The CT imaging features of hepatoblastoma in term neonates

Objective To investigate the CT features of hepatoblastoma in term neonates. Methods The clinical data and abdominal CT features of 7 children with neonatal hepatoblastoma confirmed by surgical pathology from January 2015 to January 2019 in Hunan Children′s Hospital were retrospectively analyzed, focusing on the position, size, shape, density and dynamic enhancement characteristics of the mass. Results All 7 cases were solitary intrahepatic mass, which affected the liver SⅥ in 2 cases, SⅦ in 2 cases, SⅤ+Ⅵ in 1 case, SⅡ+Ⅲ in 1 case, SⅣa+Ⅴ+Ⅷ in 1 case. The maximum diameters were 2.9-10.2 cm (median maximum diameter 4.7 cm). Four cases tumors were spherical shape, while 3 cases were irregular lobulation and extended to the outside of live. The boundary was clear in 6 cases and fuzzy in 1 case. Necrosis, calcification, patchy hemorrhage was shown in 4 cases, 1 case, 5 cases, respectively. All 7 cases tumors showed heterogeneous enhancement, with multiple nodular and lamellar obvious enhancement at the center and edge of the tumor in arterial phase, and gradually filling-in, presented as multiple bands and island-like enhancement, with prominent edge enhanced but no enhancement in the necrotic area in portal venous and delayed phase. The tumor invaded portal vein and bile duct in hilar area in 1 case, with the intra-hepatic bile duct dilation. The caliber of the abdominal aorta below celiac trunk became thinner in 3 cases. 6 cases were epithelial fetal type and 1 case was mixed type with pathological confirmed. Conclusion The main CT manifestations of neonatal hepatoblastoma are spherical or lobulated, with varied degrees of necrotic, hemorrhage and calcification, and heterogeneous enhancement with gradually regional expansion. Key words: Neonates; Hepatoblastoma; Tomomography, X-ray computed; Alpha fetoprotein