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经颈静脉肝活检:改良罗斯经间隔穿刺针与快速穿刺活检针的比较

Transjugular liver biopsy: modified Ross transseptal needle versus quick-core biopsy needle.

作者信息

Choo S W, Do Y S, Park K B, Kim S H, Han Y H, Choo I

机构信息

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Gu, Seoul, 135-710, Korea.

出版信息

Abdom Imaging. 2000 Sep-Oct;25(5):483-5. doi: 10.1007/s002610000043.

Abstract

BACKGROUND

We evaluated the differences in sample adequacy and safety between a transseptal needle and Quick-core biopsy needle for transjugular liver biopsy.

METHODS

Eighteen consecutive patients who had a bleeding diatheses and/or ascites underwent transjugular liver biopsy using a transseptal needle (11 patients) and Quick-core biopsy needle (seven patients). The length of the specimens was measured before fixation. A pathologist reviewed histologic slides for sample adequacy and pathologic diagnoses. Clinical records were reviewed for complication.

RESULTS

In all patients, liver biopsy was successful. A total of 45 specimens were obtained, with an average of 2.5 passes per patient. The length of specimen was significantly longer with the Quick-core biopsy needle than with the transseptal needle (p<0.05). Biopsied tissue was fragmented in 17 of 25 specimens with the transseptal needle but not fragmented in any specimen with the Quick-core biopsy needle. All specimens were determined to be adequate except one with the transseptal needle. There was no early or delayed complication in any patient.

CONCLUSION

Transjugular liver biopsy is a safe and effective procedure without any significant difference in complication and adequacy when using a transseptal needle or Quick-core biopsy needle. Larger specimens can be obtained without tissue fragmentation with the Quick-core biopsy needle.

摘要

背景

我们评估了经颈静脉肝活检时经间隔穿刺针与Quick-core活检针在样本充足性和安全性方面的差异。

方法

18例患有出血性疾病和/或腹水的连续患者接受了经颈静脉肝活检,其中11例使用经间隔穿刺针,7例使用Quick-core活检针。在固定前测量标本长度。病理学家审查组织学切片以评估样本充足性并进行病理诊断。回顾临床记录以了解并发症情况。

结果

所有患者肝活检均成功。共获得45个标本,每位患者平均穿刺2.5次。Quick-core活检针获取的标本长度明显长于经间隔穿刺针(p<0.05)。经间隔穿刺针获取的25个标本中有17个组织破碎,而Quick-core活检针获取的标本均无组织破碎。除1个经间隔穿刺针获取的标本外,所有标本均被判定为足够。所有患者均未出现早期或延迟并发症。

结论

经颈静脉肝活检是一种安全有效的操作,使用经间隔穿刺针或Quick-core活检针时,在并发症和样本充足性方面无显著差异。使用Quick-core活检针可获得更大的标本且无组织破碎。

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