Abstract
BackgroundTo explore a new method of kidney biopsy with coaxial trocar and bard biopsy gun under low dose computed tomography (CT)-guidance and evaluate its accuracy, safety, and efficacy.MethodsSixty patients underwent renal biopsy under CT-guidance. They were randomly divided into two groups: group I, low dose CT-guided (120 kV and 25 or 50 mAs) and group II, standard dose CT-guided (120 kV and 250 mAs). For group I, the coaxial trocar was accurately placed adjacent to the renal capsule of the lower pole, the needle core was removed, and samples were obtained with a bard biopsy gun. For group II, the coaxial trocar was not used. Total number of passes, mean biopsy diameter, mean glomeruli per specimen, mean operation time, mean scanning time, and mean radiation dose were noted. Dose-length product (DLP) was used to calculate the radiation doses. After 24 hours of the biopsy, ultrasound was repeated to identify any subcapsular hematoma.ResultsSuccess rate of biopsy in group I was 100% while using low dose CT-guidance along with coaxial trocar renal. There was no statistic differences bewteen group I and II in the total number of passes, mean biopsy diameter, mean glomeruli per specimen and mean time of operation and CT scanning. The average DLP of group I was lower as compared to the value of group II (p <0.05).ConclusionsKidney biopsy using coaxial trocar and bard biopsy gun under low dose CT was an accurate, simple and safe method for diagnosis and treatment of kidney diseases. It can be used for repeat and multiple biopsies, particularly suitable for obese and renal atrophy patients in whom the kidneys are difficult to image.
Highlights
To explore a new method of kidney biopsy with coaxial trocar and bard biopsy gun under low dose computed tomography (CT)-guidance and evaluate its accuracy, safety, and efficacy
Many of the kidney diseases are undiagnosed by non-invasive methods and renal pathological examination has indicated to establish definitive histopathological diagnosis in diffuse renal disease [4]
To understand the scope of CTguided biopsy techniques the present study was conducted to investigate the utility of a low radiation, minimally invasive, and accurate biopsy method using a low dose CTguided coaxial trocar and automatic biopsy gun
Summary
Patients and medical history We studied 60 patients, who underwent renal biopsies at the Department of Nephrology, Pudong New Area Gongli Hospital (Shanghai, China) from October 2009 to December 2010. The puncture site was fully covered and patients were asked to hold their breath, after which a 5.0 mm axial CT scan was taken through the lower pole of the kidney (Figure 2). The cross point of the laser scan lines and the U-shaped locator was localized for biopsy and the puncture site was marked with a marker pen. The biopsy gun was pulled out immediately; all the specimens inside the needle were removed and placed on ice-cold saline-soaked gauze for pathologic examination. Mean biopsies diameter, mean glomeruli per specimen, mean operation time, mean scanning time, and mean radiation dose were recorded.
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