Abstract
Paediatric hepatic masses present a diagnostic challenge to physician and surgeon alike. Dynamic new scanning techniques such as spiral computed tomography (CT) and current real time ultrasound have revolutionised scanning of liver masses, while magnetic resonance imaging (MRI) has added a fresh new spin on this topic. Focal processes include congenital lesions such as choledochal and simple cysts, infective conditions like abscesses and hydatid cysts, and neoplasms. The commonest neoplasms include benign tumours such as haemangioma and haemangioendothelioma, and malignant tumours such as metastases, hepatoblastoma (HB) and hepatocellular carcinoma (HCC). Important diffuse processes include biliary atresia, fatty infiltration, cirrhosis, iron deposition and Budd Chiari syndrome. Cognisance should also be taken of focal lesions such as focal fatty change, infarcts, anatomic variants and extrahepatic masses, which may mimic hepatic masses. This article aims to demonstrate the key CT imaging features that help in identifying these conditions.
Highlights
Paediatric hepatic masses, though uncommon, have received much attention in the literature
Paed iatric hepatic masses present a diagnostic challenge to physician and surgeon alike
Dynamic new scanning techniques such as spiral computed tomography (CT) and current real ti me ultrasou nd have revolutionised scanning of liver masses, while magnetic resonance imaging (MRI) has added a fresh new spin on this topic
Summary
CT scans show multiple hypodense round or ovoid structures, Pyogenic organisms may enter the liver via the biliary tree (ascending cholangitis), by direct implantation (trauma, surgery) or by haematogenous spread (arterial, portal). In the latter instance, there is a predilection for the superior aspect of the right lobe.P The typical CT appearance of a hypodense, rim-enhancing lesion is seen in 50% of cases, but features may. Parasitic infestation Amoebic liver abscesses occur after colonie infection in approximately and may be seen with non- 8% of cases.' Appearances are often pyogenic abscesses or tumours. Primary hepatic maligcontrast rapid bolus dynamic scanning shows centripetal enhancement as flow occurs from peripheral to central sinusoids (Figure 5). But the relation to adult types is unclear
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