Surgical liver diseases: Liver tumors, hepatic injury, and hepatic vascular and portal vein abnormalities

Abstract

This review focuses on imaging evaluation of pediatric surgical liver diseases, including tumors, trauma, and vascular/portal venous anomalies. Liver tumors require comprehensive assessment using ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), in conjunction with age and alpha-fetoprotein (AFP) level. For hepatoblastoma and pediatric hepatocellular carcinoma, staging and treatment planning are based on the PRETEXT classification. In hepatic injury, initial evaluation with focused assessment with sonography for trauma (FAST) and contrast-enhanced CT is required for determining the severity, while the PECARN rule is recommended to avoid unnecessary CT scans. For hepatic vascular and portal venous anomalies, accurate diagnosis of congenital portosystemic shunt, extrahepatic portal vein obstruction, and patent ductus venosus is critical. Imaging modalities such as US, CT, MRI, and angiography play a key role in guiding therapeutic decision-making.