Is pediatric tumor biopsy dangerous?

Author: Cheng Juan Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Reviewer: Chen Yaqing, Chief Physician, Xinhua Hospital, Shanghai Jiaotong University School of Medicine

Ultrasound-guided tumor puncture biopsy is a method of using a puncture biopsy needle to remove a small portion of tumor tissue for pathological testing under the real-time monitoring and guidance of an ultrasound diagnostic device. The following is a detailed description of the specific operation process.

First, before the puncture, a routine ultrasound examination should be performed to determine the specific location, size, shape, internal echo of the tumor, and the adjacent relationship with the surrounding important organs and blood vessels, so as to determine a safe puncture path. Then, before the puncture needle is inserted, anesthesia should be performed first. If the child is obedient and cooperative, it is only necessary to inject anesthetics into the local skin at the injection site, just like a normal injection, and the pain will be over. After that, the child will not feel pain during the puncture process. If the child is too young to cooperate, "general anesthesia" is required, which is performed by an anesthesiologist in the operating room. Some parents get nervous when they hear about "anesthesia", worrying that it will affect the intellectual development of their children. In fact, there is no need to worry at all, as anesthetic drugs do not have these side effects. After anesthesia, the ultrasound doctor can perform a puncture biopsy. The ultrasound doctor can see the tumor lesion and the puncture needle at the same time on the ultrasound image of the ultrasound instrument, and monitor the position of the puncture needle in real time, so that the puncture needle can avoid important organs and large blood vessels under ultrasound guidance and reach the tumor lesion, thereby ensuring the accuracy and safety of the puncture. The whole process of needle puncture biopsy is very fast, taking about 30 minutes, with little trauma. After the operation, compression can be used to stop bleeding. It is very safe and will not cause danger to the child. The schematic diagram of ultrasound-guided puncture biopsy is shown in Figure 1. The ultrasound sonogram of ultrasound-guided puncture biopsy is shown in Figure 2 (the white arrow indicates the puncture needle).

Figure 1 Copyright image, no permission to reprint

Figure 2 Copyright image, no permission to reprint

With the continuous improvement of the performance of ultrasound instruments, such as high-resolution ultrasound can provide clear tissue anatomy, color Doppler ultrasound can display the vascular direction of tissues and organs in real time, and ultrasound microvascular imaging technology can provide tiny tumor blood vessels. With the help of these technologies, ultrasound can accurately select the tumor site and perform puncture sampling in real time. This targeted puncture can achieve the accuracy of pathological diagnosis and grading (Figure 3). In addition, with the improvement of puncture needles and the accumulation of ultrasound doctors' operating experience, ultrasound-guided puncture biopsy has become a very mature and important diagnostic technology. Therefore, ultrasound-guided tumor puncture biopsy can not only obtain accurate pathological results, including important information such as the source, nature, specific classification, and degree of differentiation of the tumor, providing the most critical information for clinicians to diagnose the disease and determine the subsequent treatment or surgical plan; it is also a safe and minimally invasive method for tumor diagnosis.

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