<b>Combined Sonographic and Fluoroscopic Guidance During Transjugular Hepatic Biopsies Performed in Children:</b>A Retrospective Study of 74 Biopsies
Bibliographic record
Abstract
OBJECTIVE: Our aim was to evaluate the safety, effectiveness, and clinical impact of transjugular biopsies of the liver performed in children. MATERIALS AND METHODS: We retrospectively reviewed 74 transjugular hepatic biopsies performed in 64 pediatric patients. The selection criteria for transjugular approach in these children included mainly coagulopathy, thrombocytopenia, or ascites. The last 37 biopsies in our series were performed with combined sonographic and fluoroscopic guidance, which improved visualization of the biopsy tract. RESULTS: Adequate samples for histopathologic analysis were obtained in all except one case (98.6%). In most patients with fulminant hepatic failure, biopsy results allowed patients to be promptly listed for orthotopic liver transplantation; in patients with less severe hepatic failure, biopsy results helped guide medical management. In patients with liver transplants, the biopsy provided information on acute graft rejection; in patients who had undergone bone marrow transplantation, the biopsy helped to determine the status of graft-versus-host disease. One death occurred immediately after the procedure but at autopsy was deemed not to have been caused by the biopsy itself. Overall, procedural complications occurred in 8.1% of patients. Complications included neck hematomas, small subcapsular hematomas, subclavian artery puncture, and extravasation of contrast material into the retroperitoneum. CONCLUSION: Transjugular hepatic biopsy is a relatively safe procedure that has considerable impact on patient treatment. The addition of sonographic guidance during the biopsy improves visualization, increases operator confidence, and allows the performance of biopsies in smaller patients and in children with reduced liver transplants.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".