Imaging of Paediatric Liver Tumours Quiz
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Questions and Answers

Which of the following is NOT a benign primary liver tumor?

  • Hepatic Adenoma
  • Cholangiocarcinoma
  • FNH
  • HCC (correct)

What is the main difference between fatty sparing and fatty infiltration in the liver parenchyma?

  • Fatty sparing is generalized while fatty infiltration is localized.
  • There is no difference between fatty sparing and fatty infiltration.
  • Fatty sparing indicates benign tumors while fatty infiltration indicates malignant tumors.
  • Fatty sparing involves fat deposition relative to the liver, whereas fatty infiltration does not. (correct)

Which type of liver tumor is most commonly associated with a history of oral contraceptive use?

  • Hepatic Adenoma (correct)
  • Cholangiocarcinoma
  • Hemangioma
  • FNH

In the context of liver tumors, what does HCC stand for?

<p>Hepatocellular Carcinoma (A)</p> Signup and view all the answers

Which of the following statements about liver lesions is true?

<p>Focal Fat Sparing indicates fatty deposition in the liver. (B)</p> Signup and view all the answers

What is the recommended imaging modality for workup in cases of Hepatocellular adenoma?

<p>CT scan (D)</p> Signup and view all the answers

What is a risk factor for the development of Hepatocellular adenoma?

<p>Glycogen storage diseases (C)</p> Signup and view all the answers

Which type of patient is at risk for fibrolamellar HCC?

<p>Young patients (C)</p> Signup and view all the answers

What is the typical presentation of hepatocellular carcinoma (HCC)?

<p>Nodule on screening (A)</p> Signup and view all the answers

Which of the following is NOT a common symptom associated with paraneoplastic syndromes in HCC?

<p>Hypotension (A)</p> Signup and view all the answers

What is the main cause of HCC in non-cirrhosis patients?

<p>Hepatitis B (B)</p> Signup and view all the answers

Which of the following is a recommended imaging modality for the diagnosis of Hepatocellular carcinoma?

<p>MRI with gadolinium (A)</p> Signup and view all the answers

What is the most common benign liver lesion?

<p>Hemangioma (A)</p> Signup and view all the answers

What is the doubling time for hepatocellular carcinoma?

<p>$6$ months (D)</p> Signup and view all the answers

Which imaging technique is used to diagnose hemangioma with 97% sensitivity and 83% specificity?

<p>Technetium 99m labelled RBC scan (D)</p> Signup and view all the answers

'Focal Fat Sparing' and 'Focal Fat Infiltration' are associated with which condition?

<p>Focal nodular hyperplasia (FNH) (D)</p> Signup and view all the answers

What presentation is rare in patients with hemangioma?

<p>Kasaback-Merritt syndrome (C)</p> Signup and view all the answers

'Asterixis' can be a sign of what condition during physical examination?

<p>$ ext{Liver Disease}$ (D)</p> Signup and view all the answers

Which imaging technique shows arterial enhancement with washout in delayed phase for Focal Nodular Hyperplasia (FNH)?

<p>CT multiphase (D)</p> Signup and view all the answers

What is the main management approach for Focal Nodular Hyperplasia (FNH)?

<p>No need for surveillance, treat if symptomatic (D)</p> Signup and view all the answers

What is the characteristic appearance of hemangioma on ultrasound?

<p>Hyperechoic (C)</p> Signup and view all the answers

Which of the following is NOT associated with Focal Nodular Hyperplasia (FNH)?

<p>Hemangioma (C)</p> Signup and view all the answers

What is the best next step after a suspicious liver mass detected on imaging?

<p>(AFP) Alpha-fetoprotein testing (D)</p> Signup and view all the answers

In which population is Focal Nodular Hyperplasia (FNH) most common?

<p>(F&gt;M) Females more than Males (C)</p> Signup and view all the answers

What characteristic feature is seen on MRI with contrast in patients with Focal Nodular Hyperplasia (FNH)?

<p>High intensity central stellate scar on T2 (D)</p> Signup and view all the answers

What is the most common diagnostic tool for Hepatocellular Carcinoma (HCC) work up?

<p>Multiphasic CT scan (B)</p> Signup and view all the answers

In HCC management, what does 'wash out' typically refer to on the portal vein phase of a CT scan?

<p>Reduction in enhancement of the tumor (A)</p> Signup and view all the answers

What does the Child Turcotte Pugh Score assess in HCC patients?

<p>Underlying liver function (D)</p> Signup and view all the answers

In the Child Turcotte Pugh Score, what does an albumin level below 28 g/L indicate?

<p>Grade C liver function (C)</p> Signup and view all the answers

What is the 1-year survival rate for patients with a Child Pugh Score of 10-15?

<p>45% (D)</p> Signup and view all the answers

What are the contraindications to resection in HCC management?

<p>Portal hypertension (A)</p> Signup and view all the answers

'Encephalopathy' in the Child Turcotte Pugh Score refers to a condition affecting which organ?

<p>Brain (D)</p> Signup and view all the answers

'Ascites' in the Child Turcotte Pugh Score refers to an abnormal accumulation of fluid in which part of the body?

<p>Abdomen (D)</p> Signup and view all the answers

'INR' in the Child Turcotte Pugh Score is a measure of what aspect of liver function?

