09/29/2022
Procedures We Offer: Ultrasound-Guided Liver Biopsy
A liver biopsy is a procedure used for diagnosing abnormal liver conditions. This test is not a routine procedure and is only performed when it is necessary to obtain a sample of the liver without requiring surgery. This biopsy avoids the need to use anesthesia and "going under" to get a sample of your liver for pathology and laboratory tests. These tests are performed to evaluate liver diseases, liver tumors, and infections such as parasites. It may be ordered for several other reasons, such as:
• Assessing the amount of scarring in the liver due to certain diseases
• Assessing the stage or progression of a known liver condition
• Assessing the degree of inflammation and monitoring improvement or worsening inflammation
• Assessing a liver mass or abnormal spot on the liver to see if it is a tumor and if the tumor is benign or malignant
• Assessing for non-alcoholic fatty liver disease or Nonalcoholic Fatty Liver Disease (NAFLD) & NASH see
https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash
• Determining how well a treatment is working
• Evaluating your liver following a liver transplant
• Further evaluating a lump in your liver based on recent scans (ultrasound, CT, or MRI scans)
• Identifying the reason your symptoms, blood tests, and scans suggest you have liver disease
• Helping explain abnormal liver test results that can't be explained by other means
The two main imaging methods used for guiding the needle into the liver are ultrasound and computed tomography scans (CT scans). For this post, we’ll focus on the ultrasound imaging method as shown in the photos above.
Image 1: Radiologist (a highly trained physician that specializes in image-guided procedures) using Ultrasound (US) on the liver for direct visualization of the mass, safe needle placement, and successful liver biopsy.
Image 2: A high-resolution US view demonstrating the mass to be biopsied. Using live US visualization can help the Radiologist identify the mass, plan a safety trajectory, see large blood vessels, and bile ducts to optimize the chance of obtaining adequate tissue sampling of the target lesion (in this case, a mass), and reduce the risk of complications.
Image 3: A successful US core biopsy of the targeted mass. In this patient's case, the mass is round, hypoechoic (darker shade of grey), and the hyperechoic (bright or lighter shade of grey linear structure) core biopsy needle is unequivocally located within the mass, therefore increasing the probability of getting an adequate tissue sample from the mass.
Ultrasound images of your abdomen are taken to locate the precise area where the biopsy will be performed. After the area is located, a needle device is used to retrieve a sample of your liver tissue to be examined under a microscope. This can be a core liver biopsy where a piece of liver is taken with a biopsy, and/or a fine needle aspiration if the liver lesion is better suited for a small needle to be used to suck some fluid out for analysis, such as an abscess or a symptomatic cyst. The liver tissue allows your doctor to check the health of your liver and to properly assess for everything mentioned above.
