Ilivitzki Anat, Abugazala Maya, Arkovitz Marc, Benbarak Ayelet, Postovsky Sergey, Arad-Cohen Nira, Ben-Arush Myriam
†Department of Pediatric Surgery ‡Department of Pediatric Oncology, Mayer Children Hospital *Department of Radiology, Rambam Health Care Campus, Haifa, Israel.
J Pediatr Hematol Oncol. 2014 Jul;36(5):333-6. doi: 10.1097/MPH.0b013e31827e4c4d.
Traditionally in pediatric oncology, biopsies were incisional, with a recent alternative of percutaneous imaging-guided biopsies. In our department, ultrasound (US)-guided core biopsy is the first choice for tissue diagnosis in the pediatric population. We retrospectively reviewed our experience and assessed the accuracy rate, safety, and availability of the procedure.
Pediatric US-guided biopsies performed in our hospital between November 2003 and November 2011 were studied. Data collection included demographics, clinical and procedural data, and follow-up.
A total of 213 biopsies were performed on 191 patients: 40 known oncologic patients and 173 to establish diagnosis. Seventeen biopsies were excluded, as malignancy was not suspected. Sixty-five percent of the patients had a biopsy within a day. A total of 138 biopsies with tumor at the biopsy site were correctly diagnosed and 4 were missed. Fifty-eight patients were negative for tumor. The sensitivity of our ultrasound-guided core biopsy is 97.1%, specificity 100%, and accuracy 97.9%.We found no complication related to sedation, and 2 procedural complications-bleeding from the biopsy site and seeding of tumor cells-were reported.
We find US-guided core biopsy for suspected malignancy in the pediatric population to be highly available, safe, and very accurate, having a potential to become the procedure of choice.
在小儿肿瘤学领域，传统上活检采用切开活检术，近来出现了经皮影像引导下活检术作为替代方法。在我们科室，超声（US）引导下的芯针活检是小儿群体组织诊断的首选方法。我们回顾性分析了我们的经验，并评估了该操作的准确率、安全性和可行性。
对2003年11月至2011年11月在我院进行的小儿超声引导下活检进行研究。数据收集包括人口统计学资料、临床和操作数据以及随访情况。
共对191例患者进行了213次活检：40例为已知肿瘤患者，173例用于明确诊断。由于未怀疑为恶性肿瘤，17次活检被排除。65%的患者在一天内接受了活检。活检部位有肿瘤的138次活检被正确诊断，4次漏诊。58例患者肿瘤检查为阴性。我们超声引导下芯针活检的敏感性为97.1%，特异性为100%，准确率为97.9%。我们未发现与镇静相关的并发症，报告了2例操作并发症——活检部位出血和肿瘤细胞种植。
我们发现超声引导下芯针活检对于小儿群体疑似恶性肿瘤具有高度可行性、安全性且非常准确，有可能成为首选的操作方法。