<p>Blood clotting ability (B)</p> Signup and view all the answers

Which liver function score indicates moderate ascites and bilirubin levels between 34-51 µmol/L?

<p>Grade B (A)</p> Signup and view all the answers

What is the main difference between Neoplastic and Non-Neoplastic liver lesions?

<p>Presence of malignant cells (D)</p> Signup and view all the answers

Which type of liver tumor is most likely to be associated with a history of liver cirrhosis?

<p>Hepatocellular Carcinoma (HCC) (C)</p> Signup and view all the answers

What characteristic feature is typically seen in Hepatic Adenoma on imaging studies?

<p>Central stellate scar (C)</p> Signup and view all the answers

Which liver lesion is characterized by localized fatty deposition without fat deposition relative to liver tissue?

<p>Focal Fat Sparing Hemangioma (B)</p> Signup and view all the answers

What is the most common primary malignant liver tumor?

<p>Hepatocellular Carcinoma (HCC) (B)</p> Signup and view all the answers

Which imaging finding is typically observed in Focal Nodular Hyperplasia (FNH)?

<p>'Spoke-wheel' pattern on CT scan (B)</p> Signup and view all the answers

Which liver lesion exhibits a 'cavernous' appearance with vascular structures on ultrasound?

<p>Focal Fat Sparing Hemangioma (B)</p> Signup and view all the answers

'Fatty sparing' in liver parenchyma refers to what condition?

<p>'Fatty' changes without fat deposition relative to liver tissue (A)</p> Signup and view all the answers

Which liver lesion is strongly associated with a history of oral contraceptive use?

<p>'Hepatic Adenoma' (A)</p> Signup and view all the answers

'Focal Fat Infiltration' in the liver parenchyma refers to what condition?

<p>'Fatty' infiltration with localized fatty deposition (B)</p> Signup and view all the answers

Which hormone therapy should be discontinued in patients with Hepatocellular adenoma to potentially induce tumor regression?

<p>Estrogen (D)</p> Signup and view all the answers

What is the most common risk factor for the development of Hepatocellular adenoma?

<p>Glycogen storage diseases (D)</p> Signup and view all the answers

In the management of ruptured Hepatocellular adenoma in a stable patient, what is the first-line intervention?

<p>Angioembolization (B)</p> Signup and view all the answers

What percentage of hemangiomas are fed by hepatic arterial circulation and lined by a single layer of flat endothelial cells?

<p>100% (C)</p> Signup and view all the answers

Which liver disease is NOT associated with an increased risk of developing Hepatocellular carcinoma?

<p>Glycogen storage diseases (B)</p> Signup and view all the answers

Which imaging modality is NOT recommended for the workup of Focal Nodular Hyperplasia (FNH)?

<p>Biopsy before tumor board review (C)</p> Signup and view all the answers

What type of liver lesion is most commonly associated with a history of anabolic steroid use in males?

<p>Hepatic Adenoma (C)</p> Signup and view all the answers

In the management of Focal Nodular Hyperplasia (FNH), what is the indication for treatment?

<p>Symptoms (C)</p> Signup and view all the answers

What is the first-line imaging modality used for the workup of Hepatocellular carcinoma?

<p>CT with multiphase imaging (D)</p> Signup and view all the answers

Which liver tumor is associated with the presence of other vascular malformations such as telangiectases and AVM?

<p>Fibrolamellar Nodular Hyperplasia (FNH) (D)</p> Signup and view all the answers

Which benign liver lesion may require surgery if symptomatic and enlarging beyond 5cm?

<p>Hepatic Adenoma (A)</p> Signup and view all the answers

What is the characteristic appearance of the central scar on MRI with contrast in Focal Nodular Hyperplasia (FNH)?

<p>High intensity on T1 (D)</p> Signup and view all the answers

What is the main cause of mortality in patients diagnosed with Hemangioma?

<p>Spontaneous rupture (A)</p> Signup and view all the answers

Which liver function test result is indicative of severe encephalopathy in the Child Turcotte Pugh Score?

<p>INR above 2.3 (A)</p> Signup and view all the answers

What is the 2-year survival rate for patients classified as Child Pugh C in the HCC management guidelines?

<p>35% (D)</p> Signup and view all the answers

What is the main reason small liver remnants are considered a contraindication to resection in HCC management?

<p>Concerns related to portal hypertension (D)</p> Signup and view all the answers

In HCC management, what does the Child Pugh Score assess?

<p>Overall liver function (A)</p> Signup and view all the answers

What does a Child Pugh Score of 7-9 indicate in terms of liver function?

<p>Moderate liver dysfunction (A)</p> Signup and view all the answers

Which stage of HCC management is associated with a 1-year survival rate of 100%?

<p>Stage A (C)</p> Signup and view all the answers

Why is 'wash out' on portal vein phase significant in diagnostic imaging for HCC?

<p>Differentiates HCC from benign lesions (A)</p> Signup and view all the answers

'Ascites' is categorized as severe in the Child Pugh Score when it is described as:

<p>'gross' (C)</p> Signup and view all the answers

'Grade 1' survival refers to the survival rates of patients with which Child Pugh Score level at 2 years?

<p>'B' (D)</p> Signup and view all the answers

'Portal hypertension' is listed as a contraindication to resection in HCC management due to its impact on:

<p>'platelet count abnormalities' (C)</p> Signup and view all the answers

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