Imaging Appearances of Pediatric Hepatic Masses − A Review

Abstract

In the pediatric population, a wide spectrum of focal liver lesions is seen, which can be categorised into congenital, inflammatory or neoplastic origin. Majority of the patients with focal liver masses present with abdominal pain, abdominal distention or palpable abdominal lump. However, some lesions can be detected incidentally. After physical examination and clinical history, imaging plays a vital role in evaluating pediatric patients with suspected focal liver lesions. Abdominal radiography may provide some imaging findings suggesting the presence of focal hepatic mass such as hepatomegaly, presence of calcification and displacement of bowel loops. Ultrasound is the first line imaging modality as it does not involve ionising radiation. It can detect, characterise and provide the extent of lesion. However, computerised tomography and magnetic resonance imaging are performed subsequently for further characterisation of liver lesions on the basis of morphology, vascularity, enhancement pattern and for detection of associated metastases in malignant neoplasms. In this review article, we aim to describe the imaging appearances of various benign and malignant hepatic mass lesions in the paediatric age group and to provide differential diagnosis for liver lesions in a child on the basis of available imaging and clinical data. Imaging is therefore essential for making prompt and accurate diagnosis which further helps in appropriate treatment and optimal patient management.