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PubMed2001

[Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies].

PURPOSE: Comparative evaluation of specimens obtained with different MR-compatible biopsy systems and a conventional ferromagnetic system. METHODS: Biopsies of a pig liver were performed post-mortem with three different MR-compatible (Somatex; E-Z-EM; Daum) and one conventional biopsy system (Somatex), five with each device. The specimens were measured and the histopathological quality was graded on a scale from 0 (no tissue) to 9 (best). The tip of the needle was examined with an electron microscope before and after biopsy to demonstrate abrasion. RESULTS: The histopathological score between the first and fifth specimen taken with one biopsy device showed no significant difference. The conventional system yielded significantly better results in nearly all categories (p < 0.05) than the MR-compatible biopsy systems. The areas of the specimens obtained with the MR-compatible biopsy systems (4.27-5.99 mm2) were significantly smaller than those from the conventional system (9.98 mm2). The needle tip abrasion of the different biopsy systems determined by electron microscopy showed no substantial difference. CONCLUSION: Specimens obtained with MR-compatible biopsy systems compared to conventional biopsy systems are of lower histopathological quality. This might be caused by a smaller side notch of the MR-compatible biopsy devices. There was no difference in abrasion of the needle tip due to the softer, non-ferromagnetic alloys.

Animals↗
PubMed2003

[Transjugular liver biopsy: trucut or aspiration biopsy with modified Ross needles?].

PURPOSE: The transjugular liver biopsy is performed in patients with coagulopathy to evaluate diffuse hepatopathies. Using a jugular venous access, a liver vein is cannulated and a transvascular biopsy taken. The two techniques in use are the aspiration biopsy with a modified 15G or 16G Ross needle used for TIPS and the core biopsy with a Trucut needle. The sampling is quite similar for these techniques, but the costs are significantly different. This study is a meta-analysis of data published on both techniques to search for clinical evidence that justifies the use of the more expensive Trucut needle or that finds aspiration with the less expensive Ross needle equivalent. MATERIALS AND METHODS: The study includes 16 publications that were published between 1996 and 2002 and provided reliable information on technical success rate, complications and adequate histology. The data on 1374 procedures were analyzed, comprising 436 aspiration biopsies and 938 Trucut biopsies. RESULTS: Considering both procedures together, 95.9 % of the procedures were technically successful and 92.2% of the histologic samples diagnostically adequate. The technical success rate was 96.7 % for the Trucut-biopsies and 94.4 % for the aspiration biopsies. The corresponding rates of obtaining diagnostically adequate histologic samples were 92.5 % and 91.5 %, respectively. The complication rate of the entire population studied was 0.65 % without significant difference found between the two methods. With a list price of 420 Euro, the Trucut system costs about 200 Euro more than the Ross needle, which is listed as approximately 220 Euro. CONCLUSION: In the absence of any significant differences between both techniques for transjugular liver biopsies, economic considerations make the aspiration biopsy with the modified Ross needle preferable over the Trucut needle biopsy.

Biopsy, Needle↗
PubMed2005

Is transition zone biopsy valuable in benign prostatic hyperplasia patients with serum prostate-specific antigen >10 ng/ml and prior negative peripheral zone biopsy?

