Efficiency of diffusion-weighted MRI for differentiating radiologically similar simple and type I hydatid cysts of the liver

Abstract

Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.

Hydatid Disease: A Radiological Pictorial Review of a Great Neoplasms Mimicker

“…The typical appearance of a cystic part is a low signal intensity on T1Wis, a markedly high signal on T2Wis, and a low signal intensity rim on T2WIs, which represents the collagen-rich pericyst layer, and is a characteristic sign of hydatid cysts [ 20 ]. An MRI is superior for demonstrating cyst wall defects, biliary communication, and differentiating hydatid cysts from simple cysts using diffusion-weighted sequences [ 20 , 21 ].…”

Echinococcoses – A Primer for Radiologists

“…Der ADC-Wert von inaktiven Zysten ist kleiner als der von aktiven Zysten [23]. Eine Differenzierung von WHO-CE1 Zysten und blanden dysontogenetischen Leberzysten dürfte mit der DWI nicht möglich sein [24].…”

“…The ADC value of inactive cysts is smaller than that of active cysts 23 . A differentiation between WHO-CE1 cysts and simple dysontogenetic liver cysts is not possible with DWI 24 .…”

Cystic liver lesions: from diagnosis to recognition of complications and when to treat

“…This CPG specifically point out most appropriate imaging techniques and modalities in diagnosing cystic liver lesions with some potential for differentiation between simple and complex cysts ( 1 ). Ultrasound (US) has been described as gold standard for initial diagnosis of cystic liver lesion, however incidental findings on both US and computerized tomography (CT) scan also occur ( 3 ). Homogenous and hypoattenuating lesions are often described and the size of the lesion is important in regard to liver volume.…”

“…Location is also important. When cysts grow, compression can occur leading to complications including cholestasis, portal hypertension or Budd-Chiari syndrome ( 3 ). Follow up of lesions is only indicated if there are complications or symptoms ( 1 ).…”