Abstract: Objective The aim of this study was to investigate ultrasound manifestations in children with different pathological types hepatoblastoma (HB). Methods 64 children with HB were encountered in our hospital between October 2021 and October 2024, and all of them underwent abdominal color Doppler ultrasonography and surgery or biopsy for pathological examination. Expression of alpha fetoprotein, glycoprotein CD34, cytokeratin 7, CK19, integrase interactor-1, hepatocyte paraffin-1 and beta-catenin were detected immunohistochemistry. Results Liver histo-pathological examination diagnosed complete epithelial type in 43 cases, including fetal type in 14 cases and embryonic type in 29 cases, and mixed epithelial mesenchymal type in 21 cases, including teratoma-like in 13 cases and without teratoma-like in 8 cases; diameter of tumor in fetal type was (8.5±2.4)cm, much less than [(11.4±2.1)cm, P＜0.05] in tumor in embryonic type or [(10.7±2.2)cm, P＜0.05] in tumor in mixed epithelial mesenchymal type or [(10.5±2.0)cm, P＜0.05] in tumor in without teratoma-like type; percentage of hyperechoic in fetal type was 92.9%, and in embryonic type was 93.1%, both much greater than 23.1%(P＜0.05) in mixed teratoma-like or 37.5%(P＜0.05) in without teratoma-like; percentage of calcification in fetal type was 21.4% and in embryonic type was 27.6%, both much lower than 76.9%(P＜0.05)in mixed tumors with teratoma-like features or 62.5%(P＜0.05)in mixed tumors without teratoma-like features; percentage of intratumoral necrotic cystic changes in fetal tumors was 35.7%, significantly lower than 79.3% (P＜0.05)in embryonic tumors or 76.9%(P＜0.05)in mixed tumors with teratoma-like features or 75.0%(P＜0.05)in mixed tumors without teratoma-like features. Conclusion Different pathological features of HB in children could have different ultrasound manifestations, which might provide hints for pathological subtyping preliminarily.

Key words: Hepatoblastoma, Ultrasonography, Pathology Children