The Quality of the Fragment Obtained by Liver Biopsy for Staging Chronic Hepatitis

Abstract

The aim of our paper was to assess the quality of the liver fragment obtained by liver biopsy for staging chronic hepatitis.

Material and method. We analyzed retrospectively 250 echoassisted percutaneous liver biopsies (LB) concerning the length of the fragment and the mean number of portal spaces. We used Menghini modified needles 1.4 and 1.6 mm in diameter and the LBs were performed by the same senior hepatologist.

Results. The indications for the LB were represented by: chronic hepatitis C in 69 % (172 cases), chronic hepatitis B in 17 % (43 cases), chronic hepatocytolysis in 10% (25 cases), primary billiary cirrhosis in 1.5% (4 cases), chronic B+C hepatitis in 3 cases, autoimmune chronic hepatitis in 2 cases and Wilsons disease in 1 case. From the 250 LBs, in 87% of cases (217 patients) the liver sample had 8-10 portal spaces ('good fragment') and in 69% of cases (173 patients) the liver sample had at least 11 portal spaces ('very good fragment'). In 13% of the cases (33 liver biopsies) the histological sample was suboptimal, less than 8 portal spaces. In 1.6% of the cases (4 biopsies), the liver sample was not adequate for the diagnosis (less than 4 portal spaces), so that we had to perform a second biopsy (in another session). In 88% cases (219 subjects), the length of the liver fragment obtained was longer than 2 cm and only in 12% of cases (31 patients) the fragment was smaller than 2 cm. The median length of the fragment obtained by LB in our department was 30.8 ± 8.7 mm, and the mean number of portal spaces was 14.9±7.09.

Conclusion. In experienced hands, percutaneous liver biopsy can obtain 'good' histological material in the vast majority of cases.