Multivesicular cysts manifest as well-defined fluid collections in a honeycomb pattern with multiple septa representing the walls of the daughter cysts (7). Daughter cysts appear as cysts within a cyst. When daughter cysts are separated by the hydatid matrix (a material with mixed echogenicity), they demonstrate a “wheel spoke” pattern. The matrix represents hydatid fluid containing membranes of broken daughter vesicles, scolices, and hydatid sand. Membranes may appear within the matrix as serpentine linear structures, a finding that is highly specific for hydatid disease. Spotter case contributed by: Indra Neil Mekala, Consultant Radiologist, Rajahmundry.
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