title: Sonography-guided percutaneous liver biopsies in children.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the safety and efficacy of sonography-guided percutaneous core needle liver biopsy in infants and children.
  
  
  METHODS
  We conducted a retrospective analysis of all patients who underwent sonography-guided percutaneous core needle liver biopsies over a 7.5-year period by pediatric interventionalists at a single tertiary center.
  
  
  RESULTS
  A total of 597 procedures were performed in 470 patients (270 male and 200 female), with a mean age of 10.5 years (age range, 1 month-21 years). The main indications for biopsies were abnormal liver enzymes (n=129, 21.6%), grading and staging of chronic hepatitis B or C (n=105, 17.6%), evaluation of transplanted liver (n=111, 18.6%), iron overload (n=73, 12.2%), miscellaneous other diffuse parenchymal abnormalities (n=124, 20.7%), and focal hepatic lesions (n=55, 9.2%). The procedures were performed either under sedation (n=311, 52.1%) or general anesthesia (n=286, 47.9%). Diagnostic yield was obtained in 596 biopsies (99.8%) from an average of 2.4 cores in patients with diffuse disease (n=541, 90.6%) and 6.5 cores in patients with focal disease (n=55, 9.2%). Ten patients (1.7%) experienced a major complication, including pneumothorax (n=1, 0.2%), abdominal wall pseudoaneurysm (n=1, 0.2%), and symptomatic bleeding (n=8, 1.3%). Five of these children required transfusion, two were only admitted for observation, and one required surgical evacuation. There were no procedure-related deaths. Minor complications (n=49, 8.2%) included a symptomatic subcapsular hematoma (n=35) and stable small hemoperitoneum (n=9).
  
  
  CONCLUSIONS
  Sonography-guided percutaneous core liver biopsy is a safe and effective procedure in children that has a high diagnostic yield and very low complication rate.
authors: Division of Vascular and Interventional Radiology, Department of Gastroenterology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
authors: Pradeep
authors: P
authors: Govender
authors: Maureen M
authors: MM
authors: Jonas
authors: Ahmad I
authors: AI
authors: Alomari
authors: Horacio M
authors: HM
authors: Padua
authors: Brian J
authors: BJ
authors: Dillon
authors: Mary F
authors: MF
authors: Landrigan-Ossar
authors: Gulraiz
authors: G
authors: Chaudry
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D055815:Young Adult