US-guided core biopsy of the spleen in children

PURPOSE: To evaluate the safety, diagnostic yield, and clinical benefits of performing ultrasonography (US)-guided percutaneous splenic core biopsy in children. MATERIALS AND METHODS: US-guided splenic core biopsy was performed in 30 ch ildren aged 6 months to 15.3 years (mean, 7.0 years), with focal lesions in 27 patients and homogeneous splenomegaly in three. Four patients underwent repeat biopsy to identify changes in splenic disease. Four types of biopsy needles were used in this series: General anaesthesia was used in 21 patie nts and conscious sedation in nine. Medical records were reviewed to assess diagnostic accuracy, influence on treatment, and biopsy-related complicati ons. RESULTS: All biopsies were performed without complication. Among the 30 bio psies, an accurate diagnosis was obtained in 25 (83%), a false-negative res ult was obtained in two (7%), and three (10%) were nondiagnostic. All concl usive results influenced treatment decisions. The mean number of needle pas ses was 2.7 per patient (range, 2-5 passes). Use of needles was 50%-100% su ccessful in the acquisition of adequate tissue cores. Use of the 18-gauge n eedle was always successful in the:safe acquisition of adequate tissue, wit h a maximum of three passes. CONCLUSION: US-guided splenic core biopsy is a minimally invasive, simple, and safe procedure for use in children. It provides relatively high diagnos tic accuracy while minimizing complications when compared with alternative, more invasive procedures.