Hepatoblastoma: detection of tumor vascularity with duplex Doppler US
S M Bates1, M S Keller, I M Ramos
1Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, CT 06510.
Insights
Duplex ultrasound can help characterize pediatric liver tumors. High Doppler frequency shifts and antegrade diastolic flow in neoplasms may aid in diagnosing hepatoblastomas in infants.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Oncology
Background:
- Pediatric abdominal mass evaluation often uses CT, US, and MRI.
- Duplex US has shown utility in adult hepatic lesion characterization.
Purpose of the Study:
- To describe Doppler signals in infant hepatoblastomas.
- To assess the diagnostic potential of Doppler US for pediatric liver masses.
Main Methods:
- Case series of three infants with hepatoblastomas.
- Analysis of Doppler ultrasound signals, focusing on frequency shifts and flow patterns.
Main Results:
- Hepatoblastomas exhibited peak systolic Doppler frequency shifts >= 4 kHz.
- Neoplasms showed antegrade diastolic flow.
- These findings were above the normal range for hepatic arteries.
Conclusions:
- High Doppler frequency shifts indicate neovascularity in hepatoblastomas.
- Doppler US may be valuable for evaluating pediatric hepatic masses.
Abstract:
The evaluation of pediatric abdominal masses commonly includes computed tomography, ultrasound (US), and, more recently, magnetic resonance imaging. A previous study suggested that duplex US is of use in further tissue characterization of hepatic lesions in adults. The authors describe the Doppler signals arising from hepatoblastomas in three infants. Peak systolic Doppler frequency shifts in the neoplasms of these three patients were all equal to or greater than 4 kHz, well above the normal range for hepatic arteries. Each neoplasm also exhibited antegrade diastolic flow. The detection of high Doppler frequency shifts associated with neovascularity may prove useful in future evaluation of pediatric hepatic masses.
