Ultrasonography allows classification of the cysts, as the WHO classification tabulates cysts in 3 groups: the first one is active and includes CE1, which appears as unilocular anechoic cystic lesion with double-line sign, and CE2, which is a multiseptated "rosette-like" "honeycomb" cyst; the second one is transitional and contains CE3a cyst with detached membranes (water-lily sign) and CE3b cyst with daughter cysts
in the solid matrix; and finally, the third group is inactive and has CE4 and CE5 cysts with heterogeneous hypoechoic/hyperechoic contents and no daughter cysts
and solid plus calcified wall .
Of these, further surgery was not required in two patients following cyst extraction and clearance of the biliary channel of daughter cysts
When daughter cysts
are present a multilocular mass is seen.
The pulmonary embolism detected in our case may probably have resulted, on the one hand, from the accidental injury to the case's inferior vena cava during earlier liver surgery which may have allowed the spread of daughter cysts
within systemic circulation.
These nonenhancing multiloculations had low signal intensity on T1-weighted and high signal intensity on T2-weighted images compatible with daughter cysts
. Intercystic spaces were filled with material, which was isointense with muscle tissue on T1-weighted and hyperintense on T2-weighted images, suggesting hydatid sand.
The type II cyst is characterized by the appearance of many daughter cysts
and/or matrix developed within the parent cyst with or without wall calcification.
During laparoscopic treatment, one of the problems is difficulty in evacuation of cyst content, the daughter cysts
and laminated membrane.
US examination followed by the CT scan abdomen and pelvis revealed multiple unilocular and multilocular cysts along with daughter cysts
and cystic ascites.
Performing aspiration on the hydatid cyst for diagnosis is controversial owing to the risk of precipitating acute anaphylaxis or spread of daughter cysts
.  However, few studies showed no sequelae observed that was attributable to aspiration done on hydatid cyst, especially, in superficial locations, and properly done.
Intra-operative use of hypertonic saline injected in the cyst can exterminate the infective daughter cysts
Brannon has, suggested 3 mechanisms for recurrence of OKC.1 (i) Incomplete removal of cyst walls or epithelial islands of dental lamina associated with OKC (ii) cortical perforation and adherence with soft tissues and presence of daughter cysts
within bone (iii) cystic change in dental lamina initially not associated with cyst.
(2) The presence of daughter cysts
on CT is pathognomonic.