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Diagnosis and Follow-up of Incidental Liver Lesions in Children.
Karmazyn, Boaz; Rao, Girish S; Johnstone, Lindsey S; Severance, Tyler S; Ferguson, Michael J; Marshalleck, Francis E; Molleston, Jean P.
Afiliación
  • Karmazyn B; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children.
  • Rao GS; Department of Pediatric Gastroenterology, Hepatology & Nutrition, Riley Hospital for Children at IU Health.
  • Johnstone LS; Department of Pediatric Radiology and Imaging Informatics, Monroe Carell Jr. Children's Hospital at Vanderbilt.
  • Severance TS; Department of Pediatric Hematology and Oncology.
  • Ferguson MJ; Department of Pediatric Hematology and Oncology.
  • Marshalleck FE; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN.
  • Molleston JP; Department of Pediatric Gastroenterology, Hepatology & Nutrition, Riley Hospital for Children at IU Health.
J Pediatr Gastroenterol Nutr ; 74(3): 320-327, 2022 Mar 01.
Article en En | MEDLINE | ID: mdl-34984985
ABSTRACT: Incidental liver lesions are identified in children without underlying liver disease or increased risk of hepatic malignancy in childhood. Clinical and imaging evaluation of incidental liver lesions can be complex and may require a multidisciplinary approach. This review aims to summarize the diagnostic process and follow-up of incidental liver lesions based on review of the literature, use of state-of-the-art imaging, and our institutional experience. Age at presentation, gender, alpha fetoprotein levels, tumor size, and imaging characteristics should all be taken into consideration to optimize diagnosis process. Some lesions, such as simple liver cyst, infantile hemangioma, focal nodular hyperplasia (FNH), and focal fatty lesions, have specific imaging characteristics. Recently, contrast-enhanced ultrasound (CEUS) was Food and Drug Administration (FDA)-approved for the evaluation of pediatric liver lesions. CEUS is most specific in lesions smaller than 3 cm and is most useful in the diagnosis of infantile hemangioma, FNH, and focal fatty lesions. The use of hepatobiliary contrast in MRI increases specificity in the diagnosis of FNH. Recently, lesion characteristics in MRI were found to correlate with subtypes of hepatocellular adenomas and associated risk for hemorrhage and malignant transformation. Biopsy should be considered when there are no specific imaging characteristics of a benign lesion. Surveillance with imaging and alpha fetoprotein (AFP) should be performed to confirm the stability of lesions when the diagnosis cannot be determined, and whenever biopsy is not feasible.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperplasia Nodular Focal / Hemangioma / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperplasia Nodular Focal / Hemangioma / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: J Pediatr Gastroenterol Nutr Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos