Paediatric chronic liver diseases: how to investigate and follow up? Role of imaging in the diagnosis of fibrosis

Chronic liver diseases are rare in children, but encompass a wide spectrum of disorders that may all be complicated by liver fibrosis and therefore by portal hypertension. They may be classified according to the level of portal flow obstruction: prehepatic, intrahepatic or suprahepatic. Most of them...

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Bibliographic Details
Published in:Pediatric radiology 2010-06, Vol.40 (6), p.906-919
Main Authors: Pariente, Danièle, Franchi-Abella, Stéphanie
Format: Article
Language:English
Subjects:
Child
Chronic Disease
Diagnostic Imaging - methods
Follow-Up Studies
Humans
Image Enhancement - methods
Imaging
Liver cirrhosis
Liver Cirrhosis - diagnosis
Liver diseases
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Pediatrics
Radiology
Review
Ultrasound
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Summary:Chronic liver diseases are rare in children, but encompass a wide spectrum of disorders that may all be complicated by liver fibrosis and therefore by portal hypertension. They may be classified according to the level of portal flow obstruction: prehepatic, intrahepatic or suprahepatic. Most of them, except presinusoidal diseases, may progress to cirrhosis that carries additional risks of impaired liver function and development of hepatocellular carcinoma. Imaging plays an important role in guiding the diagnosis and biopsy and for follow-up during treatment. US, with high-frequency transducers and Doppler, is the first modality of choice, directs the rest of the investigations and guides interventional radiology. MDCT has made great progress and has replaced angiography for diagnostic purposes. MRI is indicated for parenchyma and nodule characterization and for biliary tract evaluation. To avoid liver biopsy, several elasticity imaging techniques have been developed and have to be evaluated for accuracy and convenience in children. The role of each modality with main imaging findings is described in extrahepatic portal vein obstruction, hepatoportal sclerosis, congenital hepatic fibrosis, cirrhosis and Budd-Chiari syndrome.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-010-1600-3