Hepatic tumors in children: ultrasonic differentiation of malignant from benign lesions

The authors studied 21 hepatic tumors in children using B-scan and real-time ultrasound as well as angiography. The final diagnosis was established surgically. Cystic tumors and hemangioendotheliomas were excluded. In all but one malignant tumor (15/16), ultrasound showed absence of one branch of the portal vein in the area of the tumor. Partial amputation of intrahepatic portal branches was confirmed angiographically in all cases. In all 6 benign tumors, ultrasound demonstrated a patent portal system despite compression by tumor. These findings were confirmed angiographically. No specific echo pattern allowing differentiation between benign and malignant tumors was found. The authors conclude that ultrasonic differentiation between malignant and benign hepatic tumors in children is possible, provided that special attention is given to the intrahepatic vessels.