Clinical and imaging features, and curative effect observation of 54 infants with hepatic hemangioma

Abstract

Abstract: Objective To analyze the clinical and imaging features of ultrasound, contrasted enhanced CT (CECT) and contrasted enhanced MRI (CEMRI) in 54 infants with hepatic hemangioma (IHHs), and to evaluate the therapeutic effect of IHH.Methods From January 2005 to March 2018, there were 54 IHHs (19 males and 35 females) with an age of (17.2±8.5) months. Fifty-eight patients with other focal liver lesions under 14 years old were selected in the same period.Results Univariate analysis of clinical data of IHHs (IHH group) and other patients with focal liver lesions (non-IHH group) showed that the ages of IHH group and non-IHH group were (17.2±7.5) months and (42.3±16.5) months, with statistical significance (P<0.05). 41 cases (75.9%) with AFP<20 ng/mL in IHH group, 13 cases (24.1%) with AFP>20ng/ml in non-IHH group, 8 cases (13.8%) with AFP<20 ng/mL and 50 cases (86.2%) with AFP>20 ng/mL had statistical significance (P<0.05). The tumor diameters of IHH group and non-IHH group were (5.6±1.8) cm and (8.4±2.6) cm, with statistical significance (P<0.05). In IHH group, resistance index (RI) was < 0.7 in 43 cases (79.6%), > 0.7 in 11 cases (20.4%), and in non-IHH group, RI was < 0.7 in 16 cases (27.6%), and > 0.7 in 42 cases (72.4%), the difference was statistically significant (P<0.05). Among the 54 IHHs, 43 were focal type (79.6%), 7 were multifocal type (13.0%), and 4 were diffuse type (7.4%). The lesion boundary was clear in 52 cases (96.3%) and unclear in 2 cases (3.7%). There was calcification in 26 cases (60.5%), and all cases were from patients with focal type. On plain CT scan of IHHs, it was showed low-density shadow, and CECT showed obvious enhancement around the lesion in arterial phase and centripetal filling enhancement in portal vein phase. On MRI of IHH lesions, T1-weighted sequence showed lower signal intensity than normal liver parenchyma, and T2-weighted sequence showed higher signal intensity. CEMRI showed the same performance as CECT. 26 cases (48.1%) of 54 IHHs were followed up. 17 cases were treated with drugs because of hepatomegaly and dyspnea, including 8 cases (14.8%) treated with hormone, 7 cases (13.0%) treated with propranolol and 2 cases (3.7%) treated with hormone combined with propranolol. 9 cases were treated with surgical intervention because of unsatisfactory drug treatment effect, including 7 cases (13.0%) with surgical resection and 2 cases (3.7%) with transcatheter arterial embolization. The lesions subsided or cured in 45 cases (83.3%) and significantly reduced in 5 cases (9.2%). All patients were followed up effectively for at least 3 months, 51 cases (94.4%) survived and 3 cases (5.6%) died of heart failure.Conclusion Compared with other focal liver lesions, IHH is younger in diagnosis, lower in AFP level and smaller in tumor diameter. Ultrasound, CECT and CEMRI are effective ways to diagnose IHH. Most IHH patients have a good natural course of disease, and hormone, propranolol and surgical resection of hepatic hemangioma are the effective treatment methods to relieve symptoms.

Key words: Infantile hepatic hemangioma, Ultrasound, Contrasted enhanced CT, Contrasted enhanced MRI

ZHOU Fei-fei, LIU Yong-gang, LIU Hao, SUN Hao-kai. Clinical and imaging features, and curative effect observation of 54 infants with hepatic hemangioma[J]. Chinese Hepatolgy, 2022, 27(1): 91-94.

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