OBJECTIVES: To evaluate the importance of transition zone (TZ) biopsy in benign prostatic hyperplasia (BPH) patients with serum prostate-specific antigen (PSA) >10 ng/ml and prior negative peripheral zone (PZ) biopsy and to estimate the sensitivity of TZ biopsy. MATERIAL AND METHODS: A total of 273 BPH patients with PSA >10 ng/ml and prior negative PZ biopsy underwent an extended biopsy protocol. In patients with a TZ volume <25 cm(3), four TZ biopsies were taken (two cores per side from the apex and base). In patients with a TZ volume > or =25 cm(3) (n=183), six TZ biopsies were taken (three cores per side from the apex, middle and base). Overall, 215 patients were subjected to either transurethral resection of the prostate (n=162) or open enucleation of the adenoma (n=53). RESULTS: The extended biopsy revealed prostate cancers in 21.2% of cases (58/273). The zonal distribution of the positive cores was as follow: PZ cancers only in 67.2% of cases (39/58), TZ cancers only in 13.8% (8/58) and PZ+TZ cancers in 19% (11/58). Overall, 73.6% (14/19) and 36.8% (7/19) of TZ cancers were detected at the apex and middle of the TZ, respectively, while no TZ cancers at all were detected at the base (p=0.00015). The incidence of carcinoma on definitive pathology was 5.6% (12/215). Consequently, TZ biopsy detected only 61.3% (19/31) of TZ cancers. The incidence of pure TZ cancers was 7.3%. On the chi(2) test, patient age, serum PSA, transrectal ultrasonography findings and PSA density did not correlate significantly with the detection rate of TZ cancer. Prostate volume (p=0.023), TZ volume (p=0.027) and PSA/TZ density (p=0.007) were predictive of TZ cancers. CONCLUSIONS: Although TZ biopsy was the sole site of cancer in only 2.9% of cases (8/273), it improved the cancer detection rate by 14% in this selected group of patients. The majority (74%) of TZ cancers were detected at the apex site. TZ biopsy has a low sensitivity (61%).

Aged↗
PubMed2004

Computed-tomography-guided percutaneous core needle biopsies of suspected malignant lymphomas: impact of biopsy, lesion, and patient parameters on diagnostic yield.

PURPOSE: To investigate the diagnostic yield of core needle biopsy in patients with malignant lymphoma. MATERIAL AND METHODS: Computed-tomography-guided core needle biopsies in patients with malignant lymphoma performed in the period 1996 to 2001 were evaluated retrospectively. A biopsy was considered as "fully diagnostic" if a histological diagnosis, including the histologic subtype in the event of malignant lymphoma, was achieved and the clinical course and CT follow-up of at least 6 months confirmed the biopsy results. A biopsy was regarded as "partly diagnostic" if histological work-up defined malignant lymphoma but not the histological subtype, and if histological diagnosis bore therapeutic relevance. Diagnostic yield was correlated with features such as size of specimen, location and depth of the target lesion, and experience of the investigator. RESULTS: 45 biopsies were performed in 40 patients. With respect to definite histopathological diagnosis, 31 biopsies (68.9%) were diagnostic and 14 (31.1%) non-diagnostic. In 4 cases (8.8%), biopsies yielded partly diagnostic results, since therapy could be scheduled after biopsy without final sub-classification. Statistical analysis of biopsy parameters revealed that sample sizes were significantly larger in the diagnostic group. CONCLUSION: CT-guided biopsy can be considered as an alternative for lymphoma diagnosis and should be the first interventional procedure. The most important parameter for diagnostic success is the size of the specimen.

Biopsy, Needle↗
PubMed1996

Repeat biopsy strategy in men with isolated prostatic intraepithelial neoplasia on prostate needle biopsy.

PURPOSE: Isolated high grade prostatic intraepithelial neoplasia on needle biopsy of the prostate is a strong predictor of malignancy on repeat biopsy. However, the optimal repeat biopsy technique for these patients has not been defined. MATERIALS AND METHODS: We reviewed the records of 66 men in whom isolated prostatic intraepithelial neoplasia was found on needle biopsy of the prostate. We evaluated the side and/or quadrant and grade of prostatic intraepithelial neoplasia on initial biopsy, and compared the findings to the location of cancer on repeat biopsy. RESULTS: Of 66 men 31 (47%) had cancer on repeat biopsy, with disease on the same side of the prostate as prostatic intraepithelial neoplasia in 20 (64%). The quadrant locations of prostatic intraepithelial neoplasia and cancer matched in 6 of 12 cases (50%). Low and high grade prostatic intraepithelial neoplasia predicted the side of cancer on repeat biopsy in 3 of 5 (60%) and 17 of 26 (65%) cases, respectively. CONCLUSIONS: Directing repeat biopsy solely to the side with prostatic intraepithelial neoplasia will miss cancer in approximately 35% of cases. The optimal repeat biopsy technique for patients with high grade prostatic intraepithelial neoplasia should include systematic biopsy of the prostate.

Aged↗
PubMed2006

Transperineal extended biopsy improves the clinically significant prostate cancer detection rate: a comparative study of 6 and 12 biopsy cores.

BACKGROUND: We evaluated the improvement in the rate of prostate cancer detection when using a 12-core transperineal biopsy protocol including transitional zone biopsy. METHODS: Between April 2003 and November 2004, 247 consecutive men underwent transperineal systemic 12-core biopsy of the prostate. Six cores were obtained at the peripheral zone, four at the transitional zone and two at the apex. We examined the cancer detection rate in each of the 12 cores, and also determined the improvement of cancer detection resulting from the extensive 12-core versus standard 6-core biopsy. RESULTS: Using the extensive 12-core biopsy, prostate cancer was detected in 98 cases (39.7%). Prostate-specific antigen (PSA), PSA density, the positive rate in digital rectal examination and transrectal ultrasound findings were significantly higher in the prostate cancer group than in the non-prostate cancer group, and prostate volume was larger in non-prostate cancer group. Every site showed almost the same positive rate, between 17.8 and 21.5%. There were 20 cases which were positive in the extended biopsy, but negative in the sextant. The detection improved significantly (20.4%). The improvement of cancer detection in extended biopsy was better in men with PSA levels of 10 ng/mL or less (28.9%), PSA density 0.3 or less (25.8%), negative digital rectal examination (23.3%), and negative transrectal ultrasound (21.6%). Of these twenty patients, no cases with insignificant tumor were detected in the six prostatectomy cases. In particular, three cases of the six were transitional-zone-only cancer. CONCLUSION: Transperineal extended 12-core biopsy including 4 transitional zone cores is a more useful procedure than transperineal 6-core biopsy. Routine transitional zone biopsy, that is different from transrectal biopsy, might be useful for detecting biologically significant cancer.

Aged↗
PubMedDate not supplied

Safety of percutaneous ultrasound-guided biopsy of renal allografts in the cynomolgus monkey: results of 348 consecutive biopsies.

The safety of a technique for ultrasound-guided biopsy of renal allografts was evaluated based on 348 consecutive procedures in cynomolgus monkeys. A spring-loaded biopsy device with an 18G tru-cut biopsy needle was used to biopsy renal allografts in 139 cynomolgus monkeys performed either on clinical indication (n = 95 animals) or as serial protocol biopsies (n = 44 animals) for a total of 348 biopsies. Monkeys having serial biopsies received between 3-9 biopsies per animal. All others received non-protocol biopsies that were performed on clinical indication, and the range was 1-15 biopsies per animal. No life-threatening complications or deaths occurred and there were no clinically detectable minor complications such as macrohematuria. Self-limiting complications such as small arteriovenous fistulas (n = 4, 3-5 mm large) were detected with Doppler ultrasound and resolved hemodynamically after 2-4 weeks. Three animals developed hematomas ranging 4 mm-2 cm in diameter and were no longer sonographically evident 2-4 weeks later. Ultrasound-guided biopsy of renal allografts can be performed with a high degree of safety in small (3-5 kg) laboratory animals such as the cynomolgus monkey and provides a valuable tool for renal transplantation research. Even when cores were taken at two week intervals no major complications occurred and only rarely were clinically irrelevant complications detected. Experience with diagnostic ultrasound, both gray scale and Doppler, is important for both safety and the recognition of complications that may arise.

Animals↗
PubMed1989

Image-directed percutaneous biopsies with a biopsy gun.

