COMBINED PERCUTANEOUS LUNG-BIOPSY AND HIGH-RESOLUTION COMPUTED-TOMOGRAPHY IN THE DIAGNOSIS AND MANAGEMENT OF LUNG-DISEASE IN CHILDREN

Computed tomography-guided percutaneous lung biopsy is a well-recogniz ed procedure for obtaining tissue for diagnosis in adults with interst itial lung diseases. Recently this methodology has been extended to pe diatric practice. We have further refined this technique by employing high-resolution computed tomography (HRCT) under general anesthesia to obtain maximum anatomical detail. High-quality images are obtained th at accurately define the extent of disease, and percutaneous biopsies are then taken from a suitable area of radiological abnormality using an 18G Monopty needle. Twenty-six investigations have been performed o n 24 patients. The diagnosis was established from 14 biopsies, and his tological and/or radiological information that contributed to patient management was obtained from a further 4 procedures. In 4 patients the histological findings were inconclusive, and the final diagnosis was only confirmed by open lung biopsy and/or other investigations. The pr ocedure was generally well tolerated, although chest drainage for pneu mothorax was required in two patients. HRCT-guided percutaneous lung b iopsy is a useful initial approach to the diagnosis of interstitial lu ng disease in selected patients; the necessity of more invasive proced ures such as open, thoracoscopic, or transbronchial lung biopsy can th us generally be avoided. (C) 1996 Wiley-Liss, Inc.