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Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy

Received: 24 July 2019     Accepted: 14 August 2019     Published: 28 August 2019
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Abstract

The liver biopsy (LB) still keeps some indications today, in spite of the progress of the non-invasive explorations. Several LB techniques have been studied. Some techniques use medical imaging. These techniques also differ in the material used to collect the hepatic sample. This study aimed to determine the current indications of LB, the interest using ultrasound guidance and an automatic device in order to improve its performance and its contribution to the diagnosis. This was a retrospective study including percutaneous LB performed under ultrasound guidance using automatic system equipped with a sharp needle. The study involved 50 patients with 26 diffuse liver diseases (DLD) and 24 focal liver lesions (FLL). The indications for DLD biopsy were dominated by suspicion of hepatic sarcoidosis, primary biliary cirrhosis and hepatic tuberculosis. FLL were dominated by the exploration of nodules or masses. The number of passes made was three in 96% of cases, otherwise it was four, with an average size of 1.3 cm for cores. DLD were dominated by chronic liver disease (42%), granulomatous hepatitis (23%), steatohepatitis (11%) and primary biliary cirrhosis (8%). FLL were dominated by secondary malignancies (46%) and primary malignant lesions (25%). For FLL, LB sensitivity, specificity, positive predictive value and negative predictive value were respectively 81%, 100%, 100% and 20%. LB confirmed 45% of DLD diagnoses, when they were well oriented by clinical and paraclinical data. The LB allowed to rectify the diagnosis in 54% of cases. When no initial diagnosis was suspected, LB enabled a specific diagnosis in 75% of cases. Major complications were void in our study. In conclusion, the use of ultrasound guidance and an automatic device with a sharp needle has increased the number of passes, improved the quality of sampling and reduced complications.

Published in International Journal of Gastroenterology (Volume 3, Issue 1)
DOI 10.11648/j.ijg.20190301.13
Page(s) 17-22
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Focal Liver Lesions, Diffuse Liver Disease, Biopsy, Ultrasound, Contribution

References
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  • APA Style

    Fatma Daoud, Mehdi Somai, Ines Ben Hassen, Imene Rachdi, Dorra Trad, et al. (2019). Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy. International Journal of Gastroenterology, 3(1), 17-22. https://doi.org/10.11648/j.ijg.20190301.13

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    ACS Style

    Fatma Daoud; Mehdi Somai; Ines Ben Hassen; Imene Rachdi; Dorra Trad, et al. Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy. Int. J. Gastroenterol. 2019, 3(1), 17-22. doi: 10.11648/j.ijg.20190301.13

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    AMA Style

    Fatma Daoud, Mehdi Somai, Ines Ben Hassen, Imene Rachdi, Dorra Trad, et al. Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy. Int J Gastroenterol. 2019;3(1):17-22. doi: 10.11648/j.ijg.20190301.13