Core tissue for histologic study is believed by many pathologists to be more diagnostic than material from needle aspiration. Recently, a biopsy "gun" has been introduced, which simplifies core biopsies. With this device, 182 biopsies of multiple anatomic sites were performed with ultrasonic, computed tomographic, and fluoroscopic guidance and 18-gauge needles. High-quality histopathologic specimens were obtained in 177 of the biopsies, and diagnostic target tissue was obtained in 167. Only three significant complications occurred: one bleeding complication that required transfusion and two cases of pneumothorax that necessitated placement of chest tubes. The biopsy gun eliminated the disjointed movements of conventional "skinny" needle biopsies, and none of the samples demonstrated significant "crush" artifact or obscuring blood, problems that are commonly associated with manual biopsy techniques. Patient discomfort was decreased with this system compared with that of manual biopsies, and the total procedure time was reduced. Because of these distinct advantages, the authors now use the biopsy gun exclusively for all percutaneous biopsies and recommend that other institutions consider the use of this biopsy method.

Adult↗
PubMed1998

Stereotactic biopsy of intracranial brain lesions. High diagnostic yield without increased complications: 65 consecutive biopsies with early postoperative CT scans.

Diagnostic yield and complication rate were analyzed for a series of 65 consecutive stereotactic biopsies of intra-axial brain lesions. The diagnostic yield was 98.5 +/- 1.5% and the complication rate was 1.5%. A median number of 14 biopsies (range 1-48) were taken per lesion. The biopsy sites followed a clockwise pattern, going from the superficial margin to the center and the deep margin of the lesion with respect to the inner table of the skull. A side window cannula biopsy needle was used. All patients underwent immediate postoperative CT scans within 4 h of biopsy to rule out intracranial complications. All patients were discharged within 24 h after biopsy, unless medical reasons unrelated to the biopsy required further hospitalization. We attribute the high diagnostic yield in our series to the high number of systematically taken biopsies per lesion. The higher number of biopsies did not lead to an increase in complications. From our experience, it appears safe to discharge patients the same day or within 24 h after a stereotactic biopsy if the postoperative CT shows no complication. Stereotactic biopsy could often safely be performed on an outpatient basis.

Adolescent↗
PubMed2004

Cost minimization study of image-guided core biopsy versus surgical excisional biopsy for women with abnormal mammograms.

PURPOSE: To describe the clinical and economic consequences of image-guided core biopsy versus surgical excisional biopsy of mammographically identified breast lesions. PATIENTS AND METHODS: Clinical and economic data were collected for 1121 patients undergoing core biopsies and 501 patients undergoing surgical biopsies between 1996 and 1998. Lesions were classified according to mammographic degree of suspicion and type of radiographic abnormality. Costs were measured from the societal perspective. A decision analytic model was constructed, with probabilistic sensitivity analysis. RESULTS: Lesions diagnosed via core versus surgical biopsy were less likely to be masses (39% v 55%), less likely to be classified as high cancer suspicion (17% v 26%), and less likely to be treated with a single procedure (74% v 81%; P <.001 for each). Cancers diagnosed by a surgical biopsy were less likely to have had a single operative procedure (33% v 84%) and were associated with higher total costs whether mastectomy (US dollars 2775 v US dollars 1849) or lumpectomy (US dollars 2112 v US dollars 1365) was used. Sensitivity analysis showed core biopsy optimal in 95.4% of trials. Core biopsy was favored for low-suspicion lesions, calcifications, and masses, and overall for patients who underwent lumpectomy alone. CONCLUSION: Image-guided core biopsy can be cost-saving compared with surgical biopsy, particularly when the mammographic abnormality is classified as low suspicion or consists of calcifications or masses. Moving to a policy in which core biopsy is the preferred approach in these settings has the potential to result in significant cost savings.

Biopsy↗
PubMedDate not supplied

High complication rate of an automatic Tru-Cut biopsy gun device for liver biopsy in cats.

