Hepatic Lesions in Infants

• Infantile hemangioma: Early peripheral enhancement with nodular puddling of contrast on later phases.
• Hepatoblastoma (shown above): Heterogeneous echogenicity with or without a spoke-wheel appearance (related to fibrous septa). Acoustic shadowing may be seen from calcifications. Typically hypervascular on Doppler. On CT, heterogeneous, predominantly low-attenuation, with or without calcifications. Heterogeneous enhancement, less than normal liver parenchyma. Low T1 signal with areas of high signal related to hemorrhage. High T2 signal with areas of hemorrhage and necrosis. Markedly elevated AFP.
• Mesenchymal hamartoma of the liver: Usually a multicystic, multilocular mass with enhancement of only the septa and solid portions. Solid lesions are less common and are hypovascular at dynamic contrast-enhanced imaging.
• Metastatic neuroblastoma: Associated with elevated levels of urinary catecholamines. Enhance less than the adjacent liver.

References

Chung EM, Cube R, Lewis RB, Conran RM. From the archives of the AFIP: Pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors. Radiographics. 2010 May;30(3):801-26.