[178] Transjugular Liver Biopsy: Are 4 Cores Better Than 3 and Does a Cassette Prevent Fragmentation

Shusang, V.; Marelli, Laura; Cholongitas, Evangelos; Kalambokis, Georgios; Manousou, E.; Senzolo, Marco; Patch, D.; Burroughs, A K

doi:10.1016/s0168-8278(07)61776-0

Cited by 3 publications

(5 citation statements)

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“…In transplanted patients we also obtained HVPG. The LSM and APRI score calculations were performed at the same time as obtaining a three or four core TJB or percutaneous biopsy [40,41]. Liver histology was scored according to Ishak et al [3], and we used our previously published methods for assessing hepatic collagen content using DIA and evaluating CPA [9].…”

Section: Discussionmentioning

confidence: 99%

“…We used a 19-gauge Tru-cut type biopsy needle (Quick core; Cook, William Cook Europe, Denmark) [9] and performed three or four passes through the same hepatic vein wall (right or middle) to ensure that sufficient liver tissue was obtained [40,41]. Hepatic vein pressures were measured using a 5-Fr balloon catheter using the technique described previously [10,42].…”

Section: Patientsmentioning

confidence: 99%

“…Each biopsy sample was evaluated histologically according to Ishak et al [2]. For each biopsy, the total length was more than 15 mm [40]. Portal tracts were defined according to Crawford et al [43] and were not counted in biopsies with severe distortion of the liver architecture, such as in cirrhosis or marked nodularity, because recognition and enumeration of individual portal tracts in these circumstance is impossible.…”

Section: Measurement Of Cpamentioning

confidence: 99%

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The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis

et al. 2012

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Background Collagen proportionate area (CPA) has a better correlation with hepatic venous pressure gradient (HVPG) than with Ishak stage. Liver stiffness measurement (LSM) is proposed as non invasive marker of portal hypertension/disease progression. Our aim was to compare LSM and CPA with Ishak staging in chronic viral hepatitis, and HVPG in HCV hepatitis after transplantation. Methods One hundred and sixty-nine consecutive patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections pre/post liver transplantation (LT), had a liver biopsy combined with LSM (transient elastography), CPA (biopsies stained with Sirius Red and evaluated by digital image analysis and expressed as CPA) and HVPG (measured contemporaneously with transjugular biopsies in LT HCV patients).Results LSM was dependent on CPA in HBV (r 2 = 0.61, p \ 0.0001), HCV (r 2 = 0.59, p \ 0.0001) and LT groups (r 2 = 0.64, p \ 0.0001). In all three groups, CPA and Ishak were predictors of LSM, but multivariately CPA was better related to LSM (HBV: r 2 = 0.61, p \ 0.0001; HCV: r 2 = 0.59, p \ 0.0001; post-LT: r 2 = 0.68, p \ 0.0001) than Ishak stage. In the LT group, multiple regression analysis including HVPG, LSM, aspartate aminotransferase to platelet ratio index (APRI) and Ishak stage/grade, showed that only CPA was related to HVPG (r 2 = 0.41, p = 0.01), both for HVPG C6 mmHg (OR 1.34, 95 % CI 1.14-1.58; p \ 0.0001) or C10 mmHg (OR 1.25, 95 % CI 1.06-1.47; p = 0.007). Conclusion CPA was related to LSM in HBV or HCV hepatitis pre/post-LT. CPA was better related to LSM than Ishak stage. In the LT HCV group, CPA was better related to HVPG than Ishak stage/grade, LSM or APRI. CPA may represent a better comparative histological index for LSM, rather than histological stages.

