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儿童肝脏肿块的影像学见解:肝脏病学实践的综合小型综述

Imaging insights into pediatric liver masses: A comprehensive minireview for hepatology practice.

作者信息

Shahid Mina'a, Hilal Kiran, Khan Memoona, Ejaz Zainab Haider, Altaf Sadaf, Islam Saleem, Khandwala Kumail

机构信息

Department of Radiology, Aga Khan University, Karachi 74800, Sindh, Pakistan.

Medical College, Aga Khan University, Karachi 74800, Sindh, Pakistan.

出版信息

World J Hepatol. 2025 Aug 27;17(8):107041. doi: 10.4254/wjh.v17.i8.107041.

Abstract

Pediatric liver masses encompass a diverse spectrum of benign and malignant lesions, with distinct patterns based on patient age. Optimal imaging is critical for timely diagnosis, management, and prognosis. This pictorial minireview categorizes pediatric liver masses by age group to guide hepatology and radiology practice, with an emphasis on imaging characteristics. In children from birth to six years of age, the most common liver masses include hepatoblastoma, the most common primary hepatic malignancy in this age group; infantile hemangioma, a benign vascular tumor with a characteristic appearance on imaging; and mesenchymal hamartoma, a rare developmental lesion. For children older than six years, liver masses are distinct, with hepatocellular carcinoma being the predominant malignant lesion. Benign masses such as focal nodular hyperplasia and hepatocellular adenoma also emerge in this age range, often linked to hormonal influences or metabolic disorders. The masses observed across all pediatric age groups include hepatic cysts, choledochal cysts, hydatid cysts, pyogenic and amebic abscesses, tuberculosis, lymphoma, and metastases, each presenting with unique imaging features essential for differential diagnosis. This minireview provides a comprehensive, age-based overview of pediatric liver masses, focusing on clinical presentation and key imaging findings to support accurate diagnosis and optimize management strategies in clinical hepatology, particularly in low resource settings.

摘要

小儿肝脏肿块包括多种良性和恶性病变,根据患者年龄具有不同的模式。最佳影像学检查对于及时诊断、治疗和预后至关重要。本图文综述按年龄组对小儿肝脏肿块进行分类,以指导肝病学和放射学实践,重点关注影像学特征。在出生至6岁的儿童中,最常见的肝脏肿块包括肝母细胞瘤,这是该年龄组最常见的原发性肝脏恶性肿瘤;婴儿血管瘤,一种在影像学上具有特征性表现的良性血管肿瘤;以及间叶性错构瘤,一种罕见的发育性病变。对于6岁以上的儿童,肝脏肿块有所不同,肝细胞癌是主要的恶性病变。在这个年龄段也会出现诸如局灶性结节性增生和肝细胞腺瘤等良性肿块,通常与激素影响或代谢紊乱有关。在所有小儿年龄组中观察到的肿块包括肝囊肿、胆总管囊肿、包虫囊肿、化脓性和阿米巴脓肿、结核病、淋巴瘤和转移瘤,每种都具有独特的影像学特征,对鉴别诊断至关重要。本综述提供了一份基于年龄的小儿肝脏肿块综合概述,重点关注临床表现和关键影像学发现,以支持临床肝病学中的准确诊断并优化管理策略,特别是在资源匮乏的环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e872/12400384/593477053f11/wjh-17-8-107041-g001.jpg

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