Diagnostic yield improvement by routine ultrasound-guided liver biopsy in viral chronic hepatitis
Ultrasound (US) assisted and US-guided percutaneous liver biopsy in patients affected by viral chronic hepatitis are considered to be safer than blind needle procedure. Some authors described diagnostic yield increasing by routine US-assisted needle biopsy but differences between diagnostic yield and safety of US-guided liver biopsy and US-assisted procedure have never been investigated. In our department we performed 176 US-guided and 181 US-assisted needle biopsies in 357 patients affected by viral chronic hepatitis. We used a Menghini modified 16 Gauche (G) automatic needle by using inter-costal approach. No major complication were observed.
Results showed increasing diagnostic yield (p less than 0,0001) in specimens from US-guided liver biopsy (83% with length of the specimen longer than 20mm and 76.6% with more than 10 portal spaces) versus US-assisted procedure (12.5% with length of the specimens longer than 20mm and 58% with more than 10 portal spaces). In our experience performing US -guided needle biopsy in the assessment of viral chronic hepatitis instead of US-assisted practice seems to increase diagnostic yield. No difference in safety are found between these two types of procedure.