Article

Value of three-dimensional sonography in biopsy of focal liver lesions.

First Department of General Surgery, Bialystok University Medical Center, 24 A.M. Sklodowskiej-Curie Street, 15-276 Bialystok, Poland.
Journal of Hepato-Biliary-Pancreatic Surgery (impact factor: 1.6). 02/2003; 10(1):87-9. DOI:10.1007/s10534-002-0832-6 pp.87-9
Source: PubMed

ABSTRACT BACKGROUND. The aim of this study was to evaluate the efficacy of three-dimensional (3D) sonography in liver biopsies. Primarily, the diagnosis of hepatic tumors is based on 2D sonography. This method allows the noninvasive evaluation of the anatomical structure and tumor localization. Interpretation difficulties emerge most often during the assessment of tumor boundaries and their relationships to the blood vessels.
The study included 19 patients, aged 40-75 years (average, 57.5 years) admitted to the Department of General Surgery due to diagnosed liver tumors.
The livers of all the examined patients displayed focal changes. In order to obtain material for histopathologic examinations, percutaneous needle biopsies were performed, with no complications.
3D sonography generated more information about hepatic changes, due to imaging of multiplanar reconstructions in oblique presentations (which are impossible to present in classical 2D), and thus facilitated design of the biopsy. Evaluation of the biopsy needle visualization inside the tumor with the use of both the 2D and the 3D presentations depends on the subjective approach of the examiner. Based on our knowledge and experience in ultrasonography-guided needle biopsy, we believe 3D sonography-guided biopsy has high efficacy.

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    ABSTRACT: The performance of percutaneous echoguided biopsy in hepatic tumor diagnosis is limited by several factors, among which tumor characteristics such as tumor type, size and location play an important role. With all the advantages offered by ultrasound guidance, the overall sensitivity of this method in the tumor diagnosis has remained around 90%. Contrast enhanced ultrasound (CEUS) guided percutaneous biopsy is a new developed technique aimed at increasing the accuracy of percutaneous biopsies. With new ultrasound devices comprising the split-screen mode, which displays both the CEUS and background B-mode US image simultaneously on a single monitor, the procedure is now technically feasible. CEUS guided percutaneous liver biopsy should be applied in large tumors with consistent necrosis, in hypovascular tumors or in those invisible or poorly visible to conventional ultrasound. An increased accuracy was demonstrated in poorly visible or invisible hepatic lesions and when CEUS was used before biopsy.
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Keywords

19 patients
 
2D sonography
 
3D sonography
 
3D sonography-guided biopsy
 
anatomical structure
 
biopsy needle visualization
 
classical 2D
 
efficacy
 
examined patients
 
examiner
 
facilitated design
 
focal changes
 
General Surgery
 
histopathologic examinations
 
Interpretation difficulties
 
livers
 
noninvasive evaluation
 
oblique presentations
 
subjective approach
 
ultrasonography-guided needle biopsy
 

Jerzy Polaków