BACKGROUND: Liver biopsies taken with an automatic Tru-Cut biopsy gun device caused unexpected fatal shock reactions in cats. The goal of the present study was to determine if this biopsy device caused more frequent fatal complications than did a semiautomatic device. ANIMALS: All cats referred to the Utrecht University, between October 1, 2002, and October 31, 2004, in which ultrasound-guided Tru-Cut liver biopsies were taken. The indications for liver biopsy were increased liver enzyme activity, increased bile acid concentrations, ultrasonographic abnormalities of the liver, ultrasonographic abnormalities of the bile ducts, or some combination of these findings. Coagulation parameters were normal. METHODS: From October 1, 2002, until October 31, 2003, 26 cats were biopsied with an automatic biopsy device. Between November 1, 2003, and October 31, 2004, 19 cats underwent liver biopsy with a semiautomatic biopsy device. RESULTS: In the first period. 5 of the 26 cats (19%) developed severe shock within 15 minutes. Resuscitation was not successful. In the second period, none of the 19 cats experienced any major adverse effect. There were no significant differences between the 2 groups with respect to diagnosis, clinical signs, clinicopathologic findings, or the use of anesthetics. CONCLUSIONS AND CLINICAL IMPORTANCE: We conclude that the difference in complication rate is explained by the biopsy technique used. The pressure wave, which occurs when firing the automatic device, may have caused intense vagotonia and shock. Use of this automatic biopsy device should be avoided in cats because of the high risk of fatal complications.

Animals↗
PubMedDate not supplied

Percutaneous lung biopsy in the horse: comparison of two instruments and repeated biopsy in horses with induced acute interstitial pneumopathy.

The aim of the study reported here was to compare complications of lung biopsy in horses and the quality of the lung specimens after biopsy using the manual Tru-Cut biopsy needle (TC) and an automated biopsy needle (ABN). For experiment 1, lung biopsy was performed in 50 horses with one instrument on one side of the thorax, and then with the other instrument on the other side. Postmortem examination was performed in 20 of the 50 horses. Coughing was detected in 10 of 50 horses and epistaxis was observed in 6 of the 50 horses. Endoscopy revealed bleeding into the airways in 16 of 49 horses and in 5 of 49 horses after biopsy with the TC or the ABN, respectively. Use of the ABN induced a significantly smaller amount of bleeding. Pneumothorax was detected by radiography in 1 of 50 horses. Hematoma diameter determined in 7 of 20 horses at postmortem examination, was significantly larger after biopsy with the TC than with the ABN. The quality of the lung specimen was good. In experiment 2, complications after repeated and multiple lung biopsies in 6 horses were evaluated. Moderate epistaxis was observed on 13 of 104 occasions. Bleeding into the airways was detected at endoscopy on 41 of 104 occasions, and pneumothorax was detected during 4 of 104 occasions. Complications such as hematoma at the biopsy site and bleeding into the airways were greater after biopsy with the TC than after use of the ABN. Lung biopsy specimens obtained with the ABN were fairly safe for the animal.

Animals↗
PubMed2003

Efficacy of thoracoscopic lung biopsy in interstitial lung diseases: comparison with open lung biopsy.

