• T2 hypointense rim is characteristic finding in hydatid disease
    • Due to fibrous pericyst
  • Imaging appearance progresses through stages
    1. Simple unilocular cyst (type I)
    2. Multilocular cyst with internal duaghter cysts (type II)
    3. Wall calcification
    4. Complete wall calcification at the end of the cycle (type III)
  • Cyst complication with rupture and/or infection is type IV
    1. Contained - floating membranes
    2. Communicating - contents pass into biliary radicles incorporated into pericyst
    3. Direct - endocyst and pericyst spillage into peritoneal cavity
  • Ddx of uncomplicated hydatid cysts includes:
    • simple hepatic (bile duct) cysts
    • biliary cystadenoma
    • biliary hamartomas are generally smaller, although similar in appearance
  • Ddx of complicated cyst includes:
    • Pyogenic abscesses
    • biliary cystadenoma/cystadenocarcinoma
    • cystic metastases