ABDOMINAL CYSTIC HYDATID-DISEASE (CHD) - CLASSIFICATION OF SONOGRAPHIC APPEARANCE AND RESPONSE TO TREATMENT

The natural history of cystic hydatid disease (CHD) can be divided int o two stages. The first is characterized by the proliferation of the p arasite; the second is marked by involution, ie, when the hydatid unde rgoes spontaneous distress or is subjected to pharmacological treatmen t. Echography makes it possible to study this evolution and to evaluat e the stages of this parasitic pathology. This study of the evolution of abdominal CHD in 81 patients suffering from 127 cysts, with or with out Albendazole treatment suggests a new sonographic classification: t ype I: simple CHD; type II: multiple CHD, type III: with detachment of membrane CHD; type TV: mixed CHD; type V: heterogeneous CHD; type VI: hyperechogenic CHD; type VII calcified CHD. Forty-seven patients suff ering from 90 cysts of types I, II, III, TV, and V were treated with A lbendazole; 31, suffering from 34 CHD of types VI and VII, were not tr eated, as they were considered involutional; 3 patients with 3 cysts r efused therapy. Albendazole treatment resulted in the disappearance of 9 and in the solidification of 62 cysts. Of the remaining cases of CH D, 10 cysts showed sonographic alterations and 5 showed no modificatio ns. Surgery was necessary for 2 patients (4 cysts). This new classific ation seems to be an aid in the recognition of the natural and therapy -induced involution of CHD and seems to improve the evaluation of the efficaciousness of the therapy. (C) 1996 John Wiley & Sons, Inc.