Abstract: Objective To evaluate the value of PRETEXT staging system and CT imaging features in evaluating treatment response of pediatric hepatoblastoma （HB）. Methods The multi-detector CT imaging features in 47 children with pathologically confirmed HB were retrospectively reviewed between January 2013 and August 2016. The consistency between PRETEXT stage and post-surgical pathological grade was assessed. The CT imaging findings, including tumor margin,morphology,intra-tumor hemorrhage,calcification and intra-tumor cystic necrosis, and pathological grades was evaluated. Results Out of 47 children with HB,30（63.8%） were pathological-proven epithelial,and 17（36.2%） with epithelial-mesenchymal type;eight children with HB,including 6 with PRETEXT stage II and 2 with PRETEXT stage III, received surgery without chemotherapy,and their PRETEXT stages was completely consistent with pathological-proven grade, and the accuracy rate between POSTTEXT stages and pathological grades reached 79.5% （31/39） in 39 children receiving surgery after chemotherapy;the overall accuracy of PRETEXT stage was 83.0% as compared with post-surgical pathological grade;out of ten children with tumor calcification,eight was with epithelial-mesenchymal type tumor, much higher than in with epithelial type （x²=8.313,P=0.004）. Conclusion The PRETEXT stage is well consistent with post-surgical grade, and it might predict the pathological grade in consideration of specific image findings,which is helpful in determining management strategy of children with HB.

Key words: Hepatoblastoma, Children, PRETEXT staging system, X-ray computed tomography