Sherwani Poonam, Kandasamy Devasenathipathy, Sharma Raju, Goel Prabudh, Jana Manisha, Krishnan Nellai
Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India.
SA J Radiol. 2024 Feb 12;28(1):2726. doi: 10.4102/sajr.v28i1.2726. eCollection 2024.
The trajectory from the clinical identification of a benign liver mass to establishing a precise diagnosis is perplexing and arduous. Related contributory factors are that such lesions are encountered infrequently and that there is a nonavailability of dedicated paediatric radiologists in the developing world. The objective of this study was to review the spectrum of benign liver lesions in children and their typical imaging features. Cross-sectional imaging of all paediatric patients (< 18 years) with liver lesions (single and multiple) performed in the institute from 01 January 2018 to 01 January 2019 as well as those acquired at outside institutions and referred to the institute for management was included. Ultrasound was done as the first line of investigation in all the cases with suspicious liver masses and retrospectively performed in referral cases in whom CT or MRI was already done. Images were analysed by two senior radiologists. Most of the cases were diagnosed based on clinical, biochemical and imaging findings, and biopsy was only performed in equivocal cases. Most of the benign liver lesions in the paediatric age group were hepatic haemangioma and mesenchymal hamartomas. A simplified clinical-radiologic paradigm should be established for benign liver lesions in children to assist in reaching the correct diagnosis.
The article demonstrates the salient radiological findings of various benign liver lesions in the paediatric age group and the role of demographic, clinical and biochemical findings, which plays a substantial role in the diagnosis and avoids unnecessary biopsies.
从临床发现儿童肝脏良性肿块到明确诊断的过程复杂且艰巨。相关因素包括此类病变相对少见,以及发展中国家缺乏专业的儿科放射科医生。本研究的目的是回顾儿童肝脏良性病变的种类及其典型影像学特征。纳入了2018年1月1日至2019年1月1日在该机构接受横断面成像检查的所有患有肝脏病变(单发和多发)的儿科患者(<18岁),以及那些在外部机构进行检查并转诊至该机构进行治疗的患者。所有可疑肝脏肿块的病例均首先进行超声检查,对于已进行CT或MRI检查的转诊病例进行回顾性超声检查。由两位资深放射科医生分析图像。大多数病例根据临床、生化和影像学检查结果进行诊断,仅在诊断不明确的病例中进行活检。儿科年龄组中的大多数肝脏良性病变为肝血管瘤和间叶性错构瘤。应建立一种简化的儿童肝脏良性病变临床 - 放射学模式,以帮助做出正确诊断。
本文展示了儿科年龄组各种肝脏良性病变的显著放射学表现,以及人口统计学、临床和生化检查结果在诊断中的作用,这在诊断中起着重要作用,并避免了不必要的活检。