Diagnostic ultrasound ( PDFDrive )

1744 PART V Pediatric Sonography
A
B
C
D
FIG. 51.14 Hemangiomas. Multiple visceral and cutaneous hemangiomas were found in this newborn with enlarged liver at birth. (A) Transverse
sonogram showing innumerable hypoechoic lesions enlarging the liver. (B) Longitudinal sonogram of the liver showing one hemangioma deforming
the adjacent hepatic vein. (C) Transverse linear array image showing the lesions in greater detail. (D) Coronal magnetic resonance single shot fast
spin echo (SSFSE) image shows only a few remaining liver lesions several months after treatment. See also Video 51.4 and Video 51.5.
of the mass (Fig. 51.15). Doppler shits exceed those seen in
normal intrahepatic arteries. When AV shunting is severe,
the celiac axis, hepatic artery, and veins are dilated, and the
infraceliac aorta is small. Doppler shits (low-resistance
high-diastolic low) from hemangioendothelioma vessels may
resemble those from malignant tumors. 38 he vascular nature
of these lesions is conirmed by bolus injection CT and the
search for rapid illing and rapid washout in these masses.
Angiography is usually reserved for patients considered for
embolization.
Mesenchymal Hamartomas
Mesenchymal hamartomas are rare, usually multiseptate, cystic
masses derived from periportal mesenchyma. Calciications occur
rarely. Hamartoma typically manifests as an asymptomatic mass
in the right lobe of the liver in children younger than 2 years. 39