الفهرس 
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Abstract
Diffuse liver diseases in pediatrics can be categorized as: hepatitis and
autoimmune hepatitis, cholestatic liver diseases, liver cirrhosis and chronic liver
diseases, metabolic liver diseases vascular liver diseases and fibrocystic liver
diseases.
In our study we prospectively tried to show if multidetector CT study can add
to the clinical and pathological diagnosis of diffuse hepatic diseases in neonates,
infants and children.
The study population consisted of 20 neonates and infants , 10 males and 10
females whose ages ranged from one day to one year (mean age 4.86 months) and
53 children 37 males and 36 females whose ages ranged from one year to 18 years
(mean age 3.79 years).
All patients underwent detailed history taking including symptoms and signs of
diffuse liver diseases and laboratory investigations, ultrasonography and MDCT of
the abdomen and pelvis. Histopathological examination was done for 61 patients.
The most common clinical presentation in neonates and infants was jaundice
while a symptomatic patients were the least. In children, the most common clinical
presentation was jaundice, while multiple neck swellings, hypoactivity, epistaxis and
easy fatigue were less common.
The abdominal ultrasound examination of the studied group showed that (20%)
of neonates and infants had hepatosplenomegally while (80%) showed average size
of the liver and spleen. (40%) of the studied children had hepatomegaly, while (66 %)
showed average size of the liver. Average spleen size was detected in (52.8%) of the
children, while (47.5%) showed splenomegaly. Liver cirrhosis was detected in
Summary
(16.9%) of the children, focal lesions in (13.2%), cirrhotic liver with focal lesions in
(5.6%) and coarse liver with focal lesion in (5.6%).
CT showed hepatomegally in (20%) of the studied neonates and infants; while
(100%) of them had smooth liver surface and homogenous liver parenchyma.
Average spleen was detected in (80%), while (20%) showed splenomegaly. (80%)
showed normal biliary radicals while they were unremarkable in (20%). Portovenous
system was normal in (85%) of patients while it was attenuated in (15%) of them.
On the other hand (66%) of the studied children showed enlarged liver, irregular
liver surface in (34%) and coarse parenchyma in (28%) of them. Biliary radicals were
dilated in (11.2%), porta hepatis lymph nodes were enlarged in (20.8%), the porto
venous system was dilated in (5.7%) while ascites was found in (39.6%)
Intrahepatic cholestasis was the most common histopathological finding among
neonates, infants and children.
According to the pathogenesis, cholestatic liver disease was the most common
cause of diffuse liver diseases among neonates and infants (60%) followed by
metabolic liver diseases (20%) and vascular liver diseases (20%); while in the studied
children, hepatitis was the most common cause (20.8%) followed by metabolic liver
disease (17.5%), structural liver disease (17%), liver cirrhosis (17%), vascular liver
disease (15.1%), cholestatic liver disease (15.1%) and autoimmune hepatitis (15.1%).
The correlation between the pathogenesis and CT findings in the studied neonates
and infants showed that hepatosplenomegally was most common among patients
diagnosed as metabolic liver disease.
The correlation between the pathogenesis and CT findings in the studied children
showed that hepatomegally and irregular liver surface were most common among
patients diagnosed as having vascular liver disease (87.5%), while low attenuation
parenchyma was most common among patients with metabolic liver disease (55.6%).
Summary
In neonates and infants CT was diagnostic in vascular liver disease but it was
unable to diagnose metabolic liver disease nor cholestatic liver disease.
In conclusion, our study showed that MDCT of the abdomen did not have a
great additive value in the diagnosis of diffuse liver disease, but was of value in the
diagnosis of vascular liver diseases in neonates and infants. Nevertheless it had a
good diagnostic value in structural and vascular liver diseases in children. Liver
biopsy and histopathological study is still of prime importance for the exact
diagnosis.