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Evaluation of the Feasibility, Safety, and Accuracy of an Intraoperative High-intensity Focused Ultrasound Device for Treating Liver Metastases
Published on: January 9, 2019
Effectiveness and safety of ultrasound-guided percutaneous liver biopsy in children
Hugo Matos1, Maria José Noruegas, Isabel Gonçalves
1Radiology Department, Hospital Pediátrico Carmona da Mota, Av. Afonso Romão, Santo António dos Olivais, 3000-602 Coimbra, Portugal. hugocmatos@gmail.com
Insights
Ultrasound-guided percutaneous liver biopsy (PLB) is a safe and effective method for diagnosing paediatric liver disease. This study confirmed its high diagnostic yield and low complication rate in children.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Medical Imaging and Interventional Radiology
- Diagnostic Pathology
Background:
- Percutaneous liver biopsy (PLB) is crucial for diagnosing and monitoring pediatric liver conditions.
- Ultrasound (US) guidance enhances the precision and safety of PLB procedures.
Purpose of the Study:
- To assess the effectiveness and safety of US-guided PLB in pediatric patients.
- To determine the diagnostic yield and complication rates associated with the procedure.
Main Methods:
- A 12-year retrospective analysis (1999-2010) of US-guided PLB in children.
- Inclusion criteria: focal liver lesions, diffuse hepatic disease, or post-liver transplant (LT).
- Exclusion criteria: bile duct dilatation, elevated INR, or low platelet count. A 16-gauge needle was used.
Main Results:
- 513 biopsies were performed, with 99.3% achieving histological diagnosis.
- The majority of biopsies (73.9%) were in post-liver transplant recipients.
- Minor complications occurred in 7.4% and major complications in 1% of patients, none requiring surgery.
Conclusions:
- US-guided PLB is a safe and highly effective diagnostic tool for pediatric liver diseases.
- The procedure demonstrates a low incidence of serious complications, supporting its clinical utility.
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.
Material And 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.
Conclusion:
US-guided PLB in children is a safe and efficient method to achieve a specific diagnosis in liver disease.
