The Diagnostic Value Of Ultrasound-guided Liver Biopsy To Difficult Diagnosed Liver Disease

Background:With recent advances in the development of medical technology and imaging technology, noninvasive methods of diagnosing liver disease increase, the majority of liver disease can be diagnosed by non-invasive means, but there are still some patients who suffered from liver disease can not be diagnosed by noninvasive means. They require the use of liver histopathology to confirm the diagnosis. Liver biopsy under the guidance of ultrasound is accurate, safe and convenient, less trauma, fewer complications.Objective:To analysis the clinical and pathological features of difficult diagnosed liver disease and evaluate the diagnostic value of liver biopsy to difficult diagnosed liver disease.Methods:Fifty-seven patients with difficult diagnosed liver disease were collected from January 2010 to February 2014, undertook liver biopsy with the guidance of color Doppler ultrasound, analyze its clinical and histological features.Result:A total of 57 cases with difficult diagnosed liver disease were enrolled. Of which 30 males and 27 females, male and female ratio is about 1.11:1, with an average age of 49.24 years old. All successfully drawn, success rate is 100%. No pain, bleeding, hematoma or other serious complications occurred.1. The primary diagnoses involved 29 patients with lesions (histopathology confirmed metastatic liver cancer [34.48%(10/29)], hepatocellular carcinoma [27.59%(8/29)], bile duct carcinoma [6.90%(2/29)], liver abscess [10.34%(3/29)], severe chronic hepatitis [3.45%(1/29)], hepatic tuberculosis [3.45%(1/29)], cavernous hemangioma [3.45%(1/29)]), liver parasites [3.45% (1/29)], two cases undiagnosed).2. Fifteen patients with difficulty to differentiate chronic hepatitis from liver cirrhosis (histopathology confirmed mild chronic hepatitis [20.00%(3/15)], moderate chronic hepatitis [33.33%(5/15)], severe chronic hepatitis [6.67%(1/15)], early liver fibrosis [6.67%(1/15)], hepatic cirrhosis [33.33%(5/15)]).3. Seven cases with cryptogenic hepatitis (histopathology confirmed acute cholestatic hepatitis one case, five cases of moderate chronic hepatitis, one is steatohepatitis).4. Three cases with cryptogenic cirrhosis (histopathology shows one is nodular cirrhosis, the rest are idiopathic portal hypertension).5. A patient with chronic hepatitis B treated by conventional methods is ineffective (histopathology showed acute cholestatic hepatitis).6. One patient showed significantly elevated AFP,with a high degree of suspicion of HCC (histopathology is moderate chronic hepatitis with nodular cirrhosis).7. A patient with autoimmune liver disease (pathological diagnosis is primary biliary cirrhosis.Histopathology confirmed 55 cases, histopathology diagnosis rate is 96.49%.Conclusion:1. Among the difficult diagnosed liver disease, liver lesions are the most common, of which the most common is hepatocellular carcinoma and metastatic liver cancer.2. Liver biopsy can significantly improve the diagnosis rate of difficult diagnosed liver disease.3. Liver biopsy with the guidance of ultrasound is safe, no major complications occurred.