Shuja Asim, Alkhasawneh Ahmad, Fialho Andre, Fialho Andrea, Shukri Amal, Harris Ciel, Smotherman Carmen, Malespin Miguel, de Melo Silvio W
Division of Gastroenterology, University of Illinois at Chicago, Chicago, IL, United States.
Department of Pathology, University of Florida College of Medicine, Jacksonville, United States.
Dig Liver Dis. 2019 Jun;51(6):826-830. doi: 10.1016/j.dld.2019.01.006. Epub 2019 Jan 22.
Liver biopsy through endoscopic ultrasound (EUS) has become a novel approach for tissue acquisition. We aim to evaluate the adequacy of EUS-guided liver biopsies in comparison to those obtained through interventional radiology (IR) techniques.
A retrospective single-center analysis was performed of all IR (transjugular or image-guided percutaneous) and EUS-guided liver biopsies performed at an academic medical center from January 2016 to January 2018. Patient demographics, histologic characteristics, and clinical outcomes were collected.
152 procedures were included for analysis. 45% of liver biopsies were performed through EUS-guidance. The most common indication for liver biopsy was NASH fibrosis staging (n = 64). IR-guided biopsies contained a higher number of complete portal triads (13.6 vs. 10.8 p ≤ 0.01) while EUS-guided biopsies produced an increased total specimen length (4.6 cm vs. 3.6 cm p ≤ 0.01).47% of biopsy samples were fragmented with the majority of these (72%) occurring with EUS-guided procedures (p ≤ 0.01). IR-guided biopsies led to more complications in comparison to EUS-guided procedures (p = 0.03) CONCLUSION: Liver biopsies performed through EUS-guidance are comparable to IR-guided liver biopsies and may have an enhanced safety profile with acceptable tissue acquisition characteristics. Standardization of techniques and needles is needed for optimization of tissue sampling.
经内镜超声（EUS）引导下的肝活检已成为一种获取组织的新方法。我们旨在评估EUS引导下肝活检与经介入放射学（IR）技术获取的肝活检的充分性。
对2016年1月至2018年1月在一家学术医疗中心进行的所有IR（经颈静脉或影像引导下经皮）和EUS引导下的肝活检进行回顾性单中心分析。收集患者人口统计学、组织学特征和临床结果。
纳入152例手术进行分析。45%的肝活检是在EUS引导下进行的。肝活检最常见的适应证是NASH纤维化分期（n = 64）。IR引导下的活检包含更多数量的完整门静脉三联征（13.6对10.8，p≤0.01），而EUS引导下的活检产生的总标本长度增加（4.6 cm对3.6 cm，p≤0.01）。47%的活检样本有碎片，其中大多数（72%）发生在EUS引导的手术中（p≤0.01）。与EUS引导的手术相比，IR引导的活检导致更多并发症（p = 0.03）。结论：EUS引导下进行的肝活检与IR引导下的肝活检相当，并且在具有可接受的组织获取特征的情况下可能具有更高的安全性。需要对技术和针进行标准化以优化组织采样。
