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Imaging of multifocal liver lesions in children and adolescents.

Hegde SV, Dillman JR, Lopez MJ, Strouse PJ - Cancer Imaging (2013)

Bottom Line: Multifocal liver lesions are encountered regularly in children and adolescents.By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis.The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

ABSTRACT
Multifocal liver lesions are encountered regularly in children and adolescents. By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis. The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

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An 8-year-old boy with progressive familial intrahepatic cholestasis and multifocal hepatocellular carcinoma. (a,b) Coronal and axial T2-weighted MR images show a dominant mass (*) within the right hepatic lobe that is hyperintense to adjacent liver parenchyma. Scattered satellite lesions are also present (arrows). Enlargement of the spleen is due to long-standing portal hypertension secondary to the patient’s underlying chronic liver disease.
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Figure 10: An 8-year-old boy with progressive familial intrahepatic cholestasis and multifocal hepatocellular carcinoma. (a,b) Coronal and axial T2-weighted MR images show a dominant mass (*) within the right hepatic lobe that is hyperintense to adjacent liver parenchyma. Scattered satellite lesions are also present (arrows). Enlargement of the spleen is due to long-standing portal hypertension secondary to the patient’s underlying chronic liver disease.

Mentions: On ultrasonography, pediatric HCCs tend to be large, heterogeneous masses. On postcontrast CT and MRI, these lesions commonly demonstrate areas of arterial phase hyperenhancement with rapid wash out on delayed phase imaging, similar to the pattern seen in adult HCC patients[17]. On delayed postcontrast MRI using a hepatobiliary contrast agent, HCCs (unless well-differentiated) typically appear hypointense to adjacent liver[4]. These tumors generally appear hyperintense on non-contrast T2-weighted MRI (Fig. 10), while their non-contrast T1-weighted MRI appearance is variable and often heterogeneous due to the presence of intralesional hemorrhage, necrosis, copper, calcification, and lipid/fat[17]. Portal and hepatic venous structures should be assessed for tumor thrombus on both CT and MRI, and upper abdominal lymph nodes should also be evaluated for potential metastatic spread.Figure 10


Imaging of multifocal liver lesions in children and adolescents.

Hegde SV, Dillman JR, Lopez MJ, Strouse PJ - Cancer Imaging (2013)

An 8-year-old boy with progressive familial intrahepatic cholestasis and multifocal hepatocellular carcinoma. (a,b) Coronal and axial T2-weighted MR images show a dominant mass (*) within the right hepatic lobe that is hyperintense to adjacent liver parenchyma. Scattered satellite lesions are also present (arrows). Enlargement of the spleen is due to long-standing portal hypertension secondary to the patient’s underlying chronic liver disease.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569672&req=5

Figure 10: An 8-year-old boy with progressive familial intrahepatic cholestasis and multifocal hepatocellular carcinoma. (a,b) Coronal and axial T2-weighted MR images show a dominant mass (*) within the right hepatic lobe that is hyperintense to adjacent liver parenchyma. Scattered satellite lesions are also present (arrows). Enlargement of the spleen is due to long-standing portal hypertension secondary to the patient’s underlying chronic liver disease.
Mentions: On ultrasonography, pediatric HCCs tend to be large, heterogeneous masses. On postcontrast CT and MRI, these lesions commonly demonstrate areas of arterial phase hyperenhancement with rapid wash out on delayed phase imaging, similar to the pattern seen in adult HCC patients[17]. On delayed postcontrast MRI using a hepatobiliary contrast agent, HCCs (unless well-differentiated) typically appear hypointense to adjacent liver[4]. These tumors generally appear hyperintense on non-contrast T2-weighted MRI (Fig. 10), while their non-contrast T1-weighted MRI appearance is variable and often heterogeneous due to the presence of intralesional hemorrhage, necrosis, copper, calcification, and lipid/fat[17]. Portal and hepatic venous structures should be assessed for tumor thrombus on both CT and MRI, and upper abdominal lymph nodes should also be evaluated for potential metastatic spread.Figure 10

Bottom Line: Multifocal liver lesions are encountered regularly in children and adolescents.By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis.The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

ABSTRACT
Multifocal liver lesions are encountered regularly in children and adolescents. By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis. The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

Show MeSH
Related in: MedlinePlus