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  • @article{10.11648/j.ijg.20190301.13,
      author = {Fatma Daoud and Mehdi Somai and Ines Ben Hassen and Imene Rachdi and Dorra Trad and Sarra Bejaoui and Raja Jouini and Hana Zoubeidi and Ehsen Ben Brahim and Dalila Gargouri and Mohamed Habib Daghfous and Achraf Chedli-Debbiche and Fatma Boussema},
      title = {Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy},
      journal = {International Journal of Gastroenterology},
      volume = {3},
      number = {1},
      pages = {17-22},
      doi = {10.11648/j.ijg.20190301.13},
      url = {https://doi.org/10.11648/j.ijg.20190301.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20190301.13},
      abstract = {The liver biopsy (LB) still keeps some indications today, in spite of the progress of the non-invasive explorations. Several LB techniques have been studied. Some techniques use medical imaging. These techniques also differ in the material used to collect the hepatic sample. This study aimed to determine the current indications of LB, the interest using ultrasound guidance and an automatic device in order to improve its performance and its contribution to the diagnosis. This was a retrospective study including percutaneous LB performed under ultrasound guidance using automatic system equipped with a sharp needle. The study involved 50 patients with 26 diffuse liver diseases (DLD) and 24 focal liver lesions (FLL). The indications for DLD biopsy were dominated by suspicion of hepatic sarcoidosis, primary biliary cirrhosis and hepatic tuberculosis. FLL were dominated by the exploration of nodules or masses. The number of passes made was three in 96% of cases, otherwise it was four, with an average size of 1.3 cm for cores. DLD were dominated by chronic liver disease (42%), granulomatous hepatitis (23%), steatohepatitis (11%) and primary biliary cirrhosis (8%). FLL were dominated by secondary malignancies (46%) and primary malignant lesions (25%). For FLL, LB sensitivity, specificity, positive predictive value and negative predictive value were respectively 81%, 100%, 100% and 20%. LB confirmed 45% of DLD diagnoses, when they were well oriented by clinical and paraclinical data. The LB allowed to rectify the diagnosis in 54% of cases. When no initial diagnosis was suspected, LB enabled a specific diagnosis in 75% of cases. Major complications were void in our study. In conclusion, the use of ultrasound guidance and an automatic device with a sharp needle has increased the number of passes, improved the quality of sampling and reduced complications.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Contribution, Indications and Technical Realization of Ultrasound-guided Liver Biopsy
    AU  - Fatma Daoud
    AU  - Mehdi Somai
    AU  - Ines Ben Hassen
    AU  - Imene Rachdi
    AU  - Dorra Trad
    AU  - Sarra Bejaoui
    AU  - Raja Jouini
    AU  - Hana Zoubeidi
    AU  - Ehsen Ben Brahim
    AU  - Dalila Gargouri
    AU  - Mohamed Habib Daghfous
    AU  - Achraf Chedli-Debbiche
    AU  - Fatma Boussema
    Y1  - 2019/08/28
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijg.20190301.13
    DO  - 10.11648/j.ijg.20190301.13
    T2  - International Journal of Gastroenterology
    JF  - International Journal of Gastroenterology
    JO  - International Journal of Gastroenterology
    SP  - 17
    EP  - 22
    PB  - Science Publishing Group
    SN  - 2640-169X
    UR  - https://doi.org/10.11648/j.ijg.20190301.13
    AB  - The liver biopsy (LB) still keeps some indications today, in spite of the progress of the non-invasive explorations. Several LB techniques have been studied. Some techniques use medical imaging. These techniques also differ in the material used to collect the hepatic sample. This study aimed to determine the current indications of LB, the interest using ultrasound guidance and an automatic device in order to improve its performance and its contribution to the diagnosis. This was a retrospective study including percutaneous LB performed under ultrasound guidance using automatic system equipped with a sharp needle. The study involved 50 patients with 26 diffuse liver diseases (DLD) and 24 focal liver lesions (FLL). The indications for DLD biopsy were dominated by suspicion of hepatic sarcoidosis, primary biliary cirrhosis and hepatic tuberculosis. FLL were dominated by the exploration of nodules or masses. The number of passes made was three in 96% of cases, otherwise it was four, with an average size of 1.3 cm for cores. DLD were dominated by chronic liver disease (42%), granulomatous hepatitis (23%), steatohepatitis (11%) and primary biliary cirrhosis (8%). FLL were dominated by secondary malignancies (46%) and primary malignant lesions (25%). For FLL, LB sensitivity, specificity, positive predictive value and negative predictive value were respectively 81%, 100%, 100% and 20%. LB confirmed 45% of DLD diagnoses, when they were well oriented by clinical and paraclinical data. The LB allowed to rectify the diagnosis in 54% of cases. When no initial diagnosis was suspected, LB enabled a specific diagnosis in 75% of cases. Major complications were void in our study. In conclusion, the use of ultrasound guidance and an automatic device with a sharp needle has increased the number of passes, improved the quality of sampling and reduced complications.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Internal Medicine and Rheumatology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Internal Medicine and Rheumatology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Radiology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Internal Medicine and Rheumatology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Gastroenterology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Radiology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Anatomopathology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Internal Medicine and Rheumatology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Anatomopathology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Gastroenterology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Radiology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Anatomopathology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

  • Internal Medicine and Rheumatology Department, Habib Thameur Hospital, Tunis El Manar University, Tunis, Tunisia

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