Objective To summarize the first experience with ultrasound-guided percutaneous ab lation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children.Methods From August 2013 to April 2015,PAT was used to treat 6 children with a total of 9 recurrent HB,including 5 patients with 8 tumors in the liver and 1 patient with 1 tumor in the lung.The mean size of ablated tumors was (1.5 ± 0.8) cm,and the tumor size range was 0.7 cm to 3.1 cm.Results Four patients were performed percutaneous radiofrequency ablation (RFA) for recurrent HB;and 2 patients were performed percutaneous ethanol injection (PEI).Ablation success was achieved in all patients (6/6,100％).The complete ablation rate after the first ablation session was 88.9％ (8/9) on a tumor-by-tumor basis.Only 1 patient developed a fever with temperature ＞ 39 ℃;it was resolved by conservative therapy.During the follow-up period of 5-30 months,3 patients died to tumor progression.The 1-and 2-year overall survival rates after ablation were 83.3％ and 41.7％,respectively.Conclusions PAT is a safe and promising therapy for children with recurrent HB after liver resection,and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.

Objective To investigate the security,applicability and diagnostic capacity of intravenous contrast-enhanced ultrasound (CEUS) in a pediatric population. Methods A total of 53 pediatric patients (8 months to 18 years old) received 66 intravenous applications of ultrasound contrast agent SonoVue.Side effects were documented.Histology,reference imaging or clinical diagnosis were compared with CEUS diagnostic results. Results Adverse effects occurred in 1/66 applications (1.5% ). For 44 focal liver lesions,the sensitivity was 100%,the specificity was 95.65%,the positive predictive value was 95.45% and the negative predictive value was 100%.The diagnostic accuracy was 97.73%.All 22 other lesions were diagnosed correctly.Conclusions It is safe and feasible to use intravenous CEUS in children.CEUS is worthy of promotion in pediatric patients with abdominal diseases.

ObjectiveTo explore the value of color Doppler ultrasonography (CDU) in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC) in infants.MethodsA total of 54 infants diagnosed with hepatic portal cystic lesion in the First Affiliated Hospital of Sun Yat-sen University from January 2012 to July 2014 who were going to receive surgical treatment were included in this prospective study. Of the 54 cases, 35 were baby boys and 19 were baby girls with a mean of (63±19) d old. According to the results of pathological examination, the patients were divided into the CBA group and the CC group.All guardians of the infants signed the informed consent and the local ethical committee approval had been received. Preoperative TB level and DB level were recorded. CDU was used to observe the incidence of hepatic portal ifbrous mass, intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst. In addition, the length diameter and width diameter of gallbladder and the inner diameter of hepatic artery were measured. The observed parameters of two groups were compared byχ2 test ort test.ResultsThe incidence of hepatic portal ifbrous mass in CBA group was 96% (25/26), which was signiifcantly higher than 0 (0/28) in CC group (P<0.05). The incidence of intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst in CBA group were both 0 (0/26), which were signiifcantly lower than 75% (21/28) and 54% (15/28) in CC group (P<0.05). The width diameter of gallbladder in CBA group was (5±1) mm, which was signiifcantly less than (8±2) mm in CC group (t=-38.68,P<0.05). The inner diameter of hepatic artery in CBA group was (2.4±0.4) mm, which was significantly greater than (1.8±0.3) mm in CC group (t=28.40,P<0.05). ConclusionsThe hepatic portal ifbrous mass, intrahepatic bile duct dilation, biliary sludge sedimentation in the cyst, width diameter of gallbladder and inner diameter of hepatic artery are effective indexes for CDU to differentiate CBA and CC, thus, CDU may be used in the preoperative differential diagnosis.