OBJECTIVE: To determine the efficacy of video-assisted thoracoscopic surgery (VATS) compared to open lung biopsy. DESIGN: Descriptive, observational case series. PLACE AND DURATION OF STUDY: The Cardio-thoracic Centre, Liverpool, UK, from January 1995 to December 1999. PATIENTS AND METHODS: One hundred consecutive patients, undergoing lung biopsy for interstitial lung disease during this period, were included in the study. Thirty patients underwent open lung biopsy, while 70 patients had VATS lung biopsy. Patient characteristics, site, size, number and laterality of biopsy, complications, morbidity, mortality and diagnostic yield was compared. P-value was determined to assess significance of findings. Statistical analysis was performed on SAS for windows version 8. RESULTS: Seventy-five percent had diagnostic yield in VATS group, while 37% in open group (p=0.04). Mean FEV1 was 3.2 litre in VATS group and 1.92 litre in open group (p=0.05). Right side was selected in 58.6% in VATS group and 36.7% in open group (p =0.04). Right lower lobe was the main site for biopsy in the VATS group compared to open group (18.6% versus 3.3%, p=0.04). Mean volume of biopsy was 15.6 cm3 in VATS group and 12.5 cm3 in open group (p=0.04). Two or more biopsies were carried out in 37.1% of the VATS group compared to 16.7% of the open group (p=0.04). Chest drain duration was in 1 day in VATS group compared to 2 days in open group (p=0.01). Length of stay was 3 days in VATS group and 4 days in open group (p=0.003). CONCLUSION: Patients undergoing thoracoscopic lung biopsy had a significantly reduced chest drain duration and post-operative length of stay. Thoracoscopic lung biopsy is beneficial in determining a diagnostic yield with an advantage of greater volume and selection of biopsy sites.

Adult↗
PubMed1993

Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease.

OBJECTIVE: The purpose of this study was to compare several of the commonly used needles with several of the new automated biopsy devices (biopsy guns) for biopsy of diffuse hepatic disease. MATERIALS AND METHODS: Nine different biopsy needles or automated devices were each used to do three biopsies of 10 cadaveric livers. The specimens were reviewed in a blinded fashion by a pathologist who did not know which needle or device was used, and they were compared on the basis of a previously published histopathologic grading scale. RESULTS: The three conventional biopsy needles (16-gauge Jamshidi, 18-gauge Sure-Cut, and 14-gauge Tru-Cut) obtained a large amount of tissue with an average of 4.1 intact portal triads per biopsy. The 18-gauge Biopty gun obtained equivalent results. The 18-gauge Autovac gun with a 2-cm biopsy depth did not obtain any tissue in 18.5% of attempts. The 14- and 16-gauge Biopty guns and the 18-gauge Autovac gun with a 4-cm biopsy depth performed best with respect to fragment size and number of intact portal triads. CONCLUSION: Automated biopsy devices can provide more diagnostic specimens than can manual or conventional needles in biopsy for diffuse hepatic disease.

Biopsy, Needle↗
PubMed2001

[Prospective study comparing ultrasonography guided trans-rectal biopsy and finger guided trans-perineal biopsy in the diagnosis of prostatic cancer].

OBJECTIVE: To compare ambulatory ultrasound-guided transrectal biopsy and finger-guided transperineal biopsy. MATERIAL AND METHODS: From June 1997 to October 1999, 51 patients were simultaneously biopsied by the two techniques and by the same operator, 30 min after antibiotic prophylaxis with 200 mg of Ciprofloxacin by intravenous injection. Transperineal biopsies were performed first, followed by ultrasound-guided transrectal biopsies. Six cores were obtained with each technique, from the apex, the middle and the base of each lobe. RESULTS: For a PSA level between 4 and 10 ng/ml, 6 cancers were detected in 23 patients (26%) and one cancer was only detected via the transrectal route. For a PSA level greater than 10 ng/ml, 17 cancers were detected in 28 patients (60%), 15 (53%) by transperineal biopsy and 11 (39%) by transrectal biopsy. Six cancers were only detected by transperineal biopsy and two were only detected by transrectal biopsy. No statistically significant difference was observed between the numbers of positive biopsies obtained with the two techniques. CONCLUSION: The use of ultrasonography is not essential to perform systematic biopsies. Rather than the technique used, the detection of prostate cancer is improved by performing 12 cores instead of 6.

Aged↗
PubMed2002

Results of the 5 region prostate biopsy method: the repeat biopsy population.

