Fortuño Andrés J R, de Lamo Muñoz S, García Pérez E, Mateos Alvarez A
Unitat de Radiología Vascular i Intervencionista, Servei Diagnòstic per l'Imatge, UDIAT-Centre Diagnòstic, Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona.
Radiologia. 2010 Mar-Apr;52(2):153-6. doi: 10.1016/j.rx.2009.11.007. Epub 2010 Jan 25.
US-guided percutaneous renal biopsy is the procedure of choice for obtaining histological specimens from the renal parenchyma. The superiority of using automatic needles under US guidance is well established in the literature. However, little information is available about the use of 16G needles, so we reviewed our experience in this technique. We report the diagnostic yield and rate of complications for US-guided percutaneous renal biopsy using automatic 16G needles.
We reviewed 243 consecutive renal biopsies obtained from native kidneys using automatic 16G needles under US guidance. We calculated the diagnostic yield using the number of biopsies with a complete histological report and the rate of major and minor complications. We used Fisher's exact test to evaluate the correlation between the occurrence of major complications, patient age, renal function, and diastolic blood pressure.
Biopsies yielded enough material to establish the diagnosis in 228 of 243 cases (93.83%). Complications were detected in 33 of 243 biopsies (13.5%); of these, 9 (3.7%) were major and 24 (9.8%) were minor. Seven patients in whom major complications occurred were successfully treated with renal arteriography and superselective embolization. We found no cases of nephrectomy or death associated to biopsy. Major complications were associated to elevated diastolic blood pressure.
The efficacy and safety of percutaneous renal biopsy using an automatic 16G needle make it a good alternative to obtain histological specimens of the kidney.
超声引导下经皮肾穿刺活检是获取肾实质组织学标本的首选方法。超声引导下使用自动活检针的优势在文献中已得到充分证实。然而,关于16G活检针使用的信息较少,因此我们回顾了我们在该技术方面的经验。我们报告了超声引导下使用自动16G活检针对经皮肾穿刺活检的诊断成功率和并发症发生率。
我们回顾了243例在超声引导下使用自动16G活检针对天然肾脏进行的连续肾穿刺活检病例。我们根据有完整组织学报告的活检病例数计算诊断成功率,并计算主要和次要并发症的发生率。我们使用Fisher精确检验来评估主要并发症的发生与患者年龄、肾功能和舒张压之间的相关性。
243例病例中有228例(93.83%)的活检获取了足够的材料以明确诊断。243例活检中有33例(13.5%)检测到并发症;其中,9例(3.7%)为主要并发症,24例(9.8%)为次要并发症。发生主要并发症的7例患者通过肾动脉造影和超选择性栓塞成功治疗。我们未发现与活检相关的肾切除或死亡病例。主要并发症与舒张压升高有关。
使用自动16G活检针进行经皮肾穿刺活检的有效性和安全性使其成为获取肾脏组织学标本的良好选择。