Purpose or Case Report: To apply the Couinaud’ system of segmentation and PRETEXT staging system of the liver to the tumor staging, combined with MSCT for evaluate the effectiveness in pre or post therapy of hepatoblatoma.
Methods & Materials: We retrospectively reviewed the outcomes of 67 cases that were diagnosed as hepatoblastoma in our hospital between July of 2012 and September of 2017. The patient ages ranged from 4 months and 5 years old (median age 3.2 years old). Couinaud’ system of segmentation of the liver and PRETEXT staging system in MSCT were used to evaluate hepatoblastoma. According to the staging system results and imaging features, received the therapy relatively. We evaluate the patient’s response to the therapy of these 67 cases. All cases were confirmed by pathology, diagnostic accuracy was calculated.

Results: Among the 67 cases: (1) The density of tumors were heterogeneous and lower than hepatic tissues, 22/67 had calcifications. (2) MSCT PRETEXT staging results: Stage I 7 cases，Stage II 31 cases，Stage III 26 cases，Stage IV 3 cases; PRETEXT staging was used again according to the results of operation: Stage I 7 cases，Stage II 27 cases，Stage III 31 cases，Stage IV 2 cases，the accuracy was 73.1%(49/67). (3) Therapy evaluation: According to the PRETEXT staging and CT features, 7 cases of Stage I and 24/27 of Stage II were underwent the operation directly; As 3/27 of Stage II had ascites or portal vein tumor thrombus, with 31 cases of Stage III and 2 case of Stage IV, were underwent tumor biopsy. 31 cases who underwent the operation directly, 7 cases were followed up and had no recurrence, 24 cases were underwent chemotherapy and had no recurrence too. 36 cases were received 2 durations of chemotherapy, all 36 tumors were reduced in size, but the PRETEXT staging had no change, then the tumors were received resection.
Conclusions: PRETEXT staging system combined with MSCT is valuable for evaluaton the hepatoblastoma and conduting the timing of surgery and the chemotherapy protocols.