Ultrasound-guided biopsy in focal liver lesions

Abstract

Introduction. Focal liver lesions represent one of the main indications of ultrasound‑guided liver biopsy. The objective of the study was to evaluate the ad‑ vantages and risks of liver biopsy, and to highlight the importance of a close follow‑up in the prevention of postprocedural complications. Methods. We have retrospectively analyzed a num‑ ber of 52 patients, who underwent liver biopsies in the Clinical Emergency Hospital of Bucharest, Romania, after being diagnosed with various types of focal liver lesions through ultrasound scanning. Results. Regarding the quality of the bioptic samples obtained: 98% of them were diagnostic, only 2% being nondiagnostic, mainly due to the tissue necrosis found within the tumor. The majority of the cases selected for the study had multiple liver lesions (70%), the rest of 30% had single lesions identified by ultrasound scanning. After histopathological analysis, in 89 % of the cases the lesion proved to be malignant (of which 70% were hepatic metastases and 30% were liver car‑ cinomas), the rest of 11% were benign. This last cat‑ egory included hepatic adenomas and focal nodular hyperplasia, identified in young female population. Our study did not reveal any relation between the lo‑ cation of the lesion within the liver and the number of needle passes needed in order to obtain viable biopsy specimens (P = 0.16). Of all the cases that underwent liver biopsy, only 4% had complications, mainly minor bleeding and only 1% major bleeding and transitory hypotension. There was no case of death registered. Conclusions. Ultrasound guided percutaneous liver biopsy is a fast, economical and user‑friendly proce‑ dure, frequently used in the diagnosis of focal liver le‑ sions. The success rate of the biopsy in obtaining viable samples is high and it depends more on the structure of the lesion and the materials used, rather than on the anatomical localization of the lesion within the liver. Severe complications can be avoided if a close follow‑up of the patients is performed.