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Clinical Investigations: TECHNIQUES |

CT in Pulmonary Hydatid Disease*: Unusual Appearances

Parvaiz A. Koul, MD; Ajaz N. Koul, MD; A. Wahid, MD; Farhad A. Mir, MD
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*From the Departments of Internal Medicine (Drs. P. Koul, A. Koul, and Wahid) and Radiodiagnosis (Dr. Mir), SheriKashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

Correspondence to Parvaiz A. Koul, MD, Department of Internal Medicine, SheriKashmir Institute of Medical Sciences, Soura, Post Bag 27, Srinagar 190 011, Kashmir, India; e-mail: parvaizk@hotmail.com



Chest. 2000;118(6):1645-1647. doi:10.1378/chest.118.6.1645
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Objective: To study the CT features of pulmonary hydatid disease.

Patients: Thirty-two consecutive patients with surgically proven pulmonary hydatid cysts.

Setting: SheriKashmir Institute of Medical Sciences, Srinagar, Kashmir, India, a tertiary-care referral center.

Interventions: CT of the chest was obtained in all cases on Somatom DR double rotate CT scanner (Siemens; Erlangen, Germany).

Results: Forty cysts of different size and shapes were encountered, 34 of them being ruptured. CT density of the cysts varied from − 42 to 160 Hounsfield units (HU; median, 15.5 HU). Apart from the classically described features of pulmonary hydatid disease, a crescent-shaped rim of air at the lower end of the cyst (inverse crescent sign) was seen in three cysts, and a bleb of air in the wall of two as-yet unruptured cysts (signet ring sign). Thick wall (>10 mm) was observed in four cysts, and each of them had associated evidence of infection.

Conclusions: Inverse crescent sign, signet ring sign, high CT density, and thick wall should be recognized as features of pulmonary hydatid cysts on CT.

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