Abstract
Purpose
Liver biopsy (LB) is a diagnostic procedure to obtain histological diagnosis, grading and staging in individuals with liver diseases. Most commonly LB is performed percutaneously. However, transjugular liver biopsy (TJLB) is considered as an alternative. The aim of this prospective study was to evaluate the diagnostic accuracy of TJLB.
Methods
TJLB with a semi-automatic Tru-Cut System (18G) was performed in 39 patients with various liver diseases (21 females and 18 males; age range 11–77 years). The number of complete portal tracts (CPTs), lengths and numbers of acquired cores, number of performed cutting steps (passes), and the possibility to obtain histological diagnosis were analyzed.
Results
There were no procedure-related complications, and in total 45 procedures were performed. Diagnosis could be established in 88.8 % of all samples, in five cases histology yielded no diagnosis due to an inadequate number of CPTs or sample fragmentation. In average, 4 passes were performed and 4 (range 1–7) cores were obtained. Median core length was 1.1 cm (range 0.4–1.9 cm), median number of CPTs was 7 (range 0–20). Liver fibrosis in general led to a decreased number of CPTs (p < 0.05).
Conclusions
TJLB is a safe procedure allowing histological diagnosis of liver diseases. In our cohort, performing 4 cutting procedures during TJLB resulted in a sufficiently high specimen quality, particularly in individuals with liver cirrhosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Burroughs AK, Dagher L (2002) Liver biopsy. In: Lighdale C, Classen MTG (eds) Gastrointestinal endoscopy. New York: Thieme New York, pp 252–259
Spengler U, Fischer HP (2008) Liver biopsy at the intersection of clinical and pathological diagnosis. Pathologe 29:6–14. doi:10.1007/s00292-007-0960-4
Smith TP, Presson TL, Heneghan MA, et al. (2003) Transjugular biopsy of the liver in pediatric and adult patients using an 18-gauge automated core biopsy needle: a retrospective review of 410 consecutive procedures. AJR Am J Roentgenol 180:167–172
von Frerichs FT (1884) Ueber den Diabetes. Berlin: Hirschwald
Dotter CT (1964) Catheter biopsy. Experimental technique for transvenous liver biopsy. Radiology 82:312–314. doi:10.1148/82.2.312
Hanafee W, Weiner M (1967) Transjugular percutaneous cholangiography. Radiology 88:35–39. doi:10.1148/88.1.35
Weiner M, Hanafee WN (1970) A review of transjugular cholangiography. Radiol Clin North Am 8:53–68
Kalambokis G, Manousou P, Vibhakorn S, et al. (2007) Transjugular liver biopsy-indications, adequacy, quality of specimens, and complications—a systematic review. J Hepatol 47:284–294. doi:10.1016/j.jhep.2007.05.001
Burak KW, Angulo P, Lindor KD (2003) Is there a role for liver biopsy in primary sclerosing cholangitis? Am J Gastroenterol 98:1155–1158. doi:10.1111/j.1572-0241.2003.07401.x
Crawford AR, Lin XZ, Crawford JM (1998) The normal adult human liver biopsy: a quantitative reference standard. Hepatology 28:323–331. doi:10.1002/hep.510280206
Bravo AA, Sheth SG, Chopra S (2001) Liver biopsy. N Engl J Med 344:495–500. doi:10.1056/NEJM200102153440706
Colloredo G, Guido M, Sonzogni A, et al. (2003) Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease. J Hepatol 39:239–244. doi:10.1016/S0168-8278(03)00191-0
Desmet VJ, Gerber M, Hoofnagle JH, et al. (1994) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19:1513–1520. doi:10.1002/hep.1840190629
Cholongitas E, Quaglia A, Samonakis D, et al. (2006) Transjugular liver biopsy: how good is it for accurate histological interpretation? Gut 55:1789–1794. doi:10.1136/gut.2005.090415
Haskal ZJ, Martin L, Cardella JF, et al. (2003) Quality improvement guidelines for transjugular intrahepatic portosystemic shunts. J Vasc Interv Radiol 14:265–270. doi:10.1097/01.RVI.0000094596.83406.19
Miraglia R, Maruzzelli L, Minervini MI, et al. (2011) Transjugular liver biopsy in liver transplant patients using a 18-gauge automated core biopsy needle. Eur J Radiol. doi:10.1016/j.ejrad.2010.12.016
McAfee JH, Keeffe EB, Lee RG, et al. (1992) Transjugular liver biopsy. Hepatology 15:726–732. doi:10.1002/hep.1840150429
Vibhakorn S, Cholongitas E, Kalambokis G, et al. (2009) A comparison of four- versus three-pass transjugular biopsy using a 19-G Tru-Cut needle and a randomized study using a cassette to prevent biopsy fragmentation. Cardiovasc Intervent Radiol 32:508–513. doi:10.1007/s00270-008-9412-7
Mammen T, Keshava SN, Eapen CE, et al. (2008) Transjugular liver biopsy: a retrospective analysis of 601 cases. J Vasc Interv Radiol 19:351–358. doi:10.1016/j.jvir.2007.09.002
Acknowledgments
The authors thank all patients for participating in this study.
Conflict of interest
We have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wolska-Krawczyk, M., Krawczyk, M., Katoh, M. et al. Liver fibrosis: How many samples in transjugular liver biopsy are sufficient? Histological vs. clinical value. Abdom Imaging 38, 461–464 (2013). https://doi.org/10.1007/s00261-012-9939-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-012-9939-6