Rawlings Clarence A, Diamond Halise, Howerth Elizabeth W, Neuwirth Lisa, Canalis Chanda
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390, USA.
J Am Vet Med Assoc. 2003 Aug 1;223(3):317-21. doi: 10.2460/javma.2003.223.317.
To compare diagnostic quality of percutaneous kidney biopsy specimens obtained with laparoscopy versus ultrasound guidance in dogs and compare diagnostic quality of specimens obtained with 14- versus 18-gauge biopsy needles.
Prospective study.
10 healthy dogs.
In each dog, 2 biopsy specimens were obtained from each kidney, 1 with a 14-gauge biopsy needle and 1 with an 18-gauge biopsy needle. Biopsy specimens were obtained from 1 kidney by means of ultrasound guidance and from the contralateral kidney by means of direct viewing during laparoscopy. Number of glomeruli, quality of the biopsy specimen, proportion of specimens that contained muscle tissue, and proportion of specimens with fragmentation or crushing were determined.
Mean +/- SD number of glomeruli (32.6 +/- 11.0) in laparoscopic, 14-gauge biopsy specimens was significantly higher than mean number of glomeruli in ultrasound-guided, 14-gauge specimens; mean number of glomeruli in ultrasound-guided, 18-gauge specimens; and mean number of glomeruli in laparoscopic, 18-gauge specimens. All 10 laparoscopic, 14-gauge biopsy specimens were classified as excellent. The proportion of 18-gauge biopsy specimens with crushing or fragmentation was significantly higher than the proportion of 14-gauge specimens. One of the kidneys biopsied with ultrasound guidance had a large amount of hemorrhage. Hemorrhage was modest and transient following laparoscopic biopsy.
Results suggest that excellent-quality renal biopsy specimens with large numbers of glomeruli can be obtained with 14-gauge, double-spring-activated biopsy needles during laparoscopy. Renal biopsy specimens obtained with 18-gauge biopsy needles frequently had few glomeruli and often were crushed or fragmented, increasing the difficulty in making an accurate diagnosis.
比较腹腔镜引导与超声引导下获取的犬经皮肾活检标本的诊断质量，并比较14号与18号活检针获取的标本的诊断质量。
前瞻性研究。
10只健康犬。
每只犬的每个肾脏获取2份活检标本，1份用14号活检针获取，另1份用18号活检针获取。1份活检标本通过超声引导从一侧肾脏获取，另一份通过腹腔镜直视从对侧肾脏获取。确定肾小球数量、活检标本质量、含有肌肉组织的标本比例以及有破碎或挤压情况的标本比例。
腹腔镜引导下14号活检标本的平均肾小球数量（32.6±11.0）显著高于超声引导下14号标本、超声引导下18号标本以及腹腔镜引导下18号标本的平均肾小球数量。所有10份腹腔镜引导下14号活检标本均被评为优秀。18号活检标本出现破碎或挤压的比例显著高于14号标本。超声引导下活检的一侧肾脏有大量出血。腹腔镜活检后出血轻微且短暂。
结果表明，在腹腔镜检查期间，使用14号双弹簧激活活检针可获得含有大量肾小球的高质量肾活检标本。用18号活检针获取的肾活检标本肾小球数量常常较少，且常出现破碎或挤压，增加了准确诊断的难度。
