Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children

IntroductionThe prevalence of hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) is notably high among children in western China, with the mortality rate for untreated children potentially reaching up to 90%. Meanwhile, hepatoblastoma is the most common malignant liver tumor in chil...

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Main Authors: Yi Tao, Hanqing Kong, Jiawu Li, Zhizhi Tan, Jun Wang, Yan Luo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1458649/full
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author Yi Tao
Hanqing Kong
Jiawu Li
Zhizhi Tan
Jun Wang
Yan Luo
author_facet Yi Tao
Hanqing Kong
Jiawu Li
Zhizhi Tan
Jun Wang
Yan Luo
author_sort Yi Tao
collection DOAJ
description IntroductionThe prevalence of hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) is notably high among children in western China, with the mortality rate for untreated children potentially reaching up to 90%. Meanwhile, hepatoblastoma is the most common malignant liver tumor in children, yet its treatment differs significantly from that of hepatic echinococcosis. This study aimed to compare and analyze the ultrasonographic and contrast-enhanced ultrasound (CEUS) characteristics of hepatic CE, AE, and hepatoblastoma in children, providing more imaging evidence for accurate clinical diagnosis.MethodsA retrospective analysis was conducted on preoperative data from children with pathologically confirmed hepatic echinococcosis in our hospital between 2012 and 2024. Furthermore, children consecutively diagnosed with hepatoblastoma between 2020 and 2024, confirmed by histopathological examination, were selected as the control group. Clinical data, conventional ultrasound images, and CEUS characteristics of hepatic echinococcosis and hepatoblastoma were analyzed and compared.ResultsThe mean ages of 22 children with hepatic CE and nine children with hepatic AE were 11.6 ± 2.8 years and 11.8 ± 3.6 years, respectively. The mean age of 36 children with hepatoblastoma was 2.9 ± 3.0 years. Significant differences were observed in age and history of residence or travel to endemic areas among children with hepatic echinococcosis and hepatoblastoma (P < 0.001). Hepatic CE and hepatoblastoma showed a higher proportion of cystic degeneration [≥50% (54.5%, 12/22), and between 0% and <50% (47.2%, 17/36, respectively)], while hepatic AE predominantly showed no cystic degeneration (88.9%, 8/9). Clear boundaries were most commonly seen in hepatic CE lesions (95.5%, 21/22), while unclear boundaries were more frequent in hepatic AE lesions (88.9%, 8/9) (P < 0.05). Calcification was more prevalent in hepatic AE compared to hepatic CE and hepatoblastoma (P < 0.05). Hepatoblastoma exhibited richer color Doppler signals (94.4%, 34/36) compared to hepatic CE and AE (P < 0.05). CEUS was performed on two hepatic echinococcosis and nine hepatoblastoma lesions. On CEUS, one hepatic AE lesion showed peripheral hyperenhancement in the arterial phase, while one hepatic CE lesion showed no significant enhancement. In hepatoblastoma, nine lesions demonstrated hyperenhancement in the arterial phase and hypoenhancement in the late phase.ConclusionThis study demonstrates the value of ultrasound in differentiating hepatic echinococcosis from hepatoblastoma in children. Hepatic CE typically manifests as a well-defined cystic or cystic-solid mass, while hepatic AE often presents as an ill-defined cystic-solid or solid mass with diffuse calcifications. Conversely, hepatoblastoma appears as a partially well-defined cystic-solid or solid mass with abundant color Doppler signals within and around the lesion.
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spelling doaj-art-03b61a4a11f14f448a0664488d9985472025-01-28T06:40:53ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011310.3389/fped.2025.14586491458649Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in childrenYi Tao0Hanqing Kong1Jiawu Li2Zhizhi Tan3Jun Wang4Yan Luo5Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Medical Ultrasound, Shandong Provincial Hospital Heze Hospital, Heze, Shandong, ChinaDepartment of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaIntroductionThe prevalence of hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) is notably high among children in western China, with the mortality rate for untreated children potentially reaching up to 90%. Meanwhile, hepatoblastoma is the most common malignant liver tumor in children, yet its treatment differs significantly from that of hepatic echinococcosis. This study aimed to compare and analyze the ultrasonographic and contrast-enhanced ultrasound (CEUS) characteristics of hepatic CE, AE, and hepatoblastoma in children, providing more imaging evidence for accurate clinical diagnosis.MethodsA retrospective analysis was conducted on preoperative data from children with pathologically confirmed hepatic echinococcosis in our hospital between 2012 and 2024. Furthermore, children consecutively diagnosed with hepatoblastoma between 2020 and 2024, confirmed by histopathological examination, were selected as the control group. Clinical data, conventional ultrasound images, and CEUS characteristics of hepatic echinococcosis and hepatoblastoma were analyzed and compared.ResultsThe mean ages of 22 children with hepatic CE and nine children with hepatic AE were 11.6 ± 2.8 years and 11.8 ± 3.6 years, respectively. The mean age of 36 children with hepatoblastoma was 2.9 ± 3.0 years. Significant differences were observed in age and history of residence or travel to endemic areas among children with hepatic echinococcosis and hepatoblastoma (P < 0.001). Hepatic CE and hepatoblastoma showed a higher proportion of cystic degeneration [≥50% (54.5%, 12/22), and between 0% and <50% (47.2%, 17/36, respectively)], while hepatic AE predominantly showed no cystic degeneration (88.9%, 8/9). Clear boundaries were most commonly seen in hepatic CE lesions (95.5%, 21/22), while unclear boundaries were more frequent in hepatic AE lesions (88.9%, 8/9) (P < 0.05). Calcification was more prevalent in hepatic AE compared to hepatic CE and hepatoblastoma (P < 0.05). Hepatoblastoma exhibited richer color Doppler signals (94.4%, 34/36) compared to hepatic CE and AE (P < 0.05). CEUS was performed on two hepatic echinococcosis and nine hepatoblastoma lesions. On CEUS, one hepatic AE lesion showed peripheral hyperenhancement in the arterial phase, while one hepatic CE lesion showed no significant enhancement. In hepatoblastoma, nine lesions demonstrated hyperenhancement in the arterial phase and hypoenhancement in the late phase.ConclusionThis study demonstrates the value of ultrasound in differentiating hepatic echinococcosis from hepatoblastoma in children. Hepatic CE typically manifests as a well-defined cystic or cystic-solid mass, while hepatic AE often presents as an ill-defined cystic-solid or solid mass with diffuse calcifications. Conversely, hepatoblastoma appears as a partially well-defined cystic-solid or solid mass with abundant color Doppler signals within and around the lesion.https://www.frontiersin.org/articles/10.3389/fped.2025.1458649/fullhepatic echinococcosishepatoblastomaultrasoundcontrast-enhanced ultrasoundchildrenpediatrics
spellingShingle Yi Tao
Hanqing Kong
Jiawu Li
Zhizhi Tan
Jun Wang
Yan Luo
Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
Frontiers in Pediatrics
hepatic echinococcosis
hepatoblastoma
ultrasound
contrast-enhanced ultrasound
children
pediatrics
title Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
title_full Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
title_fullStr Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
title_full_unstemmed Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
title_short Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
title_sort comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
topic hepatic echinococcosis
hepatoblastoma
ultrasound
contrast-enhanced ultrasound
children
pediatrics
url https://www.frontiersin.org/articles/10.3389/fped.2025.1458649/full
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