Cardiac Hydatid Disease: CT and MRI Findings
Memduh Dursun1,
Ege Terzibasioglu1,
Ravza Yilmaz1,
Bledi Cekrezi1,
Seref Olgar2,
Kemal Nisli2 and
Atadan Tunaci1
1 Department of Radiology, Istanbul University, Istanbul Faculty of Medicine,
Millet Caddesi, Capa, Istanbul, 34390 Turkey.
2 Department of Pediatric Cardiology, Istanbul University, Istanbul Faculty of
Medicine, Istanbul, Turkey.

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Fig. 1A —52-year-old woman with hydatid cyst in left ventricular apex. See
also Figure S1C, cine loop, in supplemental data online. Static image from
four-chamber cardiac MRI examination performed with cine true fast imaging
with steady-state precession shows hydatid cyst (arrow) with
hypointense ring-shaped thick wall in left ventricular apex.
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Fig. 1B —52-year-old woman with hydatid cyst in left ventricular apex. See
also Figure S1C, cine loop, in supplemental data online. Static image from
four-chamber cardiac MRI examination performed with cine true fast imaging
with steady-state precession shows left ventricular hydatid cyst
(arrow) and two huge cysts in liver (asterisks).
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Fig. 2A —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. Short-axis HASTE dark-blood MR image (A) and
static image from cine true fast imaging with steady-state precession (FISP)
MRI examination (B) show hydatid cyst (asterisk) originating
from interventricular septum and growing into right ventricular cavity.
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Fig. 2B —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. Short-axis HASTE dark-blood MR image (A) and
static image from cine true fast imaging with steady-state precession (FISP)
MRI examination (B) show hydatid cyst (asterisk) originating
from interventricular septum and growing into right ventricular cavity.
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Fig. 2C —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. Static image from right-sided two-chamber cine true
FISP MRI examination shows multiloculated cyst (arrowhead) in
pericardium and right ventricular cyst (asterisk).
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Fig. 2D —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. HASTE dark-blood MR image 1 month after C,
when patient experienced acute precordial pain, reveals that cyst in right
ventricle had multiple curvilinear areas of low signal intensity indicating
germinative membrane (arrow) and intense pericardial effusion
(arrowheads).
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Fig. 2E —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. Static images from cine true FISP MRI examination
show multiple curvilinear areas of low signal intensity within pericardial
effusion (arrowheads) and pericardial thickening attributable to
pericarditis due to rupture of multiloculated cyst in pericardium.
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Fig. 2F —12-year-old girl with complicated pericarditis due to right
ventricular and pericardial hydatid cysts. See also Figure S2G, cine loop, in
supplemental data online. Static images from cine true FISP MRI examination
show multiple curvilinear areas of low signal intensity within pericardial
effusion (arrowheads) and pericardial thickening attributable to
pericarditis due to rupture of multiloculated cyst in pericardium.
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Fig. 3A —32-year-old man with left ventricular hydatid cyst. Static image
from four-chamber cine true fast imaging with steady-state precession MRI
examination shows subepicardial left ventricular cyst (arrow).
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Fig. 3B —32-year-old man with left ventricular hydatid cyst. Static image
from four-chamber cine true fast imaging with steady-state precession MRI
examination shows subepicardial hydatid cyst (arrow) with large base
(arrowheads) originating from cardiac apex.
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Fig. 4A —82-year-old woman with hepatic hydatid cyst. Heart has been
secondarily affected by cyst. Static image from cine true fast imaging with
steady-state precession coronal MRI examination shows large multiloculated
hydatid cyst (arrow) originating from liver and growing toward right
hemithorax.
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Fig. 4B —82-year-old woman with hepatic hydatid cyst. Heart has been
secondarily affected by cyst. Static images from four-chamber (B) and
short-axis (C) cine true fast imaging with steady-state precession MRI
examinations show marked narrowing of right atrial chamber (asterisk)
due to compression of hydatid cyst. Hydatid cyst (arrow, C) in
liver contains germinative membrane. rv = right ventricle, lv = left
ventricle, la = left atrium.
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Fig. 4C —82-year-old woman with hepatic hydatid cyst. Heart has been
secondarily affected by cyst. Static images from four-chamber (B) and
short-axis (C) cine true fast imaging with steady-state precession MRI
examinations show marked narrowing of right atrial chamber (asterisk)
due to compression of hydatid cyst. Hydatid cyst (arrow, C) in
liver contains germinative membrane. rv = right ventricle, lv = left
ventricle, la = left atrium.
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Fig. 5A —31-year-old woman with hydatid cyst in right pulmonary artery.
Contrast-enhanced CT image obtained with mediastinal window settings shows
small cyst within right pulmonary artery (arrow).
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Fig. 5B —31-year-old woman with hydatid cyst in right pulmonary artery.
Control CT image obtained 7 months after A shows enlargement of lesion
(arrow) within right pulmonary artery. Another cyst is present in
pulmonary trunk (arrowhead).
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Fig. 5C —31-year-old woman with hydatid cyst in right pulmonary artery. CT
scans 6 months after B show bilateral massive right (C) and left
(D) pulmonary artery embolisms (arrow) due to rupture of
pulmonary artery hydatid cysts. Patient had dyspnea and hemoptysis.
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Fig. 5D —31-year-old woman with hydatid cyst in right pulmonary artery. CT
scans 6 months after B show bilateral massive right (C) and left
(D) pulmonary artery embolisms (arrow) due to rupture of
pulmonary artery hydatid cysts. Patient had dyspnea and hemoptysis.
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Fig. 8A —1-year-old woman with esophageal carcinoma and incidentally detected
left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental
data online. Contrast-enhanced CT image obtained to evaluate esophageal
carcinoma (asterisk) shows cystic lesion with small calcification in
inferior wall of left ventricle (arrow).
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Fig. 8B —1-year-old woman with esophageal carcinoma and incidentally detected
left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental
data online. Static short-axis (B) and sagittal (C) images from
cine true fast imaging with steady-state precession MRI examination show
hypointense ring-shaped thick-walled hydatid cyst (arrow) in inferior
wall of left ventricle and esophageal carcinoma (asterisk,
C).
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Fig. 8C —1-year-old woman with esophageal carcinoma and incidentally detected
left ventricular hydatid cyst. See also Figure S8D, cine loop, in supplemental
data online. Static short-axis (B) and sagittal (C) images from
cine true fast imaging with steady-state precession MRI examination show
hypointense ring-shaped thick-walled hydatid cyst (arrow) in inferior
wall of left ventricle and esophageal carcinoma (asterisk,
C).
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Fig. 9A —45-year-old man with left ventricular hydatid cyst. See also Figure
S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo
T1-weighted MR image shows large hypointense intracavitary left ventricular
hydatid cyst (arrowheads).
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Fig. 9B —45-year-old man with left ventricular hydatid cyst. See also Figure
S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo
T2-weighted MR image (B) and static image from cine true fast imaging
with steady-state precession short-axis MRI examination (C) show
hyperintense cyst (arrowheads) that includes multiple daughter
cysts.
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Fig. 9C —45-year-old man with left ventricular hydatid cyst. See also Figure
S9D, cine loop, in supplemental data online. Four-chamber dark-blood spin-echo
T2-weighted MR image (B) and static image from cine true fast imaging
with steady-state precession short-axis MRI examination (C) show
hyperintense cyst (arrowheads) that includes multiple daughter
cysts.
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