Aims and objectives
In our centre both 18-gauge (18G) and 16-gauge (16G) needles (Bard,
Max-Core) are used to obtain core liver biopsies under ultrasound guidance.
While a 16G needle provides a larger sample,
an 18G needle may be associated with a lower risk of complications,
including haemorrhage.
The pathological diagnosis of diffuse parenchymal liver disease is dependant on an adequate core biopsy sample.
The number of portal tracts determines the adequacy of the biopsy sample1.
Evaluation of samples with fewer portal tracts may decrease the accuracy of diagnosis,...
Methods and materials
Patients who had ultrasound-guided biopsies sampling liver parenchyma over a one year periordwere retrospectively reviewed on the Radiology Information System in St Vincent’s University Hospital.
121 cases were identified.
Pathology reports were reviewed by the Pathology Department and samples reported as having fewer than 6 portal tracts were identified.
Samples where the number of portal tracts was not reported were re-examined to ensure sample adequacy.
Results
121 cases were included in the audit.
Of these there were 40/121 (33.1%) cases were following a liver transplant.
57/121 (47.1%) cases used a 16G core biopsy needle and 64/121 (52.9%) used an 18G core biopsy needle.
The Overall rate of inadequate liver biopsies was 17/121 (14.0%),
although most of these cases were considered diagnostic.
No significant difference inrate of inadequate samples between 16G and 18G samples.9/57 (15.8%) were obtained using a 16G biopsy needle and 8/64 (12.5%) used an 18G biopsy needle (P =...
Conclusion
There was a 14% overall rate of “inadequate” liver biopsy specimens,
although most of these cases were considered “diagnostic”.
Post liver transplant specimens were disproportionately represented in the “inadequate” group (47%).
The number of portal tracts required for diagnosis is particularly important in this group of patients1.
Core biopsies of parenchymal liver tissue using a 16G needle had a similarly high rate of inadequate samples compared to biopsies using a 18G needle.
Personal information
A Yates,
Radiology Department,
St Vincent's University Hospital,
Elm Park,
Dublin 4,
Ireland.
+353851607615
[email protected]
References
1.
Fryer E,
Wang LM,
Verrill C,
Fleming K.
How often do our liver core biopsies reach current definitions of adequacy?,
Journal of Clinical Pathology 2013 ;0:1–3.
doi: 10.1136/jclinpath- 2013 - 201440