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Pediatric Radiology

, Volume 48, Issue 9, pp 1234–1244 | Cite as

Magnetic resonance imaging features of common focal liver lesions in children

  • Prakash M. Masand
Pediatric Body MRI
  • 139 Downloads

Abstract

Magnetic resonance imaging (MRI) is commonly used to characterize focal liver masses in the pediatric population. MRI is the preferred modality because of its superior contrast resolution and utility for obtaining functional sequences such as diffusion-weighted imaging (DWI). MR exams performed with a hepatocyte-specific gadolinium-based contrast agent can characterize focal liver lesions, which helps in differentiating a common benign entity such as focal nodular hyperplasia from other liver pathology when the background liver is normal. The most common benign focal lesion is a hemangioma, and metastases followed by hepatoblastoma are the most common malignant lesions. This article can help radiologists become familiar with the pre- and post-contrast imaging features of common pediatric liver masses.

Keywords

Children Hepatocyte-specific contrast agent Liver Magnetic resonance imaging Mass 

Notes

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Bakshi P, Srinivasan R, Rao KL et al (2006) Fine needle aspiration biopsy in pediatric space occupying lesions of liver: a retrospective study evaluating its role and diagnostic efficacy. J Pediatr Surg 41:1903–1908CrossRefPubMedGoogle Scholar
  2. 2.
    Meyers RL (2007) Tumors of the liver in children. Surg Oncol 16:195–203CrossRefPubMedGoogle Scholar
  3. 3.
    Adeyiga AO, Lee EY, Eisenberg RL (2012) Focal hepatic masses in pediatric patients. AJR Am J Roentgenol 199:W422–W440CrossRefPubMedGoogle Scholar
  4. 4.
    Shelmerdine SC, Roebuck DJ, Towbin AJ et al (2016) MRI of paediatric liver tumours: how we review and report. Cancer Imaging 16:21CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    von Schweinitz D (2006) Management of liver tumors in childhood. Semin Pediatr Surg 15:17–24CrossRefGoogle Scholar
  6. 6.
    Chavhan GB, Shelmerdine S, Jhaveri K et al (2016) Liver MR imaging in children: current concepts and technique. Radiographics 36:1517–1532CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell CL, Vasanawala SS (2011) An approach to pediatric liver MRI. AJR Am J Roentgenol 196:W519–W526CrossRefPubMedGoogle Scholar
  8. 8.
    Meyers AB, Towbin AJ, Serai S et al (2011) Characterization of pediatric liver lesions with gadoxetate disodium. Pediatr Radiol 41:1183–1197CrossRefPubMedGoogle Scholar
  9. 9.
    Basaran C, Karcaaltincaba M, Akata D et al (2005) Fat-containing lesions of the liver: cross sectional imaging findings with emphasis on MRI. AJR Am J Roentgenol 184:1103–1110CrossRefPubMedGoogle Scholar
  10. 10.
    Kochin IN, Miloh TA, Arnon R et al (2011) Benign liver masses and lesions in children: 53 cases over 12 years. Isr Med Assoc J 13:542–547PubMedGoogle Scholar
  11. 11.
    Chavhan GB, Babyn PS, Temple M et al (2013) Diagnosis of postoperative bile leak and accurate localization of the site of leak by gadobenate dimeglumine-enhanced MR cholangiography in a child. Pediatr Radiol 43:763–766CrossRefPubMedGoogle Scholar
  12. 12.
    Chung EM, Cube R, Lewis RB et al (2010) From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors Radiographics 30:801–826CrossRefPubMedGoogle Scholar
  13. 13.
    Donnelly LF, Adams DM, Bisset GS 3rd (2000) Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic. AJR Am J Roentgenol 174:597–608CrossRefPubMedGoogle Scholar
  14. 14.
    Kollipara R, Dinneen L, Rentas KE et al (2013) Current classification and terminology of pediatric vascular anomalies. AJR Am J Roentgenol 201:1124–1135CrossRefPubMedGoogle Scholar
  15. 15.
    Masand P (2014) Radiographic findings associated with vascular anomalies. Semin Plast Surg 28:69–78CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Dickie B, Dasgupta R, Nair R et al (2009) Spectrum of hepatic hemangiomas: management and outcome. J Pediatr Surg 44:125–133CrossRefPubMedGoogle Scholar
  17. 17.
    Christison-Lagay ER, Burrows PE, Alomari A et al (2007) Hepatic hemangiomas: subtype classification and development of a clinical practice algorithm and registry. J Pediatr Surg 42:62–67CrossRefPubMedGoogle Scholar
  18. 18.
    Kassarjian A, Zurakowski D, Dubois J et al (2004) Infantile hepatic hemangiomas: clinical and imaging findings and their correlation with therapy. AJR Am J Roentgenol 182:785–795CrossRefPubMedGoogle Scholar
  19. 19.
    Moore M, Anupindi SA, Mattei P et al (2009) Mesenchymal cystic hamartoma of the liver: MR imaging with pathologic correlation. J Radiol Case Rep 3:22–26PubMedPubMedCentralGoogle Scholar
  20. 20.
    Jha P, Chawla SC, Tavri S et al (2009) Pediatric liver tumors — a pictorial review. Eur Radiol 19:209–219CrossRefPubMedGoogle Scholar
