Vascular and Interventional Units, Department of Diagnostic Radiology, Hasharon Hospital, Petach Tikva, Israel.
Cardiovasc Intervent Radiol. 2010 Jun;33(3):560-4. doi: 10.1007/s00270-009-9743-z. Epub 2009 Nov 12.
The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.
本研究旨在评估经颈静脉肝活检（TJLB）和经皮穿刺肝活检（PB）在伴有凝血功能障碍、腹水或两者并存的严重肝病患者中的有效性和安全性，并验证用于选择合适程序的内部方案。2000-2006 年，在一家主要的三级中心，根据内部方案，有 329 名患者（208 名男性[62.8%]和 121 名女性[37.2%]）接受了 150 次 TJLB（39.1%）或 233 次 PB（60.9%）检查。比较了两组的标本特征、技术成功率和并发症。TJLB 的技术成功率为 97.4%（146/150），PB 为 99.1%（231/233）。TJLB 与平均活检长度较短（1.29cm 比 1.43cm）和平均活检标本数量较少（2.44 个比 2.8 个）相关，但两种方法都获得了足够的组织进行明确诊断。两组均无严重并发症。TJLB 和 PB 可安全有效地用于诊断有标准经皮肝活检禁忌证的肝病患者。当两种方法都可技术应用时，我们建议选择 PB，尤其是在移植肝脏中。
