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How to improve the quality of the tissue sample obtained by percutaneous liver biopsy

100%
Sporea I., Popescu A., Şirli R.
Open Medicine
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2011
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vol. 6
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issue 1
103-106
EN
The evaluation of liver lesions in patients with chronic hepatopathy is mandatory for assessing prognosis and sometimes for making treatment decisions. The liver biopsy (LB) is still considered the gold standard for the evaluation of chronic hepatopathy, despite the fact that noninvasive methods (serologic markers and transient elastography or real-time elastography) are being used more often. The quality of the hepatic tissue sample obtained at biopsy is important for the correct diagnosis. Usually, a liver specimen is considered to be adequate for pathological examination if it is no less than 20 mm and preferably more than 25 mm and if it includes 8 to 11 portal tracts. To improve the quality of the tissue sample obtained by percutaneous LB, we believe it is optimal for the operator to use the Menghini needle technique with two intrahepatic passages (specimens up to 4 cm in length can be obtained), to use echo guidance or ultrasonographic assistance, to have extensive personal experience (defined as having performed between 50 and 100 biopsies), and to assess the length of the tissue sample immediately after the LB, and, in the event the specimen is inadequate in length, to rapidly perform another passage.
2
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The value of transabdominal ultrasound for assessment of the severity of liver steatosis as compared to liver biopsy

76%
Sporea I., Şirli R., Başa E., Cornianu M., Popescu A., Dănilă M., Focşa M.
Open Medicine
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2009
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vol. 4
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issue 4
490-495
EN
The purpose of our paper was to evaluate the performance of ultrasound (US) for assessment of the severity of liver steatosis as compared to a pathological examination, which is presently considered to be the gold standard, in patients that have undergone liver biopsy for various reasons. We performed echo-assisted liver biopsy in 161 patients with chronic hepatitis with the US aspect of “bright liver” with “posterior attenuation”, using modified Menghini needles. Following the US examination, the severity of liver steatosis was estimated as minimal, mild, moderate. or severe according to the Hepburn classification: absent (affecting 0% to 2% of the hepatocytes), minimal (2% to 10%), mild (10% to 30%), moderate (30% to 60%), and severe (more than 60% of the hepatocytes). The results of this study showed that the sensitivity of US for the prediction of histological steatosis of at least moderate severity was 0.64, with 0.77 specificity, 0.55 positive predictive value, and 0.94 negative predictive value. The overall accuracy was 0.75. This study showed that the transabdominal ultrasound evaluation of the fatty liver is a quite good predictor, perhaps sufficient for most purposes, for the estimation of the severity of liver steatosis in the moderate to severe range.
3
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Do the needle type and the operator experience influence liver biopsy specimen quality?

52%
Sporea I., Popescu A., Focşa M., Becheanu G., Şirli R., Cornianu M., Gheorghe L., Prelipcean C., Mihai C., Rogoveanu I., Săndulescu L.
Open Medicine
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2013
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vol. 8
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issue 5
669-673
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