PURPOSE: The decision to repeat prostate biopsy in a patient in whom the first biopsy did not detect prostate cancer poses a challenge to urologists. Many published series show a low yield on repeat biopsy using standard techniques. We reviewed our data on the 5 region prostate biopsy method to evaluate its yield in the repeat biopsy population. MATERIALS AND METHODS: A total of 125 repeat transrectal ultrasound guided prostate needle biopsy sessions were done in 110 patients for standard indications using the 5 region method. Pathological findings were reviewed and the yield of the additional regions was analyzed. RESULTS: Patients were categorized with respect to the initial biopsy technique. In those who underwent 1 and more than 1 previous sextant biopsy the relative increase in yield of the 5 region technique over the standard sextant technique was 31% and 33%, respectively. In the cohort that underwent previous 5 region biopsy the relative increase in yield of the 5 region technique over the standard sextant technique was 38%. CONCLUSIONS: In the setting of repeat biopsy the 5 region method results in an increased yield over the sextant method. It is true in patients who have previously undergone biopsies with the sextant or 5 region technique.

Aged↗
PubMed2002

Hawaii's Neuromuscular Disease Biopsy Registry. A quarter-century compilation of muscle biopsy diagnoses in Hawaii.

INTRODUCTION: The Department of Pathology at Straub Clinic & Hospital began using enzyme histochemical techniques to examine muscle biopsies in 1976 and has processed most of the muscle biopsies performed in Hawaii for the past 25 years. A Muscle Biopsy Registry of biopsy findings was established in 1992 and information concerning 1,230 biopsies during the period December 1976 to June, 2000 entered into the Registry's data base. The goal was to document data derived from biopsy-based diagnoses of neuromuscular diseases since none currently exists. METHODS: Muscle biopsies received in a fresh state in the Straub Pathology Department were processed utilizing a modern approach incorporating routine histological and enzyme histochemical staining techniques of frozen sections. One pathologist [LJL] documented findings and established diagnoses for all cases. Patient information, demographics and diagnoses were recorded utilizing a Microsoft Excel spreadsheet program. RESULTS: Data sorts conducted from the Registry's data base of 1,230 biopsies produced graphs and tables illustrating demographic statistics regarding diagnoses and findings in 1,044 different patients some of whom had multiple biopsies. CONCLUSIONS: Hawaii's Neuromuscular Disease Biopsy Registry constitutes a compilation of a quarter-century of muscle biopsy-based diagnoses utilizing enzyme histochemical diagnostic techniques in pediatric and adult age groups, including specific diagnoses encountered in different ethnic groups. This information constitutes a benchmark for future epidemiologic studies, and a basis for comparison with data derived from clinical diagnoses and data derived from Death Certificates.

Biopsy↗
PubMedDate not supplied

[Ultrasound-guided puncture-biopsy of the liver could replace blind puncture-biopsy in diffuse hepatopathies. Retrospective study of 1293 patients].

OBJECTIVES: The aim of this retrospective study was to compare the efficiency and complications of percutaneous hepatic biopsy either guided by ultrasonography in the left lobe, or blindly by the intercostal route in the right lobe, in the diagnosis of diffuse liver diseases. PATIENTS AND METHODS: Liver biopsy was performed in 1,293 patients for 5 years. In group 1 (289 patients, including 140 out-patients), liver biopsy was guided by ultrasound. In group 2, blind intercostal liver biopsy was performed in 1,004 patients. Patients were observed for 6 hours after biopsy in both groups. RESULTS: The failure rate of liver biopsy was significantly lower in group 1 (1.7%) than in group 2 (9.25%, P < 0.01). The prevalence of the histological lesions was similar in both groups. No related-biopsy death occurred. Complications were more serious after blind biopsy (1 acute pancreatitis with a hematoma of the liver, 1 bile leakage around the gallbladder, 1 hemoperitonitis, 1 large intrahepatic hematoma), than after guided biopsy (1 small hematoma of the liver, 1 acute biliary pain on the 10th day). CONCLUSION: Hepatic biopsy guided by ultrasonography could replace blind biopsy in the diagnosis of diffuse liver diseases.

Biopsy, Needle↗