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Ultrasound guidance. For interventional and intraoperative techniques in infants and children
1Department of Radiology, Children's Hospital of Philadelphia, Pennsylvania 19104.
Insights
Real-time ultrasound (US) imaging enables safe percutaneous biopsy and drainage in pediatric patients. This study found US-guided interventional procedures were safe and accurate in 96 children, with no complications.
Area of Science:
- Pediatric Radiology
- Interventional Radiology
- Medical Ultrasound
Background:
- Real-time ultrasound (US) imaging has advanced, improving diagnostic capabilities.
- Needle biopsy attachments are now readily available for ultrasound equipment.
Purpose of the Study:
- To evaluate the safety and accuracy of US-guided interventional procedures in pediatric patients.
- To review a 3-year experience with US-guided techniques in children.
Main Methods:
- A retrospective review of 96 pediatric patients (5 days to 21 years) undergoing US-guided procedures.
- Procedures included renal biopsy, nephrostomy tube placement, renal mass biopsy, cyst puncture, shunt placement, and tumor/calculi localization.
- Ultrasound was used to guide needle insertion for biopsy and drainage.
Main Results:
- A wide range of US-guided interventional procedures were successfully performed.
- No complications were reported in any of the 96 pediatric patients.
- Ultrasound provided safe and accurate guidance for all procedures.
Conclusions:
- US-guided percutaneous biopsy and drainage are safe and effective in pediatric patients.
- Accurate US guidance requires clear visualization of the target area and predetermination of needle trajectory.
- Ultrasound is a valuable tool for interventional procedures in pediatric radiology.
Abstract:
Since the advent of improved realtime ultrasound (US) imaging and the availability of the needle biopsy attachment, US-guided percutaneous biopsy and the drainage procedure can be performed safely in the pediatric patient. The authors review their experience over 3 years using US-guided interventional techniques in 96 children aged 5 days to 21 years. A wide variety of procedures were performed and included renal biopsy, nephrostomy tube placement, renal mass biopsy, puncture of bladder sinus tract and pancreatic pseudocyst, ventriculoperitoneal shunt placement and intraoperative localization of brain or renal tumor and renal calculi. No complication occurred. US can be safely and accurately used as guide for interventional procedures in children as long as the area of interest can be clearly demonstrated and the depth and necessary angle of needle insertion can be predetermined as feasible.