Cluzel P, Martinez F, Bellin M F, Michalik Y, Beaufils H, Jouanneau C, Lucidarme O, Deray G, Grenier P A
Diagnostic and Interventional Polyvalent Radiology Service, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France.
Radiology. 2000 Jun;215(3):689-93. doi: 10.1148/radiology.215.3.r00ma07689.
To compare the effectiveness and safety of transjugular renal biopsy with those of percutaneous renal biopsy for diagnosis of renal parenchymal disease.
Results and complications of 400 consecutive transjugular renal biopsies performed between 1993 and 1998 with a modified Colapinto transjugular hepatic biopsy system were compared retrospectively with those of 400 percutaneous renal biopsies performed during the same period. Transjugular renal biopsy was associated with 14 cardiac and 35 hepatic biopsies. Number of glomeruli per tissue core, adequacy of tissue core for histopathologic diagnosis, and rate and severity of complications were analyzed.
Renal tissue was obtained with percutaneous renal biopsy in 382 (95.5%) of 400 patients and with transjugular renal biopsy in 383 (95.8%) of 400 patients. The mean numbers of intact glomeruli per tissue core with optical microscopy were 11.2 +/- 7.7 (SD) and 9.8 +/- 7.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. With immunofluorescent microscopy, the mean numbers were 6.4 +/- 5.3 and 4.6 +/- 4.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. Tissue cores were adequate for histopathologic diagnosis in 98.2% with both techniques. Major complications occurred with transjugular renal biopsy in four patients and with percutaneous renal biopsy in three patients.
Use of transjugular renal biopsy provides diagnostic yield and safety similar to those of percutaneous renal biopsy and allows multiorgan biopsy during the same procedure. It can be recommended in patients with percutaneous renal biopsy contraindication or failure.
比较经颈静脉肾活检与经皮肾活检在诊断肾实质疾病方面的有效性和安全性。
回顾性比较1993年至1998年间使用改良的科拉平托经颈静脉肝活检系统连续进行的400例经颈静脉肾活检的结果和并发症，与同期进行的400例经皮肾活检的结果和并发症。经颈静脉肾活检还包括14例心脏活检和35例肝脏活检。分析每个组织芯中的肾小球数量、组织芯对组织病理学诊断的充分性以及并发症的发生率和严重程度。
400例患者中，382例（95.5%）经皮肾活检获得肾组织，383例（95.8%）经颈静脉肾活检获得肾组织。光学显微镜下，经皮肾活检和经颈静脉肾活检每个组织芯完整肾小球的平均数量分别为11.2±7.7（标准差）和9.8±7.6。免疫荧光显微镜下，经皮肾活检和经颈静脉肾活检的平均数量分别为6.4±5.3和4.6±4.6。两种技术的组织芯均有98.2%足以进行组织病理学诊断。经颈静脉肾活检有4例发生主要并发症，经皮肾活检有3例发生主要并发症。
经颈静脉肾活检的诊断率和安全性与经皮肾活检相似，并且可以在同一次操作中进行多器官活检。对于有经皮肾活检禁忌证或失败的患者可以推荐使用。
