Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

Çakmakçı, Emin; Çalışkan, Kosti Can; Tabakci, Omer Naci; Tahtabaşı, Mehmet; Karpat, Zeki

doi:10.5812/iranjradiol.13184

Cited by 17 publications

(14 citation statements)

References 15 publications

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“…In our study, rates of diagnosis with 16G and 18G needles were 90.7% and 83.3%, respectively, and no statistically significant difference was found between the needles in terms of establishing the diagnosis. However, our rate of diagnosis was lower compared to the studies in the literature (25,32).…”

Section: Discussioncontrasting

confidence: 81%

“…There are many studies in the literature evaluating liver biopsy related complications and sufficiency of establishing diagnosis with G: Gauge different techniques and needles of different thickness. However, we could not find a study comparing diagnostic material sufficiency specifically between Menghini and tru-cut biopsy needle in patients with CHB (6,(22)(23)(24)(25). Quality of liver biopsy is usually determined with length, width, fragmentation and complete portal routes (26).…”

Section: Discussionmentioning

confidence: 99%

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A Comparison of Needle Types and Biopsy Techniques used in Liver Biopsies of Chronic Hepatitis B Patients

Karavaş¹,

KARAKEÇİLİ²,

Balcı³

2019

vhd

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Objectives: To investigate the effect on pathological evaluation of the biopsy technique used in percutaneous liver biopsies applied with semi-automatic 16 gauge (G) and 18G Tru-cut and Menghini aspiration needles in patients with chronic hepatitis B(CHB). Materials and Methods: The study included 104 cases diagnosed with CHB applied with liver biopsy between 2013-2018. The pathology results of biopsies were evaluated with the Menghini technique under ultrasound(USG) guidance (n:26), and with 16G (n:54) and 18G (n:24) semi-automatic Tru-cut needles under USG. Results: The fibrosis score in 5 (9.3%) of the 16G cases and in 3 (12.5%) of the 18G cases, and the ISHAK score in 3 (5.6%) of the 16G and in 1 (4.2%) of the 18G cases could not be determined. There was no significant difference between the methods and needle types in terms of the number of pieces, number of portal sites, fibrosis and ISHAK score(p>0.05). There was a statistically significant difference between the biopsies performed with Menghini method and tru-cut method with 16G and 18G(p<0.0001) in terms of material length. The diagnosis rates for the Menghini technique, and 16G and 18G Tru-cut needles were 100%, 90.7% and 83.3%, respectively, with no statistically significant difference determined (p>0.05). Conclusion: Although a larger tissue piece is obtained with the Menghini technique, allowing evaluation of a larger portal area, no significant difference was determined between the techniques in the pathological evaluation. Taking patient safety and comfort into consideration, Tru-cut needle biopsy under USG guidance is recommended rather than the Menghini technique as less trauma is created.

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Section: Discussioncontrasting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

A Comparison of Needle Types and Biopsy Techniques used in Liver Biopsies of Chronic Hepatitis B Patients

Karavaş¹,

KARAKEÇİLİ²,

Balcı³

2019

vhd

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“…The increased popularity of liver biopsy is because it is less invasive and has lower risk than surgery, has high diagnostic accuracy, and is cost effective. 1,2 Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications or technical failures may occur in 5% patients, including pain that causes hospital admission, bleeding that necessitates transfusion or surgery, pneumothorax, failure to obtain tissue, and obtaining other tissues. [3][4][5] However, attempts should be made to increase safety and decrease complications of liver biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] However, attempts should be made to increase safety and decrease complications of liver biopsy. 2,5 There is a statistically significant decrease in the complication rate of liver biopsy when performed with ultrasonography guidance. [6][7][8] However, biopsy can cause lifethreatening complications.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Safety and Efficacy of Liver Biopsy Following Liver Transplant

