Ultrasonic guidance of liver biopsy and fine-needle aspiration in difficult cases

Liver biopsy under the guidance of ultrasonography, rather than ordinary liver biopsy, appears to be the procedure of choice in patients with ascites, small liver, hepatic focal defect, jaundice, and chronic lung disease. Moreover, fine-needle aspiration of liver masses under ultrasonic guidance is as good as liver biopsy under ultrasonic guidance and superior to regular liver biopsy. Guided fine-needle aspiration is the procedure of choice in cases of malignant metastases of the liver because of its simplicity and safety, and because it can be performed on an outpatient basis. Our rate of success with positive diagnosis in guided liver biopsy was 97%, with one false-negative; in guided fine-needle aspiration, it was 96.5% with 9.5% false-negative for malignant lesions.