Focal liver lesion in children

Abstract

There are several potential roles for the radiologist in the evaluation and treatment of focal liver lesions in children. Firstly, the following questions must be addressed: where is it; what is it; and what are we going to do about it? The approaches to these problems are somewhat different for large masses (arbitrarily defined here as greater than 2 cm in diameter) than for small focal lesions, and this paper will address these possibilities separately. The most useful imaging techniques in this context are US, CT and MRI. Diagnostic catheter angiography is no longer used for evaluation of a liver mass, and nuclear medicine techniques such as labelled red cell or sulphur colloid scintigraphy are rarely helpful. Ultrasonography of liver masses requires skill and patience, but is extremely valuable for detecting very small lesions, for identifying fluid and characterising blood flow in a lesion, and for evaluation of the hepatic vascular anatomy. Both medium-frequency sector or curvilinear transducers and high-frequency (>7 MHz) linear-array transducers are useful [1]. MRI is usually better than CT for evaluation of liver masses. It is difficult to establish standard MRI parameters, even in the context of a clinical trial, because technology is changing rapidly [1]. Liver mass