Ultrasound wall-sign in pulmonary echinococcosis (new application).
OBJECTIVE
We report our experience in diagnosing pulmonary cystic echinococcosis using an ultrasound sign related to the cystic wall.


METHODS
40 patients with 46 cysts, suspected of pulmonary echinococcosis, based on plain chest radiographs and clinical findings, were examined by ultrasound over a 9-year period (1996 - 2004), and followed up until discharge. We applied our long experience with echinococcal cysts utilising the wall sign (WS) to diagnose pulmonary hydatid disease. All cysts were subject to surgical removal, and postoperative histopathology was the gold standard.


RESULTS
There were 34 (74 %) unilocular and 12 (26 %) multivesicular echinococcal cysts. In the univesicular cysts, the WS was found in 20 cases (66.7 %) while it was present in all multivesicular cysts (100 %). Following surgical removal, echinococcosis was confirmed by histopathology in all cases.


CONCLUSIONS
We conclude that a double layered border in univesicular and double layered internal septum in multivesicular pulmonary echinococcal cysts is a reliable indicator of pulmonary echinococcosis, with a specificity of 66 % and 100 %, respectively.
El Fortia
M
M
Department of Radiology, Misurata Teaching Hospital, Misurata, Libya. elfortia@doctor.com
El Gatit
A
A
Bendaoud
M
M
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004445:Echinococcosis, Pulmonary / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography