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Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study

Departments of ¹ Nuclear Medicine, ² Surgery and ³ Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

View larger version (139K): [in a new window]   Figure 1. Contrast enhanced CT of the abdomen. A cystic lesion with enhancing walls is seen in the right lobe of the liver (arrow). An oval subcapsular fluid collection with enhancing walls is also seen in the vicinity. Intrahepatic biliary radicles are dilated.

View larger version (129K): [in a new window]   Figure 2. Magnetic resonance cholangiopancreatography. The cystic lesion in the right lobe of the liver is seen communicating with biliary radicles. Collapsed wall of the cyst is seen as multiple linear filling defects.

View larger version (148K): [in a new window]   Figure 3. Coronal T2 weighted MRI shows membrane in the gall bladder, seen as hypointense linear filling defects (arrows).

View larger version (71K): [in a new window]   Figure 4. 99Tcm-mebrofenin hepatobiliary study. (a) An early image (15 min) showing two photopenic areas in the right lobe of the liver (arrow). (b) The same area shows increased uptake on delayed imaging (120 min), suggesting biliary communication (arrow).