Hepatic hydatid cyst disease in low- and middle-income countries: Spectrum of imaging findings and complications

Table 1 Imaging differentials of hepatic hydatid disease with key distinguishing imaging features

Differential diagnosis	Key differentiating imaging features
Simple hepatic cyst	Homogeneous water attenuation, thin smooth wall, no enhancement, no calcification, no septations or evolution on follow-up
Pyogenic liver abscess	Thick irregular rim enhancement, diffusion restriction, perilesional inflammatory edema, possible intralesional gas, clinical fever/right upper quadrant pain
Amoebic liver abscess	Solitary lesion with shaggy/ill-defined wall, peripheral enhancement, surrounding inflammatory changes, clinical fever/right upper quadrant pain
Cystic metastases	Irregular wall thickening with enhancing solid components, heterogeneous internal architecture, often known primary malignancy
Biliary cystic neoplasm	Multiloculated cystic lesion with enhancing septations and mural nodules or papillary projections
Hydatid disease	Cystic lesion with variable internal architecture depending on stage, typically without dominant solid enhancing components or aggressive inflammatory features