The Clinical Value Of Ultrasound-guided Percutaneous Liver Biopsy In Children

Objective： To explore the value of ultrasound-guided percutaneousliver biopsy in diagnosis of liver disease in children by empirical analyzingclinic data in children underwent liver biopsy in our hospital.Methods： Data were collected and analyzed in46cases performedultrasound-guided percutaneous liver biopsy from September,2011, toOctober,2013in children’s hospital affiliated to Chongqing medicaluniversity retrospectively.Results：1． Ultrasound-guided percutaneous liver biopsy was performedsuccessfully in46cases (100%). None appeared the complication such aspostoperative bleeding, liver hematoma, infection, bile leakage and injurythe adjacent organs.Only3/46cases complained minor pain in the puncturesite postoperative,2/46cases vomited once postoperative,1/46cases hadhypoglycemia.2．Only4cases (8.7%) confirm the diagnosis before ultrasound-guidedpercutaneous liver biopsy. Finally,27cases (57%) confirm the diagnosisthrough a comprehensive analysis of the clinical data, laboratory tests and pathology examinations.3．Among the confirmed cases,3/46chronic hepatitis B,3/46CMVhepatitis,12/46glycogen storage disease,2/46Niemaoh-Pick disease,2/46drug-induced hepatitis,1/46Budd-Chiari syndrome,1/46hepatolenticulardegeneration,3/46Alagille syndrome.6/27cases related to infection,21/27cases not related to infection.4．Some cases have characteristic pathologic changes. In tissues withchronic hepatitis B, pathologic changes included swelling liver cells,piecemeal necrosis, infiltrated by Chronic inflammatory cells, proliferationof periportal fibrous tissues and HBsAg positive. In tissues with Alagillesyndrome, pathologic changes included narrow sinusoidal, reduction andsmaller volume bile ducts in periportal, bureaucratic disappear, precipitatebilirubin. In tissues with hepatolenticular degeneration, pathologic changesincluded many glycogen granules in liver cells, PAS is positive.Conclusion：1．The ultrasound-guided percutaneous liver biopsy in children is amethod which has high success rate, good safety and minimal side effects.2．Children who have long duration before admission，no effect totreatment and difficulty to diagnosis should do the ultrasound-guidedpercutaneous liver biopsy as soon as possible for accurate diagnosis, andcatching the best time for treatment.3． The ultrasound-guided percutaneous liver biopsy have the irreplaceable advantages and inevitable limitations. In order to improve thediagnostic accuracy, we need to comprehensive analyze the completemedical records, laboratory test result and pathology examination.