Effectiveness and safety of ultrasound-guided percutaneous liver biopsy in children.
BACKGROUND
Percutaneous liver biopsy (PLB) is an important procedure in the diagnosis and follow-up of paediatric liver disease. Its purpose is to obtain tissue for histopathological observation, in our case, with ultrasound (US) guidance.


OBJECTIVE
To evaluate the effectiveness and safety of US-guided PLB in children.


METHODS
A retrospective study over a period of 12 years, from January 1999 until December 2010, with a selection of US-guided PLB performed in children with focal liver lesions or diffuse hepatic disease and liver transplant (LT). A 16-gauge automatic needle was used and a maximum of three fragments of liver were collected. Contraindications were: bile duct dilatation (>3 mm) INR > 1.5 (reference range, 0.9 -- 1.2) and platelet count <50,000 (reference range, 150,000 -- 450,000). Analysis focused on complications and final diagnosis.


RESULTS
A total of 513 biopsies were performed, 379 (73.9%) in children who had undergone orthotopic LT, 117 (22.8%) in children with liver disease of unknown cause and 17 (3.3%) in children with focal hepatic lesions. Histological diagnosis was obtained in 509 of 513 (99.3%) biopsies performed. Minor complications were registered in 38 patients (7.4%) and major complications occurred in 5 patients (1%). None needed a surgical intervention.


CONCLUSIONS
US-guided PLB in children is a safe and efficient method to achieve a specific diagnosis in liver disease.
Radiology Department, Hospital Pediátrico Carmona da Mota, Av. Afonso Romão, Santo António dos Olivais, 3000-602 Coimbra, Portugal. hugocmatos@gmail.com
Hugo
H
Matos
Maria José
MJ
Noruegas
Isabel
I
Gonçalves
Conceição
C
Sanches
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity