Hepatic hydatid disease - extension into the biliary tree and portal vein
Presentation
Right upper quadrant pain with jaundice.
Patient Data
MRI Liver
Atrophied right hepatic lobe mainly the posterior segments (V and VI) with numerous hydatid cysts of various size and stage. The largest cysts are located in the segments IV/V and VII with an empty cyst sign/serpent sign and segment VIII with a honeycomb pattern. The cyst located in the segment VIII shows peripheral enhancement with direct communication with dilated intrabiliary ducts at two levels as well as with the anterior branch of the right portal vein (well-visualized on post-contrast sequences) which are dilated, containing a cystic material. Also, the similar cystic material is noted within a dilated CBD with thick enhanced wall indicating most likely cholangitis. Note also a reactive cholecystitis and periportal lymph nodes.
Case Discussion
MRI features consistent with numerous hepatic hydatid cysts with invasion/extension of the biliary tree and right portal vein.
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