RENAL HYDATID CYSTS AND THE EVALUATION OF THEIR RADIOLOGIC IMAGES

Objective: We present our experiences with the various sonographic and CT findings observed in patients with hydatid disease involving the k idney. The imaging characteristics of various echinococcal cysts were evaluated comparatively to offer a diagnostically better explanation f or the radiologic images and to assist the urologist in defining the n ature of the cyst and its content preoperatively. Renal involvement is extremely rare in patients with hydatid disease. Methods: The clinica l and radiological features in 17 patients with renal hydatid disease are described. Two patients (4 and 28 years old) had renal colic with passage of debris in urine (hydatiduria). Five males and twelve female s were 4-61 years old (mean 37 years). Their histories, physical findi ngs and imaging procedures were evaluated. Plain abdominal radiographs were taken in 17 patients. Results: Plain film showed calcified mass compressing the pevicalyceal system and/or ureter in 10 cases. Sonogra phy showed typical features of echinococcal cysts in 14 cases, especia lly in the liver and spleen. Conclusions: Sonography demonstrates the internal cystic content better. When daughter cysts are present, CT es tablishes the diagnosis. CT scan provides further information on the a ffected organ and involvement of other organs, calcification of the cy st wall and density. The diagnosis was suggested preoperatively in all patients, and confirmed surgically in 12 patients. Eight total nephre ctomies and four partial nephrectomies were performed. The others are being followed up.