Correlation Analysis Between CT Images And Clinical Pathology Of Hepatic Hydatid Cyst

Objective: To investigate the correlation between CT images and the clinical pathologicalchanges of Hepatic hydatid cyst and to understand the natural history by CT images.Methods:558cases with691hepatic hydatid cysts which had been confirmed by CTdiagnosis and pathology were collected. The CT appearances and intra-operative findingswere analyzed retrospectively.Results:1The variability of the CT value of the different types of mother cyst and daughtercyst was statistically significant (P<0.001). The the CT value of mother cyst was increasedfrom type CL to type CE5.2The variability of the CT value of four kinds of cystic content (liquid, jelly-like, solidationand calcification) was statistically significant (P<0.001).3330hydatid cysts with biliary fistula in294cases were confirmed by surgery. Thevariability had no statistical significance between type CL and type CE1, type CE3and typeCE4, type CE4and type CE5(P>0.05). The incidence of biliary fistula was increased alongwith the growth and degeneration of hydatid cyst.4According to CT characteristic findings in the cases with biliary fistula,36cases withdilated bile duct,67cysts with “crescent-like” apophysis,25cysts with calculus,29cysts with“concentric circles sign”,24cysts with gas-fluid level,42cysts with daughter cyst eccentricarrangement. The incidence of five kinds of CT characteristic findings above was12.24%,20.30%,7.58%,8.79%,7.27%,12.72%respectively.5Intrahepatic rupture:158cysts, the incidence of22.9%. CT showed by “gourd-like” lesions,the prominent cystic wall was thinner than original one. Extrahepatic rupture:92cysts, theincidence of13.3%. CT showed the extrahepatic part, in which can be seen “cord-like” highdensity, has a irregularly shaped with thicker cystic wall.6According to CT characteristic findings in267cysts, which indicated by “liver capsuleannular depressed”, of454cysts which with an exophytic component or adjacent liver edge.The variability of the CT characteristic images of the different types was statisticallysignificant (P<0.001). The variability had no statistical significance between type CL and typeCE1, type CE1and type CE2, type CE4and type CE5,(P>0.003125）. The incidence of “livercapsule annular depressed” was increased along with the growth and degeneration of hydatidcyst.7The variability of the mean diameter of two kinds of HHCs without daughter cysts and withdaughter cysts of the different types was statistically significant respectively (P<0.001). Thesize of hydatid cyst was decreased along with the growth and degeneration of hydatid cyst.Shrinking trend of HHCs without daughter cysts was greater than ones with daughter cysts. 8273cysts had calcification in varying degrees, and the calcification rate was38.4%. Thevariability of the calcification rate of only cyst wall or content of two kinds of HHCs withoutdaughter cysts and with daughter cysts were statistically significant respectively (P<0.001).The variability of the calcification rate of cyst wall and content was no significant (P>0.05).9According to the degree and the trend of degeneration they could be divided into four stages:pre-degeneration, concentration, consolidation and calcification.Conclusion: the CT images had an important role in reflecting the cystic content, shrinkand the calcification trend in natural history of Hepatic hydatid cyst. And it’s useful fordetermine biliary fistula and rupture of hydatid cyst. According to CT characteristic findings,growth state of hydatid cyst could be acknowledged.