Imaging insights into pediatric liver masses: A comprehensive minireview for hepatology practice

Table 2 Summary of pediatric hepatic lesions from birth to six years of life

Lesion	Age	AFP	Calcifications	Imaging appearance	Quantitative metrics
Hepatoblastoma	< 5 years (peak: 6 months-3 years)	Markedly elevated (> 100000 ng/mL in many cases)	Chunky calcifications commonly seen in 50% of cases	US: Heterogeneous, solid mass, may have necrosis and calcifications. CT: Enhancing soft tissue with coarse calcifications. MRI: Isoechoic/hypoechoic on T1, hyperintense on T2, with heterogeneous enhancement	Size: > 5 cm at diagnosis. AFP: > 10000-100000+ ng/mL
Hepatic hemangioma	Neonates and infants (< 6 months)	Normal or mildly elevated (< 100 ng/mL). Limited diagnostic value	Rare. May be present in the congenital forms of hemangioma but absent in the infantile type	US: Hypoechoic or mixed echotexture, high vascularity with Doppler. CT/MRI: Vascular lesion with peripheral enhancement and centripetal fill-in	Size: Ranges from small (< 3 cm) to giant (> 5 cm). May cause high-output cardiac failure in giant hemangiomas
Mesenchymal hamartoma	< 2 years (typically < 18 months)	Normal	Rare	US and CT: Multiseptated cystic lesion interspersed with solid component. Minimal enhancement	Size: Often large (> 10 cm), displacing adjacent organs

AFP: Alpha-fetoprotein; CT: Computed tomography; MRI: Magnetic resonance imaging; US: Ultrasound.