Routine ultrasound-guided liver biopsy versus echo-assisted procedure in viral chronic hepatitis

Ultrasound (US)-assisted liver biopsy is the most widespread practice for the staging of chronic hepatitis, but there are no data about a comparison with the US-guided procedure in terms of safety and diagnostic yield. The aim of this study was a retrospective analysis about 357 biopsies performed by using both these techniques.

We analysed 176 US-guided biopsies and and 181 US-assisted liver biopsies performed in the same unit in patients with chronic viral hepatitis. We recorded the number of passes, sample fragmentation and sample size, number of portal spaces and degree of fibrosis. Mortality and morbidity were also assessed. Differences between the two groups of needle biopsies were analysed statistically by the Welch test, with significance at p<0.05.

Specimens obtained by US-guided liver biopsy were 27 mm long (range 25-28.9 mm) versus 13 mm mean value (range 12.2-13.9 mm, p<0.0001) of samples from US-assisted liver biopsies and contained 15.7 portal tracts (range 14.7-16.7) versus 11 mean value (range 10-11.9, p<0.0001) of specimens obtained by echo-assisted needle biopsy. Mortality and major complication rate was zero in our series. Both groups of liver biopsies were comparable with respects to number of passes and sample fragmentation.

Both methods showed overlapping security. The diagnostic yield seems to be greater if liver biopsy is performed by the echo-guided technique.