title: Comprehensive Evaluation of Cardiac Hydatid Using 256 Slice Dual Source CT: One Stop Shop.
abstract: Hydatid disease results from infection with larval stage of Echinococcus granulosus tapeworm. Dogs and other canines are the definitive hosts; Human beings are common accidental intermediate hosts. Liver is the most common organ to be involved in this condition. Cardiac hydatid, seen in only 0.5 to 2% cases, is a rare entity because of myocardial contractility. Larvae reach the myocardium through coronary circulation. Among various locations of cardiac hydatid, due to its rich coronary arterial supply Left ventricle (LV) myocardium is the most common site of involvement followed by interventricular septum and right ventricle. Rare locations include pericardium, right atrium and left atrium. A 50-year-old woman presented with dyspnoea for 11 months, chest X-ray showed a well defined, homogenous left paracardiac mass, which is not separable from left heart border. Transthoracic echocardiography revealed a complex multicystic mass lesion abutting antero-lateral wall of left ventricle. Contrast enhanced computed tomography showed a well-circumscribed multicystic mass lesion with honeycomb appearance arising from myocardium of anterolateral wall of left ventricle. Indirect haemagglutination test for hydatid disease was positive. At surgery the cyst was seen to arise from LV myocardium. It was incised and grape like contents were evacuated. The cavity was irrigated with scolicidal solution. Thereafter, the cyst was marsupialised. Histopathological examination revealed grape like cyst contents consistent with the diagnosis of hydatid cyst.
authors.affiliation: Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India .
authors.forename: Neeraj
authors.initials: N
authors.lastname: Jain
authors.affiliation: Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India .
authors.forename: Sonali
authors.initials: S
authors.lastname: Sethi
authors.affiliation: Senior Resident, Department of Radiology, G B Pant Hospital , New Delhi, India .
authors.forename: Nishant
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Assistant Professor, Department of Radiology, G B Pant Hospital , New Delhi, India .
authors.forename: Vandana
authors.initials: V
authors.lastname: Goel
authors.affiliation: Head and Director Professor, Department of Radiology, G B Pant Hospital , New Delhi, India .
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Puri
keywords: Cardiac hydatid; Grape like cysts; Multi-detector CT