Levien A S, Weisse C, Donovan T A, Berent A C
J Vet Intern Med. 2014 Mar-Apr;28(2):338-45. doi: 10.1111/jvim.12305.
Transjugular liver biopsy (TJLB) is used in humans at risk of bleeding. There are no reports of its use in veterinary medicine.
To assess the efficacy and potential complications of TJLB in canine cadavers, and compare with samples obtained via needle liver biopsy (NLB) and surgical liver biopsy (SLB).
Twenty-five medium and large breed canine cadavers.
Prospective study. TJLBs were procured through the right jugular vein. After biopsy, intravenous contrast and gross inspection were used to assess the biopsy site. Minor and major complications were recorded. NLBs and SLBs were then obtained. Histopathology was performed, and TJLB and NLB were compared for number of complete portal tracts (CPTs), length, and fragmentation. Pathologic process and autolysis were assessed in all samples.
All TJLBs yielded liver tissue. The proportion of minor complications was 12/25 (48%), and major complications 16/25 (64%); 13/16 (81%) of the major complications were liver capsule perforation. In 21/25 (84%), the histopathology in the SLB was reflected in the TJLBs. For cases with minimal autolysis, median number of CPTs in TJLBs was 7.5, compared with 4 in NLBs (P = .018). Median length of TJLB specimen was 28 mm compared to 22 mm in NLBs (P = .007). Fragmentation rate was median of 1.25 for TJLB compared to 1.50 in NLBs (P = .11).
TJLB is technically feasible and achieves comparable results to NLB and SLB. The number of complications, in particular liver capsule perforation, was greater than expected. Further studies are indicated before clinical use is recommended.
经颈静脉肝活检（TJLB）用于有出血风险的人类。尚无其在兽医学中应用的报道。
评估TJLB在犬类尸体中的有效性和潜在并发症，并与经皮肝穿刺活检（NLB）和手术肝活检（SLB）获取的样本进行比较。
25只中大型犬类尸体。
前瞻性研究。通过右颈静脉进行TJLB。活检后，使用静脉造影剂和大体检查评估活检部位。记录轻微和严重并发症。然后进行NLB和SLB。进行组织病理学检查，并比较TJLB和NLB的完整门静脉分支数量（CPT）、长度和破碎情况。评估所有样本的病理过程和自溶情况。
所有TJLB均获取到肝组织。轻微并发症的比例为12/25（48%），严重并发症为16/25（64%）；16例严重并发症中有13例（81%）为肝包膜穿孔。在21/25（84%）的病例中，SLB的组织病理学结果在TJLB中得到体现。对于自溶程度最小的病例，TJLB的CPT中位数为7.5，而NLB为4（P = 0.018）。TJLB标本的中位数长度为28 mm，而NLB为22 mm（P = 0.007）。TJLB的破碎率中位数为1.25，而NLB为1.50（P = 0.11）。
TJLB在技术上是可行的，且取得了与NLB和SLB相当的结果。并发症数量，尤其是肝包膜穿孔，比预期的要多。在建议临床使用之前，需要进一步研究。
