Korean J Hepatol > Volume 6(3); 2000 > Article
The Korean Journal of Hepatology 2000;6(3): 321-327.
원저 : 미만성 간질환 진단에 있어서 초음파 유도하 간침생검의 정확도 - 수술 후 간조직과의 비교 - ( Diagnostic Accuracy of Ultrasonography - Huided Needle Bopsy of the Liver as determined by Postsurgical Sampling )
Diagnostic Accuracy of Ultrasonography - Huided Needle Bopsy of the Liver as determined by Postsurgical Sampling
Young Doo Lee, M.D., Seong Woo Jeon, M.D., Seung Yup Lee, M.D., Jae Hong Park, M.D., Seung Soo Ha, M.D., Dae Hyun Kim, M.D., Won Young Tak, M.D., Young Oh Kwon, M.D., Sung Kuk Kim, M.D., Yong Hwan Choi, M.D., Joon Mo Chung, M.D., Dong Ja Kim, M.D.1 and Han Ik Bae, M.D.1
Department of Internal Medicine, Pathology1, Liver research institute, Kyungpook National University College of Medicine, Taegu, Korea.
ABSTRACT
Background/Aims
It is questionable whether the needle biopsy of the liver can represent the whole pathology of the liver. This study evaluates the diagnostic accuracy of ultrasonography-guided needle biopsy of the liver as determined by surgically resected liver. Method: The histopathologic findings of preoperative ultrasonography-guided needle biopsy for confirming the background liver disease and surgically resected liver were compared in the 40 patients with primary hepatocellular carcinoma. Results: 1) Of the 40 cases, 30 (75.0%) cases showed the same histopathological diagnosis between the two methods. Their histopathological results were: 20 cases of cirhosis, 6 cases of chronic hepatitis and 4 cases of normal tissue.2) There was a direct proportion between histologic concordance, the number of portal areas, and the size of the needle biopsy specimen. The histologic concordance rate was 79.2% in the cases with 4 portal areas in their biopsy sample and 100% in the cases with more than 5 areas. 3) Of the 10 cases in which diagnostic discrepancy was found between the two methods, 8 cases of chronic hepatitis and 1 case of normal tissue, all diagnosed by needle biopsy, proved to be cirrhosis by surgically resected liver. One case of normal tissue proved to be chronic hepatitis. The causes of diagnostic error were fragmentations of tissue and inadequate specimens. Conclusion: The diagnostic accuracy of the ultrasonography-guided needle biopsy of the liver was 75.0% in our study. To lessen the diagnostic error, at least 4 or more portal areas should be contained in the biopsy sample and the fragmentation of tissue should be minimized.
KeyWords: Ultrasonography- guided needle biopsy, Surgically resected liver.
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