated by folded endocyst (pseudotumor appearance). Cyst size is also decreased.

View larger version (93K): [in a new window]   Fig. 2A —Serial sonograms of liver hydatid cyst in 45-year-old woman in group 1. Before percutaneous treatment.

View larger version (109K): [in a new window]   Fig. 2B —Serial sonograms of liver hydatid cyst in 45-year-old woman in group 1. One year after percutaneous treatment, sonogram shows that cyst cavity is obliterated by folded endocyst.

View larger version (107K): [in a new window]   Fig. 2C —Serial sonograms of liver hydatid cyst in 45-year-old woman in group 1. Three years after percutaneous treatment, cyst cavity is almost obliterated and decreased. Fluid content has totally disappeared, and solid, heterogeneous pseudotumor appearance representing degenerated endocyst is seen. Thickening and irregularities are observed in cyst wall during follow-up period.

View larger version (97K): [in a new window]   Fig. 3A —54-year-old woman in group 2 with hydatid cysts. CT scan shows pure cystic liver hydatid cysts before treatment.

View larger version (117K): [in a new window]   Fig. 3B —54-year-old woman in group 2 with hydatid cysts. After treatment, CT scan shows increased cavity density.

View larger version (111K): [in a new window]   Fig. 4 —28-year-old woman in group 1 with hydatid cysts. Daughter cyst (solid arrows) of approximately 2 cm in diameter is seen in treated cyst pouch (open arrows) at end of 12th month. Oral albendazole treatment was started and daughter cyst disappeared at end of second month of treatment (not shown).

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