Percutaneous CT-Guided Biopsy of Adrenal Masses

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Abstract
To determine the immediate and delayed complications of percutaneous adrenal biopsy and any relationship between biopsy methods and complications. Medical records and radiological examinations of 83 percutaneous adrenal biopsy were reviewed. Indication for biopsy, inpatient/outpatient status, lesion size and location, imaging modality used, needle type, size, approach and number of passes, biopsy results, immediate complications, and delayed complications were recorded. Computed tomography was used in 79 cases (95%) and ultrasound in 4 (5%). The biopsy approach was posterior in 37 cases, transhepatic in 33, transpancreatic in 9, anterior in 2, transsplenic in 1, and lateral in 1. The total complication rate was 8.4% and was slightly higher for the transhepatic approach (12%) than the posterior approach (8%). Seven complications occurred: two pneumothoraces, two pain, one perinephric hemorrhage, one subcapsular and intrahepatic hematoma, and one hepatic needle-tract metastasis. The posterior approach was complicated by the two pneumothoraces and perinephric blood; the transhepatic was used in the other four. Five of the complications occurred with 22 gauge needles. Percutaneous adrenal biopsy is a safe procedure. Complications occurred in 7 of our patients (8.4%).

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