Sonographic course of a systemic cystic echinococcosis in a 10-year old girl (with cardiac, hepatic, renal and muscle involvement)

Purpose: To present the predominantly ultrasonographic (initial and follow- up) imaging in a disease that is rare among the Central European paediatric population - and to evaluate the role of ultrasound for initial staging an d followup under antihelmintic therapy. Method: The imaging documents as we ll as the clinical record of a 10-year old Armenian girl with systemic hyda tid disease (cystic echinococcosis) were analysed retrospectively. Results: By means of ultrasound, the complete initial systemic spread of the diseas e with at least 11 cysts within the liver, 1 cyst in the left kidney, 1 per i-/2 intracardiac cysts, and 1 cyst in the dorsal musculature was detected. Repeated sonographic examinations allowed the estimation of successful med ical treatment by the following criteria: size reduction of all cysts with changing internal structures from an initially echo-free to an increasingly homogeneous echodense character; no developing new cysts. In addition, CT and MRI enabled a more complete demonstration of especially the intra- and pericardiac lesions (preoperatively) and the exclusion of further intracran ial cysts. Conclusion: In paediatric hydatid disease, ultrasonography yield s important information not only with regard to the initial staging, but al so to the antihelmintic therapeutic effects and thus helps to determine whe n to discontinue medical treatment.