  21. 21.
    Bahador A, Geramizadeh B, Rezazadehkermani M et al (2014) Mesenchymal hamartoma mimicking hepatoblastoma. Int J Organ Transplant Med 5:78–80PubMedPubMedCentralGoogle Scholar
  22. 22.
    Towbin AJ, Luo GG, Yin H, Mo JQ (2011) Focal nodular hyperplasia in children, adolescents, and young adults. Pediatr Radiol 41:341–349CrossRefPubMedGoogle Scholar
  23. 23.
    Ma IT, Rojas Y, Masand PM et al (2015) Focal nodular hyperplasia in children: an institutional experience with review of the literature. J Pediatr Surg 50:382–387CrossRefPubMedGoogle Scholar
  24. 24.
    Gupta RT, Iseman CM, Leyendecker JR et al (2012) Diagnosis of focal nodular hyperplasia with MRI: multicenter retrospective study comparing gadobenate dimeglumine to gadoxetate disodium. AJR Am J Roentgenol 199:35–43CrossRefPubMedGoogle Scholar
  25. 25.
    Chavhan GB, Mann E, Kamath BM et al (2014) Gadobenate-dimeglumine-enhanced magnetic resonance imaging for hepatic lesions in children. Pediatr Radiol 44:1266–1274CrossRefPubMedGoogle Scholar
  26. 26.
    Katabathina VS, Menias CO, Shanbhogue AK et al (2011) Genetics and imaging of hepatocellular adenomas: 2011 update. Radiographics 31:1529–1543CrossRefPubMedGoogle Scholar
  27. 27.
    Fowler KJ, Brown JJ, Narra VR (2011) Magnetic resonance imaging of focal liver lesions: approach to imaging diagnosis. Hepatology 54:2227–2237CrossRefPubMedGoogle Scholar
  28. 28.
    Grazioli L, Olivetti L, Mazza G, Bondioni MP (2013) MR imaging of hepatocellular adenomas and differential diagnosis dilemma. Int J Hepatol 2013:374170CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Van Aalten SM, Thomeer MG, Terkivatan T et al (2011) Hepatocellular adenomas: correlation of MR imaging with pathologic subtype classification. Radiology 261:172–181CrossRefPubMedGoogle Scholar
  30. 30.
    Grazioli L, Bondioni MP, Haradome H et al (2012) Hepatocellular adenoma and focal nodular hyperplasia: value of gadoxetic acid-enhanced MR imaging in differential diagnosis. Radiology 262:520–529CrossRefPubMedGoogle Scholar
  31. 31.
    Siegel MJ, Chung EM, Conran RM (2008) Pediatric liver: focal masses. Magn Reson Imaging Clin North Am 16:437–452CrossRefGoogle Scholar
  32. 32.
    van Aalten SM, Thomeer MG, Terkivatan T et al (2011) Hepatocellular adenomas: correlation of MR imaging findings with pathologic subtype classification. Radiology 261:172–181CrossRefPubMedGoogle Scholar
  33. 33.
    Thomeer MG, Willemssen FE, Biermann KK et al (2014) MRI features of inflammatory hepatocellular adenomas on hepatocyte phase imaging with liver-specific contrast agents. J Magn Reson Imaging 39:1259–1264CrossRefPubMedGoogle Scholar
  34. 34.
    Agarwal S, Fuentes-Orrego JM, Arnason T et al (2014) Inflammatory hepatocellular adenomas can mimic focal nodular hyperplasia on gadoxetic acid-enhanced MRI. AJR Am J Roentgenol 203:W408–W414CrossRefPubMedGoogle Scholar
  35. 35.
    Techavichit P, Masand PM, Himes RW et al (2016) Undifferentiated embryonal sarcoma of the liver (UESL): a single-center experience and review of the literature. J Pediatr Hematol Oncol 38:261–268CrossRefPubMedGoogle Scholar
  36. 36.
    Walther A, Geller J, Coots A et al (2014) Multimodal therapy including liver transplantation for hepatic undifferentiated embryonal sarcoma. Liver Transplant 20:191–199CrossRefGoogle Scholar
  37. 37.
    Chung EM, Lattin GE Jr, Cube R et al (2011) From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics 31:483–507CrossRefPubMedGoogle Scholar
  38. 38.
    Towbin AJ, Meyers RL, Woodley H et al (2018) 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol 48:536–554CrossRefPubMedGoogle Scholar
  39. 39.
    Felsted AE, Shi Y, Masand PM et al (2015) Intraoperative ultrasound for liver tumor resection in children. J Surg Res 198:418–423CrossRefPubMedGoogle Scholar
  40. 40.
    Yikilmaz A, George M, Lee EY (2017) Pediatric hepatobiliary neoplasms: an overview and update. Radiol Clin North Am 55:741–766CrossRefPubMedGoogle Scholar
  41. 41.
    Schmid I, Schweinitz VD (2017) Pediatric hepatocellular carcinoma: challenges and solutions. J Hepatocell Carcinoma 4:16–21CrossRefGoogle Scholar
  42. 42.
    Xue M, Masand P, Thompson P et al (2014) Angiosarcoma successfully treated with liver transplantation and sirolimus. Pediatr Transplant 18:E114–E119CrossRefPubMedGoogle Scholar
  43. 43.
    Fernandez-Pineda I, Sandoval JA, Davidoff AM (2015) Hepatic metastatic disease in pediatric and adolescent solid tumors. World J Hepatol 7:1807–1817CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cardiovascular Imaging, Department of Pediatric RadiologyTexas Children’s HospitalHoustonUSA
  2. 2.Baylor College of MedicineHoustonUSA

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