Hydatid recurrence occurs particularly associated with some risk factors .Diagnosis and management is needed especially in managing persistent cavity detected on ultrasound years after primary surgery.
It is not my area of specialization. I have done Ph.D in Engineering.May be another one who has done in research work in medical field
We routinely used CT for patients in whom a second operation was planned to reveal the nature of the cyst, association with the biliary system, vascular structures and related organs as well as to demonstrate the extent of compensatory hyperplasia.
Serological tests detect specific antibodies to the parasite and are the most commonly employed tools to diagnose past and recent infection with E. granulosus. Detection of IgG antibodies implies exposure to the parasite, while in active infection high titers of specific IgM and IgA antibodies are observed. Detection of circulating hydatid antigen in the serum is of use in monitoring after surgery and pharmacotherapy and in prognosis. ELISA is used most commonly, but alternate techniques are counter-immuno-electrophoresis and bacterial co-agglutination.
Elisa techniques have a high sensitivity above 90% and are useful in mass scale screening. The counter-immuno-electrophoresis has the highest specificity (100%) and high sensitivity (80 – 90%). CASONI TEST has been used most frequently in the past but is at present considered only of historical importance and has largely been abandoned because of low sensitivity.
Tests of humoral immunity are still widely used to confirm the diagnosis. The sensitivity and specificity of any humoraltest depends largely on the quality of the antigens utilised.
Antigens can be derived from the whole parasites or organelles, or soluble antigens from cyst fluid. Indirect immunofluorescence assay (IFA) is the most sensitive test (95%) in patients with hepatic CHD.
The sensitivity and specificity of enzyme-linked immunosorbentassay (ELISA) is highly dependent on the method of antigen preparation, and cross-reactions with other helminthic diseases occur if crude antigens are used. Purified fractions may yield high sensitivities (95%) and specificity (100%)
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