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Spinal hydatid disease

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Low back pain. Had surgery at the lower dorsal region 10 years ago.

Patient Data

Age: 35 years
Gender: Female
mri

Lower dorsal kyphosis centered on T11-T12 level with collapsed T11 and T12 vertebral bodies (mainly of T12) of low signal on T1WI, inhomogeneous high signal on T2WI with no enhancement on postcontrast sequences. Multiple perivertebral intracanalar cysts of various size, the largest are of prevertebral (7.3x4.3x3.6 cm), and right paravertebral (5.2x4.4x3.2 cm) location, composed of numerous vesicular cysts (size < 1cm) of low signal on T1WI, high signal on a T2WI with a peripheral hypointense rim of the pericyst. A regular peripheral enhancement is noted on postcontrast sequences.

The right paravertebral cyst shows an intracanalar epidural extension encasing the adjacent segment of the spinal cord which is compressed with no signs of compressive myelopathy.

Also, small cysts are noted in the left paravertebral region as well as at the lower soft tissues adjacent to the laminectomies.

 A small calcified hydatid cyst of the left lobe of the liver.

Case Discussion

MRI features of spinal hydatid disease (recurrence in this case), type 3, 4, and 5 according to the Dew/Braithwaite and Lees classification. The patient had surgery 10 years ago for the same disease.

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