Hall Thomas C, Deakin Claire, Atwal Gurprit Ss, Singh Rajeev K
1 Department of Radiology, Royal Derby Hospital , Derby , UK.
2 Department of Cellular Pathology, Royal Derby Hospital , Derby , UK.
Br J Radiol. 2017 Dec;90(1080):20170397. doi: 10.1259/bjr.20170397. Epub 2017 Oct 3.
The purpose of this study was to compare the adequacy rates of percutaneous liver biopsies, in parenchymal liver disease, using the Biopince (Argon Medical, Texas, TX, ) 16G and Achieve (Carefusion, Illinois, IL, USA) 18G biopsy needles in relation to the Royal College of Pathologists guidelines and to assess risk of complications.
Data for all percutaneous non-targeted "medical" liver biopsies using the Biopince 16G and Achieve 18G biopsy needles were collected retrospectively over a 2-year period. Total biopsy core length and number of portal tracts was recorded along with adequacy of biopsy as assessed according to Royal College of Pathologists criteria.
In total, 194 percutaneous liver biopsies met the inclusion criteria; 53 using the Biopince needle and 141 using the Achieve needle. The mean total core length was 23 mm (SD 4.1) and 20 mm (SD 6.8) for the Biopince and Achieve needles, respectively (p = 0.0005). The mean number of portal tracts was 11 (SD 4.2) and 7 (SD 3.4) for the Biopince and Achieve needles, respectively (p < 0.0001). An adequate biopsy was obtained in 15 (31.3%) and 1 (1.3%) case using the Biopince and Achieve needles, respectively (p < 0.001). Compromised biopsies were obtained in 32 (66.7%) and 39 (50.6%) cases using the Biopince and Achieve needles, respectively. Inadequate biopsies were obtained in 1 (2%) and 37 (48.1%) cases using the Biopince and Achieve needles, respectively.
The Biopince 16G needle, when compared with the Achieve 18G needle, acquires a significantly greater total core length and number of portal tracts with significantly improved adequacy rates. There were no major complications associated with its use. Advances in knowledge: The Biopince 16G needle achieves significantly better specimen adequacy, when compared with the Achieve 18G needle and with no added major complications associated with its use.
本研究旨在比较使用Biopince(氩气医疗公司,得克萨斯州,TX)16G活检针和Achieve(Carefusion公司,伊利诺伊州,IL,美国)18G活检针对实质性肝病进行经皮肝活检的取材充足率,并参照皇家病理学家学院的指南评估并发症风险。
回顾性收集了2年期间内所有使用Biopince 16G和Achieve 18G活检针进行的经皮非靶向“医疗性”肝活检数据。记录活检组织芯的总长度、门静脉分支数量以及根据皇家病理学家学院标准评估的活检取材充足情况。
共有194例经皮肝活检符合纳入标准;其中53例使用Biopince针,141例使用Achieve针。Biopince针和Achieve针的平均组织芯总长度分别为23毫米(标准差4.1)和20毫米(标准差6.8)(p = 0.0005)。Biopince针和Achieve针的平均门静脉分支数量分别为11个(标准差4.2)和7个(标准差3.4)(p < 0.0001)。使用Biopince针和Achieve针分别有15例(31.3%)和1例(1.3%)获得了充足的活检组织(p < 0.001)。使用Biopince针和Achieve针分别有32例(66.7%)和39例(50.6%)获得了质量欠佳的活检组织。使用Biopince针和Achieve针分别有1例(2%)和37例(48.1%)获得了取材不足的活检组织。
与Achieve 18G针相比,Biopince 16G针获取的组织芯总长度和门静脉分支数量显著更多,取材充足率显著提高。使用该针未出现重大并发症。知识进展:与Achieve 18G针相比,Biopince 16G针能显著提高标本取材的充足性,且使用过程中未增加重大并发症。