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Diffusion-Weighted Imaging in the Differential Diagnosis of Simple and Hydatid Cysts of the Liver

Nagihan Inan1, Arzu Arslan, Gur Akansel, Yonca Anik, H. Tahsin Sarisoy, Ercument Ciftci and Ali Demirci

1 All authors: Department of Radiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey.


Figure 1
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  		Fig. 1A —49-year-old woman with completely liquid type of hydatid cyst in liver. Her hemagglutinin inhibition test was positive. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in right lobe of liver.

 

Figure 2
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  		Fig. 1B —49-year-old woman with completely liquid type of hydatid cyst in liver. Her hemagglutinin inhibition test was positive. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in right lobe of liver.

 

Figure 3
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  		Fig. 1C —49-year-old woman with completely liquid type of hydatid cyst in liver. Her hemagglutinin inhibition test was positive. Cyst (arrow) shows higher signal intensity than liver on diffusion-weighted image (b = 1,000 s/mm2).

 

Figure 4
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  		Fig. 1D —49-year-old woman with completely liquid type of hydatid cyst in liver. Her hemagglutinin inhibition test was positive. Apparent diffusion coefficient (ADC) map shows cyst-to-liver ADC ratio is 1.8.

 

Figure 5
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  		Fig. 2A —5-year-old boy with simple cyst in liver. Cyst was unchanged during 12 months of follow-up. Completely anechoic cyst is seen on transverse right subcostal sonogram.

 

Figure 6
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  		Fig. 2B —5-year-old boy with simple cyst in liver. Cyst was unchanged during 12 months of follow-up. Axial T2-weighted turbo spin-echo MR image shows cyst in right lobe of liver.

 

Figure 7
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  		Fig. 2C —5-year-old boy with simple cyst in liver. Cyst was unchanged during 12 months of follow-up. Cyst is isointense to liver on this diffusion-weighted image (b factor, 1,000 s/mm2).

 

Figure 8
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  		Fig. 2D —5-year-old boy with simple cyst in liver. Cyst was unchanged during 12 months of follow-up. Apparent diffusion coefficient (ADC) map shows cyst-to-liver apparent diffusion coefficient ratio is 2.4.

 

Figure 9
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  		Fig. 3A —15-year-old boy with cystic echinococcosis type 3 (cyst with floating membrane) hydatid cyst of liver. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cystic echinococcosis type 3 hydatid cyst in left lobe of liver.

 

Figure 10
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  		Fig. 3B —15-year-old boy with cystic echinococcosis type 3 (cyst with floating membrane) hydatid cyst of liver. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cystic echinococcosis type 3 hydatid cyst in left lobe of liver.

 

Figure 11
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  		Fig. 3C —15-year-old boy with cystic echinococcosis type 3 (cyst with floating membrane) hydatid cyst of liver. Cyst is isointense to liver on diffusion-weighted image (b = 1,000 s/mm2).

 

Figure 12
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  		Fig. 4A —Scattergram distribution of cyst-to-liver signal intensity ratios. Scattergrams of hydatid ({blacksquare}) and simple ({square}) cysts (A) and completely liquid hydatid ({blacksquare}) and simple ({square}) cysts (B) on diffusion-weighted images (b = 1,000 s/mm2) show distribution of signal intensity ratios relative to cutoff values.

 

Figure 13
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  		Fig. 4B —Scattergram distribution of cyst-to-liver signal intensity ratios. Scattergrams of hydatid ({blacksquare}) and simple ({square}) cysts (A) and completely liquid hydatid ({blacksquare}) and simple ({square}) cysts (B) on diffusion-weighted images (b = 1,000 s/mm2) show distribution of signal intensity ratios relative to cutoff values.

 

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