Percutaneous liver biopsy – Tru-cut vs Menghini needle, the experience of a referral service

Aims Liver histology remains the gold standard in the diagnosis and staging of liver pathology. The present study evaluated the role of percutaneous hepatic biology in the clinical practice of a Gastroenterology referral Service, with the main objective of retrospectively comparing the two available techniques (Tru-cut 16/18G vs Menghini). The frequency, sample size, diagnostic accuracy and safety profile of the procedures were evaluated.

Methods Included all percutaneous liver biopsies with ultrasound support between 01-01-2011 and 03-08-2023 in a referral Service.

Results Included 267 patients (53.9% female), with a mean age of 56.2 (+/- 15.2 standard deviation). The main indication was elevations in liver tests (43.1%), followed by liver nodules (16.5%) and suspicion of autoimmune hepatitis (9.4%). The diagnostic accuracy was 69.7%, the main one being unclassified steatohepatitis (22.5%), followed by neoplasms (19.9%) ​​and autoimmune hepatitis (5.6%). Most of the procedures were carried out in an outpatient setting and only 18% on hospitalized patients.

Complications were observed in 11.2% of the procedures (pain – 42%), 1.5% considered severe, demanding hospitalization (hepatic hematoma with hemoperitoneum).

A Menghini needle was used in 106 biopsies, obtaining an average of 1.9 fragments, 28.2 mm long, including 15.3 portal spaces, in 1.17 passages, with 81% diagnostic accuracy and 9.5% of complications. A total of 116 biopsies were performed with a Tru-Cut needle (38 with 16G, 78 with 18G), obtaining an average of 1.7 fragments, 17.6mm long, including 9.4 portal spaces, in 1.4 passages. , with 66.5% diagnostic accuracy and 9.4% complications, with a statistically significant difference for the number of passages (p=0.004), number of portal spaces (p<0.001), and length of the fragments obtained (p<0.001). [1]

Conclusions Percutaneous liver biopsy showed similar diagnostic accuracy and safety regardless of the used needle. Menghini needles made it possible to collect larger fragments with more portal spaces, being associated with a smaller number of passages. However, due to the better experience and comfort we use Tru-Cut needle in our Service.

Publication History

Article published online:
15 April 2024

• References

• 1 Al Knawy B, Shiffman M.. Percutaneous liver biopsy in clinical practice. Liver Int 2007