From the Department of Diagnostic and Interventional Radiology (F.H., C.R., G.B.C.), Department of Pediatric Laboratory Medicine, Division of Pathology (I.S.), and Division of Neonatology (C.T.), The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8; and Departments of Medical Imaging (F.H., C.R., G.B.C.), Laboratory Medicine and Pathobiology (I.S.), and Pediatrics (C.T.), University of Toronto, Toronto, Ontario, Canada.
Radiographics. 2024 Dec;44(12):e240034. doi: 10.1148/rg.240034.
The neonatal liver may be affected by a variety of congenital and acquired diseases. Imaging has an important role in the workup and management of many neonatal hepatic abnormalities. Some aspects of imaging the liver and imaging findings are specific to neonatal patients when compared with those in older children. Therefore, selecting and tailoring the imaging technique for each indication in the neonate is important for optimal care, with minimal invasiveness. Common indications for imaging include incidental focal lesions, neonatal liver failure, cholestasis, and sepsis. US is the primary imaging modality, and for most conditions it is the only imaging modality required. MRI is the next modality after US for neonatal liver assessment and is especially required for complete assessment and staging of neoplasms, vascular abnormalities, and diagnosis of neonatal hemochromatosis. CT can be used when MRI is not available and should be used sparingly and in patients with acute conditions such as intra-abdominal bleeding. The authors emphasize imaging modalities that can be used for assessment of neonatal liver abnormalities, the imaging appearances of normal and changing structures in the neonatal liver, and indications for imaging. Abnormalities that are described include neonatal liver failure, infections, hepatic calcifications, umbilical venous catheter-related complications, and vascular abnormalities. RSNA, 2024 Supplemental material is available for this article.
新生儿的肝脏可能会受到多种先天性和后天性疾病的影响。影像学在许多新生儿肝脏异常的检查和管理中具有重要作用。与年长儿童相比，新生儿肝脏的某些影像学表现和影像学发现具有特异性。因此，为了实现最佳护理并将微创性降至最低，为每个适应症选择和调整适合新生儿的成像技术非常重要。常见的适应症包括偶然的局灶性病变、新生儿肝衰竭、胆汁淤积和败血症。US 是主要的成像方式，对于大多数情况，它是唯一需要的成像方式。MRI 是新生儿肝脏评估的下一种成像方式，对于肿瘤、血管异常和新生儿血色病的全面评估和分期尤其需要。当 MRI 不可用时，可以使用 CT，但应在急性情况下（如腹腔内出血）慎用。作者强调了可用于评估新生儿肝脏异常的成像方式、新生儿肝脏正常和变化结构的影像学表现以及成像的适应症。描述的异常包括新生儿肝衰竭、感染、肝钙化、脐静脉导管相关并发症和血管异常。RSNA，2024 补充材料可用于本文。
