Mahoney M C, Racadio J M, Merhar G L, First M R
Department of Radiology, University Hospital, University of Cincinnati, OH 45267-0742.
AJR Am J Roentgenol. 1993 Feb;160(2):325-6. doi: 10.2214/ajr.160.2.8424343.
We evaluated the safety and efficacy of using a 14-gauge Tru-Cut needle without imaging guidance vs using an 18-gauge Biopty gun with sonographic guidance for percutaneous biopsy of kidney transplants.
We retrospectively analyzed data from 105 biopsies (in 68 patients) in which the Biopty gun with an 18-gauge needle was used and data from 100 biopsies (in 64 patients) in which a 14-gauge Tru-Cut needle was used.
Significantly fewer major complications (p = .03) occurred when the Biopty gun was used (2%) vs when the Tru-Cut needle was used (10%). Two major complications (2%), both hematuria requiring transfusion, occurred in the 105 biopsies performed with the Biopty gun. Major complications occurred in 10 (10%) of the 100 biopsies done with the Tru-Cut needle: three obstructed allografts caused by blood clots, two episodes of hypovolemic shock, one case of shock and obstruction, and four intraperitoneal hemorrhages (one of which required nephrectomy). Biopsy specimens were adequate for histopathologic diagnosis in more than 98% of cases for both the Biopty gun and the Tru-Cut needle.
We conclude that imaging-guided percutaneous biopsy of renal allografts with a Biopty gun is as accurate as and safer than biopsy with the Tru-Cut needle.
我们评估了在无成像引导下使用14号Tru-Cut针与在超声引导下使用18号活检枪对肾移植进行经皮活检的安全性和有效性。
我们回顾性分析了105例活检（68例患者）的数据，这些活检使用了18号针的活检枪，以及100例活检（64例患者）的数据，这些活检使用了14号Tru-Cut针。
使用活检枪时发生的严重并发症（p = 0.03）明显少于使用Tru-Cut针时（2%对10%）。在使用活检枪进行的105例活检中发生了2例严重并发症（2%），均为需要输血的血尿。在使用Tru-Cut针进行的100例活检中，有10例（10%）发生了严重并发症：3例因血凝块导致移植肾梗阻，2例低血容量性休克，1例休克和梗阻，4例腹腔内出血（其中1例需要肾切除术）。活检枪和Tru-Cut针在超过98%的病例中活检标本足以进行组织病理学诊断。
我们得出结论，使用活检枪对肾移植进行成像引导下的经皮活检与使用Tru-Cut针活检一样准确且更安全。