Kırnap¹,

Akdur²,

Haberal³

et al. 2015

Exp Clin Transplant

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Objectives: Liver biopsy is a diagnostic tool for liver pathology after liver transplant. However, biopsy can cause life-threating complications. There is limited knowledge about efficacy and complications of liver biopsy after liver transplant. Our aim was to evaluate the risk and benefit of liver biopsy after liver transplant and quality of biopsy specimens. Materials and Methods:We retrospectively analyzed all liver biopsies performed after liver transplant between January 2000 and October 2014. All patients were monitored for minimum 24 hours after biopsy. Results: We performed 245 liver biopsies in 159 liver transplant patients. Fifteen biopsies (6%) were nondiagnostic. In the samples, there were 102 cases (41%) of acute rejection, 79 cases (35%) of cholangitis, and 49 cases (20%) of cholestasis observed. Complications after biopsy were seen in 23 patients (9%) and biopsies. There were 7 patients who had severe abdominal pain followed by fever. We diagnosed 4 patients who had intercostal/ subcapsular bleeding and 12 patients who had vasovagal reaction. All patients were treated with analgesic agents and monitored for 24 hours. No blood transfusion or surgery was required. Conclusions: Liver biopsy after liver transplant is an invasive diagnostic tool for liver pathology.However, it can be used safely in experienced centers.

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“…Therefore, the evaluation of the degree of liver steatosis, fibrosis, and steatohepatitis has a fundamental importance for the therapeutic decision for patients with alcoholic liver diseases. Liver biopsy, that is considered the gold standard for evaluating the stage of liver fibrosis, is an invasive procedure and leads to complications in 0.6-5.0% of patients [1,2]. Additionally, the liver samples from patients with chronic hepatitis C infection can be a cause of diagnostic error in up to 30% of patients, leading to an underestimation of the stage of liver fibrosis [3].…”

mentioning

confidence: 99%

The Distribution of Liver Steatosis, Fibrosis, Steatohepatitis and Inflammation Activity in Alcoholics According to FibroMax Test

Gudowska¹,

Wójtowicz²,

Cylwik³

et al. 2015

Adv Clin Exp Med

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Background. The diagnosis of alcoholic liver diseases is based on the history of alcohol abuse, clinical evidence of liver disease and laboratory abnormalities. The new non-invasive biomarkers have higher sensitivity to quantify and predict steatosis and fibrosis than ultrasonography. Objectives. The aim of this study was to evaluate the prevalence of liver diseases in alcoholics by means of FibroMax. Material and Methods. A total of 142 consecutive alcoholics were enrolled in the study. The prevalence of liver diseases was assayed by means of non-invasive biomarkers: fibrosis by FibroTest, steatosis by SteatoTest, steatohapatitis by AshTest (alcoholic origin) and NashTest (non-alcoholic origin) and necroinflammatory activity by ActiTest. Results. 38.7% of alcoholics do not have fibrosis, 38% -steatosis, 94.1% -alcoholic steatohepatitis, 56.6% -non--alcoholic steatohepatitis and 33.6% -necroinflammatory activity. The insignificant fibrosis (F < 2) is present in 37.2%, advanced (F ≥ 2) -15.3% and cirrhosis (F4) -in 8.8%. Insignificant steatosis (S < 2) is observed in 31.3% and advanced (S ≥ 2) in 30.5%. Minimal alcoholic steatohepatitis (H1) exists in 5.2% patients, moderate (H2) in none of the patient and severe (H3) in only one patient (0.7%). The distribution of NashTest scores is as following: N0 -56.6%, N1 -38.2% and N2 -5.1%. Insignificant inflammatory activity (A < 2) is present in 40.8% of alcoholic patients but significant (A ≥ 2) in 25.5%. The frequency of severe steatosis (F3) and necroinflammatory activity (A3) in patients with cirrhosis (F4) is 50% for each of them. Conclusions. The prevalence of advanced fibrosis and cirrhosis evaluated by means of FibroMax in alcoholics is higher than in alcoholic liver disease (ALD) and lower than in mixed, alcoholic and non-alcoholic ones. This may indicate the presence of non-alcoholic liver disease in alcoholics (Adv Clin Exp Med 2015, 24, 5, 823-827).

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Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

Cited by 17 publications

References 15 publications

A Comparison of Needle Types and Biopsy Techniques used in Liver Biopsies of Chronic Hepatitis B Patients

A Comparison of Needle Types and Biopsy Techniques used in Liver Biopsies of Chronic Hepatitis B Patients

Evaluation of Safety and Efficacy of Liver Biopsy Following Liver Transplant

The Distribution of Liver Steatosis, Fibrosis, Steatohepatitis and Inflammation Activity in Alcoholics According to FibroMax Test

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