Dartmouth Medical School, Dartmouth College, Hanover, NH 03755, USA.
Cardiovasc Intervent Radiol. 2011 Apr;34(2):369-75. doi: 10.1007/s00270-010-9924-9. Epub 2010 Oct 21.
To retrospectively review patients who underwent transjugular and image-guided percutaneous biopsy and compare the relative risk of ascites, thrombocytopenia, and coagulopathy.
From August 2001 through February 2006, a total of 238 liver biopsies were performed. The radiologist reviewed all patient referrals for transjugular biopsy. These patients either underwent transjugular biopsy or were reassigned to percutaneous biopsy (crossover group). Patients referred to percutaneous image-guided liver biopsy underwent this same procedure. Biopsies were considered successful if a tissue diagnosis could be made from the samples obtained.
A total of 36 transjugular biopsies were performed with 3 total (8.3%) and 1 major (2.8%) complications. A total of 171 percutaneous biopsies were performed with 10 (5.8%) total and 3 (1.8%) major complications. The crossover group showed a total of 4 (12.9%) complications with 1 (3.2%) major complication. Sample adequacy was 91.9% for transjugular and 99.5% for percutaneous biopsy.
Both transjugular and percutaneous liver biopsy techniques are efficacious and safe. Contraindications such as thrombocytopenia, coagulopathy, and ascites are indicators of greater complications but are not necessarily prevented by transjugular biopsy. Percutaneous biopsy more frequently yields a diagnostic specimen than transjugular biopsy.
回顾性分析行经颈静脉和影像引导经皮穿刺活检的患者,比较腹水、血小板减少症和凝血障碍的相对风险。
2001 年 8 月至 2006 年 2 月,共进行了 238 例肝脏活检。放射科医生回顾了所有经颈静脉活检的患者转诊情况。这些患者要么接受了经颈静脉活检,要么被重新分配到经皮活检(交叉组)。经皮影像引导肝活检的患者接受了相同的程序。如果从获得的样本中可以做出组织诊断,则认为活检是成功的。
共进行了 36 例经颈静脉活检,总并发症发生率为 3 例(8.3%),严重并发症发生率为 1 例(2.8%)。共进行了 171 例经皮活检,总并发症发生率为 10 例(5.8%),严重并发症发生率为 3 例(1.8%)。交叉组的总并发症发生率为 4 例(12.9%),其中严重并发症发生率为 1 例(3.2%)。经颈静脉和经皮活检的样本充足率分别为 91.9%和 99.5%。
经颈静脉和经皮肝脏活检技术均有效且安全。血小板减少症、凝血障碍和腹水等禁忌症是并发症发生率较高的指标,但经颈静脉活检不一定能预防这些并发症。经皮活检比经颈静脉活检更常获得诊断性标本。