Pediatric multifocal liver lesions evaluated by MRI
Majed Almotairi1, Kamaldine Oudjhane1, Govind B Chavhan1
1Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Objective:
The purpose of this study is to present our experience with MRI evaluation of multifocal liver lesions in children and describe the MRI characteristics of these lesions.
Patients And Methods:
A retrospective review of consecutive MRI exams performed for the evaluation of multiple liver lesions between 1 January 2007 and 31 December 2012 was done to note the number of lesions, the size of the largest lesion, MR signal characteristics, and background liver. Final diagnosis was assigned to each case based on pathology in the available cases and a combination of clinical features, imaging features, and follow-up in the remaining cases.
Results:
A total of 48 children (22 boys, 26 girls; age between 3 months and 18 years with average age 10.58 years and median age 11 years) were included in the study. Totally 51 lesion diagnoses were seen in 48 children that included 17 focal nodular hyperplasia (FNH), 8 hemangiomas, 7 metastases, 6 regenerative nodules, 3 adenomas, 3 abscesses, and one each of angiomyolipoma, epithelioid hemangioendothelioma, focal fatty infiltration, hepatocellular carcinoma, hepatic infarction, nodular regenerative hyperplasia, and hepatic cyst. Background liver was normal in 33, cirrhotic in 10, fatty in 3, and siderotic in 2 children. Most FNH, hemangiomas, and regenerative nodules showed characteristic MRI features, while metastases were variable in signal pattern.
Conclusion:
Many commonly seen multifocal liver lesions in children have characteristic MRI features. MRI can help to arrive at reasonable differential diagnoses for multifocal liver lesions in children and guide further investigation and management.
Insights
Magnetic resonance imaging (MRI) effectively characterizes multifocal liver lesions in children. This study details MRI features to aid in diagnosing common pediatric liver conditions like focal nodular hyperplasia (FNH) and hemangiomas.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Hepatology
Background:
- Multifocal liver lesions in children present diagnostic challenges.
- Accurate characterization is crucial for appropriate management and treatment.
- Magnetic resonance imaging (MRI) offers detailed anatomical and functional information.
Purpose of the Study:
- To present experience with MRI evaluation of pediatric multifocal liver lesions.
- To describe the characteristic MRI features of these lesions.
- To assess MRI's utility in differential diagnosis for pediatric liver conditions.
Main Methods:
- Retrospective review of MRI exams for multifocal liver lesions (2007-2012).
- Analysis of lesion number, size, signal characteristics, and background liver parenchyma.
- Diagnosis based on pathology, clinical, imaging features, and follow-up.
Main Results:
- 48 children (3 months-18 years) evaluated.
- Common diagnoses included focal nodular hyperplasia (FNH), hemangiomas, metastases, and regenerative nodules.
- Characteristic MRI features were observed for FNH, hemangiomas, and regenerative nodules; metastases showed variable patterns.
Conclusions:
- Many common pediatric multifocal liver lesions exhibit distinct MRI features.
- MRI aids in forming differential diagnoses for these lesions.
- MRI findings can guide further pediatric liver lesion investigation and management.
