Paediatric hepatic masses present a diagnostic challenge to physician and surgeon alike. Dynamic new scanning techniques such as spiral computed tomography (CT) and current real time ultrasound have revolutionised scanning of liver masses, while magnetic resonance imaging (MRI) has added a fresh new spin on this topic. Focal processes include congenital lesions such as choledochal and simple cysts, infective conditions like abscesses and hydatid cysts, and neoplasms. The commonest neoplasms include benign tumours such as haemangioma and haemangioendothelioma, and malignant tumours such as metastases, hepatoblastoma (HB) and hepatocellular carcinoma (HCC). Important diffuse processes include biliary atresia, fatty infiltration, cirrhosis, iron deposition and Budd Chiari syndrome. Cognisance should also be taken of focal lesions such as focal fatty change, infarcts, anatomic variants and extrahepatic masses, which may mimic hepatic masses. This article aims to demonstrate the key CT imaging features that help in identifying these conditions.

liver abscess; haemangioendothelioma; hepatoblastoma; hepatocellular; carcinoma