US-guided core biopsy of the spleen in children.
OBJECTIVE
To evaluate the safety, diagnostic yield, and clinical benefits of performing ultrasonography (US)-guided percutaneous splenic core biopsy in children.


METHODS
US-guided splenic core biopsy was performed in 30 children aged 6 months to 15.3 years (mean, 7.0 years), with focal lesions in 27 patients and homogeneous splenomegaly in three. Four patients underwent repeat biopsy to identify changes in splenic disease. Four types of biopsy needles were used in this series. General anaesthesia was used in 21 patients and conscious sedation in nine. Medical records were reviewed to assess diagnostic accuracy, influence on treatment, and biopsy-related complications.


RESULTS
All biopsies were performed without complication. Among the 30 biopsies, an accurate diagnosis was obtained in 25 (83%), a false-negative result was obtained in two (7%), and three (10%) were nondiagnostic. All conclusive results influenced treatment decisions. The mean number of needle passes was 2.7 per patient (range, 2-5 passes). Use of needles was 50%-100% successful in the acquisition of adequate tissue cores. Use of the 18-gauge needle was always successful in the safe acquisition of adequate tissue, with a maximum of three passes.


CONCLUSIONS
US-guided splenic core biopsy is a minimally invasive, simple, and safe procedure for use in children. It provides relatively high diagnostic accuracy while minimizing complications when compared with alternative, more invasive procedures.
Muraca
S
S
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.
Chait
P G
PG
Connolly
B L
BL
Baskin
K M
KM
Temple
M J
MJ
D000293:Adolescent; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009339:Needles; D013158:Splenic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography