Hepatic Imaging in Neonates and Young Infants: State of the Art

Abstract

Neonatal liver disease is an important source of morbidity in the pediatric population. The manifestation of liver disease in young infants may be different than in older patients, and there are a number of diagnoses that are unique to this age group. Familiarity with these entities is important as imaging plays a key role in the diagnostic workup, and prompt diagnosis is necessary to prevent complications. This article reviews the spectrum of liver pathologies that can manifest in the first 6 months of life and is intended to educate the general radiologist who may be faced with interpretation of neonatal liver imaging. Categories of disease that will be reviewed include cholestatic diseases, tumors, vascular anomalies, and acquired diseases. The authors will also review optimization of ultrasonography (US) and magnetic resonance imaging of the liver and present a systematic method for interpretation of neonatal liver US findings in the context of clinical and laboratory findings. RSNA, 2017.

Abklärung erhöhter Aminotransferasen (ALT und AST) im Kindesalter

“…B. Choledochuszysten) oder aber auch Zeichen einer Cholangitis (infektiös, ischämisch, SSC, ASC oder PSC) sein. Hilfreich ist in diesem Zusammenhang auch die Darstellung von Lymphknoten im Bereich der Leberpforte [21]. Die Flussgeschwindigkeiten in der Leberarterie (Thrombose, hoher RI bei Fibrose/Zirrhose), Portalvene (Thrombus, portaler Hypertonus) und Lebervene (kardiale Stauung) sollten dopplersonografisch dargestellt werden.…”

Ultrasound and alternative multimodality imaging of intra-abdominal and pelvic cystic masses in the newborn

“…Hepatic haemangiomas are the most common benign hepatic tumour of infancy 4 (Figures 1 and 2). There are two types: infantile hepatic haemangiomas (IHH) and congenital hepatic haemangiomas (CHH).…”

“…CHHs are usually detected prenatally, fully formed at birth and, unlike IHHs, tend to present as a solitary mass in the newborn. 4 They tend to then undergo varying degrees of involution. Like IHHs, they can also present with thrombocytopenia and congestive heart failure.…”

“…Dynamic post-contrast magnetic resonance (MR) imaging allows for further characterization and they typically show early peripheral enhancement, confirming the diagnosis. 4…”

Shunt portosistémico congénito extrahepático asociado a hemangiomas múltiples del hígado. Reporte de un caso

“…Los hallazgos por ultrasonido consisten en la ausencia de la vena porta, en la mayoría de los casos, y la demostración de la dirección del flujo de los vasos. Otros hallazgos no específicos son la disminución del tamaño del hígado o el aumento de la ecogenicidad de los vasos periportales intrahepáticos 8 .…”