Ultrasound-Guided Liver Biopsy

Introduction:

In case any signs and symptoms of a suspected disease are observed, doctors prescribe a biopsy to be sure about it. A biopsy is a procedure in which a small amount of tissue is extracted as a sample from the patient’s body and sent to the laboratory for testing. It is performed by an expert doctor. A liver biopsy is performed to rule out the diseases associated with the liver, like hepatitis, any inflammation, or malignancy. It is termed as ultrasound-guided as it is performed by the guidance of ultrasound with the help of an expert team involving an expert physician, a diagnostic medical sonographer, and a registered and experienced nurse.

What Is Ultrasound-Guided Biopsy?

Ultrasound-guided biopsy is a form of image-guided biopsy, performed by a radiologist mostly. It is the most frequently incorporated form of image-guided biopsy that offers convenience and real-time dynamic observation with echogenic markers on cannulae allowing for precise placement.

It can be used to perform a biopsy of any body part, being regularly used to perform the biopsy of the kidney, liver, breast, and lymph nodes.

What Is Ultrasound-Guided Liver Biopsy?

Ultrasound-guided liver biopsy is regarded as a safe procedure that helps ensure the proper placement of the biopsy needle tip to sample the appropriate place on the body. A doctor asks for this test if they suspect liver anomalies and need confirmation for them.

During this procedure, a small skin incision is placed below or between the lower ribs by the doctor. A slender needle is then inserted via an opening to obtain a sample of liver tissue for examination. Ultrasound images guide the needle properly through the liver so that the procedure is safe and less complicated.

Why Is Ultrasound-Guided Liver Biopsy Performed?

Doctors consider ultrasound-guided liver biopsy as a standard tool for diagnosing liver problems, including:

1. Liver cancer.

2. Hepatitis.

3. Cirrhosis.

A biopsy is used as a confirmatory diagnosis when a blood test or imaging tools cannot confirm the presence of a disease. The doctor might advise an ultrasound-guided liver biopsy to understand the severity of liver disease or the degree of damage the liver has attained in a better way. In some cases, a liver biopsy is performed to identify the best treatment or to know how appropriate the current treatment is working.

How to Prepare for Ultrasound-Guided Liver Biopsy?

Before initiating the procedure, certain instructions are to be followed by the patient:

• One should avoid taking blood thinners, Aspirin, or aspirin‑related medications for seven days prior to the procedure.

• One should avoid eating or drinking for eight hours before the procedure.

• Some blood tests are needed before going for the biopsy. If these have not been done before the day of the biopsy, one should immediately get them done so that they can be reviewed timely.

• Once the procedure is done, patients are not allowed to drive themselves home.

• How Is Ultrasound-Guided Liver Biopsy Performed?

• A patient is asked to lie down on their back on the examination table.

• Firstly, ultrasound images of the abdomen area are taken to locate exactly which area’s biopsy is required.

• A warm gel is applied to the abdomen area. This gel facilitates the transmission of sound waves from the machine into the abdomen.

• Once the location is identified, the imaging physician cleans the gel and places a sterile drape over the abdomen’s working area.

• The biopsy site is then numbed. However, a slight stinging sensation is felt as the medication is injected.

• During the biopsy, a special needle device is used to obtain a sample from the liver. A staple “gun‑like" noise is heard as the sample is withdrawn.

What Happens After the Ultrasound-Guided Liver Biopsy Is Performed?

• After the biopsy, the site from which the sample is extracted is cleaned and bandaged. After three to four hours approximately, if the person feels better, they can go home. However, they are not allowed to drive.

• Some pain or discomfort is felt at the injection site for the first 24 to 48 hours after the procedure as the effect of anesthesia starts reducing.

• Medication can be prescribed frequently to relieve this pain, and simple painkillers such as Tylenol can be taken.

• One should avoid lifting heavy objects after the procedure; small daily tasks can be resumed within a day or two, as suggested by the doctor.

• Approximately two weeks are required for the reports to come, and the treatment plan is taken into action accordingly.

What Are the Benefits of Ultrasound-Guided Liver Biopsy?

• The biopsy helps to find the cause and severity of liver disease or the nature of abnormalities in the liver, as seen on previous scans.

• It is a safe and short procedure, which means the patient need to remain in the hospital for a day.

What Are the Risks of Ultrasound-Guided Liver Biopsy?

• One of the frequently noted risks is bleeding from the biopsy site, but this is self-limiting mostly and very rarely needs blood transfusions.

• Some sort of discomfort or pain is felt for a few hours.

• Serious complications are rarely observed after this procedure, and the risk of death is about 1 in 10,000.

• In case of a fever or pain that seems to get worse or bleeding from the site that does not stop, get immediate medical attention.

• Rarely, the bile produced by the liver might leak around the liver.

• A small risk that the needle site might get infected after the biopsy.

Conclusion:

A liver biopsy is a procedure to take a tiny tissue sample from the liver via a hollow needle. Doctors do this in multiple ways, depending on the condition. After the procedure, the tissue sample is sent to a pathologist for analysis in a lab to help diagnose and stage various liver diseases. This is done with the help of ultrasounds in the case of ultrasound-guided liver biopsy. It helps in more accurate determination of the biopsy site, and the results obtained are better. Treatment can be planned accordingly based on the results.