Transjugular Liver Biopsy: Comparison of Sample Adequacy with the Use of Two Automated Needle Systems

Behrens, George; Ferral, Héctor; Giusto, Deborah; Patel, Jay; Thiel, David H. Van

doi:10.1016/j.jvir.2010.10.012

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Previous reports of TJLB have consistently reported complication rates of 1.3–6.5%, lower than those after PLB [15, 16]. With recent developments and improvements in devices, the quality of TJLB specimens has become comparable to those obtained with PLB [17, 18]. In our case, the liver specimen obtained after five punctures during TJLB was sufficient to make a histological diagnosis of AIH.…”

Section: Discussionsupporting

confidence: 51%

Autoimmune Hepatitis with Concomitant Idiopathic Thrombocytopenic Purpura Diagnosed by Transjugular Liver Biopsy

Fukuda

Takata

Kitaguchi

et al. 2018

Case Reports in Hepatology

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Patients with autoimmune hepatitis (AIH) may sometimes have concomitant idiopathic thrombocytopenic purpura (ITP). Severe thrombocytopenia in ITP interferes with percutaneous liver biopsy for pathological diagnosis of AIH. Here, we report a case of AIH with ITP in a 63-year-old woman. The patient presented to our hospital with liver dysfunction and thrombocytopenia. For histological examination, transjugular liver biopsy (TJLB) was performed, leading to a diagnosis of AIH. Corticosteroids treatment led to an improvement in her liver enzyme levels and platelet count. In conclusion, patients with AIH may sometimes have concomitant ITP. TJLB was effective for making the diagnosis of AIH with severe thrombocytopenia due to ITP.

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Section: Discussionsupporting

confidence: 51%

Autoimmune Hepatitis with Concomitant Idiopathic Thrombocytopenic Purpura Diagnosed by Transjugular Liver Biopsy

Fukuda

Takata

Kitaguchi

et al. 2018

Case Reports in Hepatology

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“…10,27 This standard is achieved during TJLB in 89 to 96% of cases. 4,21 The minimum requirement for a sample to be useful for grading and staging in chronic hepatitis is to obtain a specimen of 20 mm length and 11 complete portal tracts. 4 Data previously reported by Behrens et al demonstrated that it is possible to obtain a total sample of 28 to 29 mm in length containing a mean of 10 to 12 complete portal tracts during a TJLB.…”

Section: Resultsmentioning

confidence: 99%

“…4,21 The minimum requirement for a sample to be useful for grading and staging in chronic hepatitis is to obtain a specimen of 20 mm length and 11 complete portal tracts. 4 Data previously reported by Behrens et al demonstrated that it is possible to obtain a total sample of 28 to 29 mm in length containing a mean of 10 to 12 complete portal tracts during a TJLB. It is important to emphasize the fact that to obtain such samples, it is necessary to provide at least three good tissue specimens to the pathologist.…”

Section: Resultsmentioning

confidence: 99%

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Transjugular Liver Biopsy

Behrens

Ferral

2012

Semin intervent Radiol

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Liver biopsy is considered the gold standard for the evaluation of acute and chronic liver disorders. Transjugular liver biopsy (TJLB) was described by Dotter in 1964 and clinically performed for the first time by Hanafee in 1967. TJLB consists of obtaining liver tissue through a rigid cannula introduced into one of the hepatic veins, typically using jugular venous access. The quality of the TJLB specimens has improved so much that the samples obtained by this method are comparable with those obtained with the percutaneous technique. TJLB is indicated for patients with coagulopathy, ascites, peliosis hepatis, morbid obesity, liver transplant, or in patients undergoing a transjugular intrahepatic portosystemic shunt procedure. The technical success rate for a TJLB procedure ranges from 87 to 97%. Sample fragmentation has been reported in 14 to 25% of the TJLB samples. The complication rates are low and range between 1.3% and 6.5%. The purpose of this article is to provide a review of the fundamental aspects of the TJLB procedure, including technique, indications, contraindications, results, and complications.

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“…However, histological interpretation of liver biopsy is subject to micro‐inhomogeneity of liver tissue, sampling error based on length of liver biopsy core, presence of unfragmented core, and observer variability among pathologists . Moreover, it requires the patient to undergo an invasive procedure that could be associated with discomfort and could rarely be associated with life‐threatening complications …”

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confidence: 99%

Performance characteristics of vibration‐controlled transient elastography for evaluation of nonalcoholic fatty liver disease

et al. 2017

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Vibration-controlled transient elastography estimates liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), which are noninvasive assessments of hepatic fibrosis and steatosis, respectively. However, prior vibrationcontrolled transient elastography studies reported high failure rates in patients with nonalcoholic fatty liver disease. We examined the performance characteristics of the FibroScan 502 Touch with two probes, medium (M1) and extra large (XL1), in patients with nonalcoholic fatty liver disease in a multicenter setting. A total of 1,696 exams were attempted in 992 patients (body mass index, 33.6 6 6.5 kg/m 2 ) with histologically confirmed nonalcoholic fatty liver disease. Simultaneous assessment of LSM and CAP was performed using the FibroScan 502 Touch with an automatic probe selection tool. Testing was conducted twice in patients by either a single operator (87%) or two operators (13%). Failure was defined as the inability to obtain a valid examination. An examination was considered unreliable if LSM interquartile range/ median was >30%. Significant disagreement between two readings was defined as >95% limits of agreement between two readings. A total of 1,641 examinations yielded valid results with a failure rate of 3.2% (55/1,696). The proportion of unreliable scans for LSM was 3.9%. The proportion of unreliable scans with operator experience in the top quartile ( 59 procedures) was significantly lower than that in the lower three quarters combined (1.6% versus 4.7%, P 5 0.02 by Fisher's exact test). The significant disagreement between first and second readings for LSM and CAP when obtained back to back was 18% and 11%, respectively. Conclusion: Vibration-controlled transient elastography for estimation of LSM and CAP can be successfully deployed in a multicenter setting with low failure (3.2%) and high reliability (>95%) rates and high reproducibility. (HEPATOLOGY 2018;67:134-144).

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Transjugular Liver Biopsy: Comparison of Sample Adequacy with the Use of Two Automated Needle Systems

Cited by 14 publications

References 11 publications

Autoimmune Hepatitis with Concomitant Idiopathic Thrombocytopenic Purpura Diagnosed by Transjugular Liver Biopsy

Autoimmune Hepatitis with Concomitant Idiopathic Thrombocytopenic Purpura Diagnosed by Transjugular Liver Biopsy

Transjugular Liver Biopsy

Performance characteristics of vibration‐controlled transient elastography for evaluation of nonalcoholic fatty liver disease

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