LIVER

Question 1

First line of investigation in any suspected abdominal pathology in children

Answer 1

US

Question 2

Does the liver change quick?

Answer 2

NO the liver has a very large functional reserve and may need to suffer extensive disease before dysfunction becomes clinically apparent

Question 3

When imaging pediatric liver all _______must be acquired

Answer 3

‘adult’ landmarks

Question 4

Liver echogenicity to kidneys

Answer 4

echogenic

Question 5

Most common hepatic mass in the neonate

Answer 5

Hemangioma

Question 6

Hemangioma arrise from

Answer 6

AV malformations

Question 7

2 types of hemangioma

Answer 7

Hemangioendotelioma

Cavernous hemangioma

Question 8

what is hemangioendothelioma

Answer 8

Blood filled spaces with multilayered endotelium

Question 9

what is cavernous hemangioma

Answer 9

single layered endotelium

Question 10

who do hemangioendothelioma affect

Answer 10

infants less than 6 months of age

Question 11

hemangioendothelioma associated with

Answer 11

skin hemangiomas

Question 12

clinical presentations of hemangioendothelioma (3)

Answer 12

hepatomegaly
congestive heart failure
hemoperitoneum from rupture

Question 13

asymptomatic hemangioendothelioma will

Answer 13

go away on its own accord

Question 14

hemangioendothelioma sono appearance (5)

Answer 14

single or multiple
varying echo and size
contains “fine, linear foci of calcium” 
may have enhancement
vascular

Question 15

Cavernous Hemangioma 3x more likely in

Answer 15

girls

Question 16

clinical presentation of Cavernous Hemangioma (4)

Answer 16

hepatomegaly (palpable)
obstructive jaundice
bowel obstruction (vomiting)
respiratory insufficiency

Question 17

Cavernous Hemangioma treatments is

Answer 17

lobectomy or resection

only if large and threatening health

Question 18

Cavernous Hemangioma sono appearance (5)

Answer 18

• well defined
• hyperechoic (multiple interfaces between walls of the blood-filled vessels)
• can be hypoechoic (atypical)
• enhancement
• vascular
  (looks like what it does in adults )

Question 19

Mesenchymal Hamartoma cause

Answer 19

Congenital-arises from connective tissue of the portal tracts

Question 20

Mesenchymal Hamartoma clinical presentation

Answer 20

painless abdo swelling

Question 21

sono feature difference of Mesenchymal Hamartoma from hemangioma

Answer 21

it is avascular

Question 22

adenoma highly associated with

Answer 22

glycogen storage disease

Question 23

is FNH common? and appearance

Answer 23

no, rare

isoechoic with blood in center shown by doppler

Question 24

_____ of all liver tumours are malignant

Answer 24

2/3

Question 25

hepatoblastoma US appearance (6)

Answer 25

``` Solitary multinodular mass Heterogeneous Hyperechoic ill-defined borders Areas of necrosis and hemorrhage Calcifications ```

Question 26

hepatocellular carcinoma (hepatoma) find in children of what age

Answer 26

older than 3

Question 27

lab findings for hepatocellular carcinoma (hepatoma)

Answer 27

increased AFP, hypoglycemia

Question 28

clinical presentations of hepatocellular carcinoma (hepatoma) (5)

Answer 28

``` sudden liver failure due to thrombosis of portals or HVs hepatomegaly pain GI bleeding, anemia ascites ```

Question 29

sono features of hepatocellular carcinoma (hepatoma) (5)

Answer 29

``` similar to Hepatoblastoma solid hyperechoic mass involving the entire liver well-defined or ill-defined borders anechoic areas within mass from necrosis hypo-anechoic halo around mass ```