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Measurement Of Cpamentioning

confidence: 99%

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The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis

et al. 2012

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“…The procedure has been detailed elsewhere,27 using a 19‐gauge Tru‐cut type biopsy needle (Quick core; Cook, William Cook Europe, Denmark). We performed three or, more recently, four passes21 through the same hepatic vein wall (right or middle) to optimize sampling of liver tissue 21, 27. Hepatic vein pressures were measured using a 5‐F balloon catheter (Royal Flush plus Straight Visceral Angiographic Beacon tip catheter‐Cook‐William Cook Europe) using the technique recently described 28.…”

Section: Methodsmentioning

confidence: 99%

“…A liver biopsy should be at least 20 to 25 mm long or contain 11 or more complete portal tracts3, 16 to reliably assess grade and stage in chronic viral hepatitis. TJB with at least three passes is superior to the average quality of percutaneous liver biopsy reported in the literature17–21 and has the advantage of obtaining several cores, reducing histological variability 19…”

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confidence: 99%

Analysis of Pax7 expressing myogenic cells in zebrafish muscle development, injury, and models of disease

Seger

Hargrave

Wang

et al. 2011

Developmental Dynamics

117

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*The transcription factor Pax7 is a marker and regulator of muscle progenitors and satellite cells that contribute to the embryonic development and postembryonic growth of skeletal muscle in vertebrates, as well as to its repair and regeneration. Here, we identify Pax7 1ve myogenic cells in the zebrafish and characterize their behavior in postembryonic stages. Mononucleate Pax7 1ve cells can first be found associated with myofibers at 72 hours post fertilization (hpf). To follow the behavior of muscle progenitor cells in vivo, we generated transgenic lines expressing fluorescent proteins under the control of the pax7a or pax3a promoters. We established an injury model using cardiotoxin injection and monitored cell proliferation and myogenic regulatory factor expression in myogenic precursors cells and muscle fibers after injury using proliferation markers and the transgenic lines. We also analyzed Pax7 1ve cells in animals with dystrophic phenotypes and found an increased number compared with wild-type. Developmental Dynamics 240:2440-2451,

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Computer-assisted image analysis of liver collagen: Relationship to Ishak scoring and hepatic venous pressure gradient #

Calvaruso¹,

Burroughs²,

Standish³

et al. 2009

Hepatology

261

281

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Histopathological scoring of disease stage uses descriptive categories without measuring the amount of fibrosis. Collagen, the major component of fibrous tissue, can be quantified by computer-assisted digital image analysis (DIA) using histological sections. We determined relationships between DIA, Ishak stage, and hepatic venous pressure gradient (HVPG) reflecting severity of fibrosis. One hundred fifteen patients with hepatitis C virus (HCV) who had undergone transplantation had 250 consecutive transjugular liver biopsies combined with HVPG (median length, 22 mm; median total portal tracts, 12), evaluated using the Ishak system and stained with Sirus red for DIA. Liver collagen was expressed as collagen proportionate area (CPA). Median CPA was 6% (0.2-45), correlating with Ishak stage (stage 6 range, 13%-45%), and with HVPG (r ‫؍‬ 0.62; P < 0.001). Median CPA was 4.1% when HVPG was less than 6 mm Hg and 13.8% when HVPG was 6 mm Hg or more (P < 0.0001) and 6% when HVPG was less than 10 mm Hg and 17.3% when HVPG was 10 mm Hg or higher (P < 0.0001). Only CPA, not Ishak stage/grade, was independently associated by logistic regression, with HVPG of 6 mm Hg or more [odds ratio, 1.206; 95% confidence interval (CI), 1.094-1.331; P < 0.001], or HVPG of 10 mm Hg or more (odds ratio, 1.105; 95% CI, 1.026-1.191; P ‫؍‬ 0.009). CPA increased by 50% (3.6%) compared with 20% in HVPG (1 mm Hg) in 38 patients with repeated biopsies. Conclusion: CPA assessed by DIA correlated with Ishak stage scores and HVPG measured contemporaneously. CPA was a better histological correlate with HVPG than Ishak stage, had a greater numerical change when HVPG was low, and resulted in further quantitation of fibrosis in cirrhosis.

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[178] Transjugular Liver Biopsy: Are 4 Cores Better Than 3 and Does a Cassette Prevent Fragmentation

Cited by 3 publications

References 0 publications

The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis

The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis

Analysis of Pax7 expressing myogenic cells in zebrafish muscle development, injury, and models of disease

Computer-assisted image analysis of liver collagen: Relationship to Ishak scoring and hepatic venous pressure gradient #

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