Ultrasound guided percutaneous fine-needle biopsy of the liver: efficacy of color doppler sonography

BACKGROUND/AIMS

Fine-needle biopsy (FNB) is one of the diagnostic methods for the diagnosis of focal lesions in the liver. The method is relatively fast, inexpensive and safe. Complications after FNB are observed in only a few cases. Color Doppler sonography (CDS) is one way of minimizing the number of FNB complications. The aim of the present study is to evaluate CDS in the monitoring of FNB in the diagnosis of focal lesions in the liver.

METHODOLOGY

The patient group consisted of 73 patients: 28 male and 45 female with a mean age of 53.5 years. Initially, all patients were examined using traditional B-mode gray-scale sonography. After visualization of focal lesions in the liver their echostructure and position were analyzed. Color Doppler sonography was the introduced for the visualization of vascularization of the liver. FNB was performed under the guidance of CDS. The cytological specimens obtained were microscopically evaluated.

RESULTS

Of the 73 patients, 18 cases were diagnosed with liver abscess, 19 with cysts of the liver, and 36 with malignant tumors. Amongst the patients with malignancy tumors, the tumors were unifocal in 15 cases, and multifocal in 221. Histopathologically, there were primary hepatocellular carcinomas in 22 patients and metastatic tumors in 14 patients. During the first 48 hours after FNB no complications such as subcapsular hematoma or intraperitoneal bleeding were observed.

CONCLUSIONS

Introducing CDS for ultrasound guided percutaneous FNB of the liver avoids such complications as bleeding, especially in patients with a high risk of hemorrhage.

Serum level of parathyroid hormone in certain rheumatic diseases

The mechanism of joint destruction in rheumatic diseases is a complex and not fully known phenomenon in which many factors probably take part. The hormones which regulate the bone metabolism may be engaged in this process. In this study the serum level of the parathyroid hormone was correlated with the degree of joint destruction observed in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis. Besides the degree of joint changes (radiologic aspects) the extension of the pathological process and duration of disease were also considered and the serum and urine level of calcium and phosphorus was analyzed. Similar patterns of the parameter investigated were observed in the rheumatic diseases studied and in healthy persons.