title: US-guided percutaneous needle biopsy of the spleen using 18-gauge versus 21-gauge needles.
abstract: OBJECTIVE
  To compare the techniques of sonographically (US)-guided percutaneous needle biopsy of the spleen using 18-gauge and 21-gauge needles.
  
  
  METHODS
  Forty-two patients undergoing 43 spleen biopsy procedures for focal lesions (n = 27 [16 single, 11 multiple]) or diffuse splenomegaly (n = 15) were analyzed. Two groups were divided randomly according to needle type: group 1 comprised 25 patients biopsied with an 18-gauge cutting needle for histologic examination; group 2 comprised 17 patients biopsied with a 21-gauge needle for histologic and cytologic examinations. Diagnostic accuracy, complication rate, and number of needle passes were compared between the 2 groups.
  
  
  RESULTS
  Correct histopathologic diagnosis was obtained in 36 cases, whereas incorrect diagnosis occurred in 6 cases. The accuracy of US-guided spleen biopsy in this series was 85.7%, with 1 patient (2.4%) having postprocedural hemorrhage. Compared with the 21-gauge needle, the 18-gauge needle had higher diagnostic accuracy (P < 0.05), required fewer needle passes (P < 0.05), and there was no significant difference in overall complication rate.
  
  
  CONCLUSIONS
  Because biopsy with an 18-gauge needle yields larger and unfragmented samples with higher diagnostic rate compared with a 21-gauge needle, and no increased rate of major complication requiring surgical intervention, it may be advantageous to use an 18-gauge cutting needle in the US-guided needle biopsy of splenic lesions.
authors.affiliation: Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.forename: Yangyan
authors.initials: Y
authors.lastname: Gao
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Yu
authors.forename: Dejiang
authors.initials: D
authors.lastname: Yu
authors.forename: Baowei
authors.initials: B
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002648:Child; D003581:Cytodiagnosis; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology; D013154:Spleen / Q000473:pathology*; D013158:Splenic Diseases / Q000473:pathology; D013160:Splenic Neoplasms / Q000473:pathology; D013163:Splenomegaly / Q000473:pathology; D018084:Ultrasonography, Interventional