9%20ECOGRAFIA%20ABDOMINAL%20COMO%20CUANDO%20DONDE

THE PAEDIATRIC ABDOMEN 219
B
A
B
Figure 9.2 (A) Large choledochal cyst at the porta hepatis. (B) Intrahepatic choledochal cysts in biliary atresia with
no proximal biliary tract dilatation.
A
B
Figure 9.3 (A) A large hepatoblastoma, containing both cystic and solid areas, occupies most of the right lobe of the
liver in this 18-month-old girl. (She is undergoing chemotherapy at the time of going to press.) (B) Multiple
hypoechoic haemangiomata. Hyperdynamic circulation was noted in the portal vein and hepatic artery on Doppler.
These lesions spontaneously regressed, leaving only a solitary haemangioma at the time of going to press.
the two types of tumour are not distinguishable on
ultrasound, the clinical history may give a clue and
ultrasound-guided biopsy can be used to obtain a
histological diagnosis.
Ultrasound is useful in identifying the extent of
the tumour and, when combined with colour flow
Doppler imaging, adjacent vascular invasion can be
evaluated. CT or MRI complements the ultrasound
findings and is essential for staging and
assessment of suitability for resection or transplantation.
9 Chemotherapy may be used to shrink the
tumour prior to surgery.
Rhabdomyosarcoma is a rare tumour which may
originate in the biliary ducts, causing biliary dilatation.
It is indistinguishable from other liver
tumours on ultrasound. Rhabdomyosarcoma originates
from muscle cells and is the commonest type
of soft-tissue sarcoma seen in childhood, with a