Canis ISSN: 2398-2942

Biopsy: ultrasound-guided

Contributor(s): Andrew Holloway, Tobias Schwartz

Introduction

  • For use in the investigation of:

Liver

Kidney disease

  • Diffuse diseases (acute or chronic nephritis).
  • Protein losing nephropathy.
  • Mass lesions.

Intestine

  • Mass lesions.

Thorax

  • Mass lesions of chest wall, mediastinum or lung.

Lymph nodes

Prostate

  • Diffuse or multifocal non-cystic prostatic disease Prostate disease.
  • Solid prostatic masses.

Advantages

  • Low cost.
  • Minimally-invasive.
  • Rapid.
  • Straightforward in hands of experienced operator.
  • Short time requirement.
  • May be performed without general anesthesia under certain circumstances.

Disadvantages

  • Requires patient's coat to be clipped.
  • Difficult to obtain samples in obese patients, from deeply located structures, highly vascularized lesions and in the presence of a large amount of fluid.
  • Samples may be non-diagnostic or non-representative of disease process.
  • Risk of serious complications (bleeding, penetration of viscera, introduction or spread infection, seeding of neoplasia).
  • Requires significant operator skill.
  • General anesthesia General anesthesia: overview may be required.

Potential problems

  • Hemorrhage:
  • Penetration of other viscera.
  • Inadequate patient restraint:
    • Movement could result in laceration of vessels or organ.
  • Operator inexperience.
  • Excess intestinal gas or large gall bladder may limit visibility of target tissue.
  • Inadequate equipment (needle diameter too small or too long, blunt needle).
  • Failure to visualize needle due to improper technique or patient factors (obese, excessive respiratory movement).
  • Target may be too small to safely obtain sample (particularly in small dogs and cats).
  • Non-diagnostic sample:
    • Fibrotic or cirrhotic livers may be very firm and difficult to penetrate serosal surface.
    • Fibrotic or cirrhotic livers may produce poor samples despite the use of new needles and be associated with fragmentation of sample.
    • Sample size may be too small.
    • Sample not from affected area (multifocal disease).

Alternatives

Equipment

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Patient preparation

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Technique

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Complications

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Groman R P, Bahr A, Berridge B R, Lees G E (2004) Effects of serial ultrasound-guided renal biopsies on kidneys of healthy adolescent dogs. Vet Radiol Ultrasound 45(1), 62-69 PubMed.
  • Rawlings C A, Diamond H, Howerth E W, Neuwirth L, Canalis C (2003) Diagnostic quality of percutaneous kidney biopsy specimens obtained with laparoscopy versus ultrasound guidance in dogs. JAVMA 223(3), 317-321 PubMed.
  • Bigge L A, Brown D J & Penninck D G (2001) Correlation between coagulation profile findings and bleeding complications after ultrasound-guided biopsies: 434 cases (1993-1996). J Am Anim Hosp Assoc 37(3), 228-233 PubMed.
  • Drost W T, Henry G A, Meinkoth J H, Woods J P, Payton M E, Rodebush C (2000) The effects of a unilateral ultrasound-guided renal biopsy on renal function in healthy sedated cats. Vet Radiol Ultrasound 41(1), 57-62 PubMed.
  • de Rycke L M, van Bree H J, Simoens P J (1999) Ultrasound-guided tissue-core biopsy of liver, spleen and kidney in normal dogs. Vet Radiol Ultrasound 40(3), 294-299 PubMed.
  • Lamb C R, Trower N D, Gregory S P (1996) Ultrasound-guided catheter biopsy of the lower urinary tract: technique and results in 12 dogs. J Small Anim Pract 37(9), 413-416 PubMed.
  • Barr F (1995) Percutaneous biopsy of abdominal organs under ultrasound guidance. J Small Anim Pract 36(3), 105-113PubMed.
  • Leveille R, Partington B P, Biller D S, Miyabayashi T (1993) Complications after ultrasound-guided biopsy of abdominal structures in dogs and cats: 246 cases (1984-1991). J Am Vet Med Assoc 203(3), 413-415 PubMed.
  • Yamamoto K, Ishiyama N, Yamaga Y, Hayashi T, Kagota K (1991) Ultrasound-guided techniques for biopsy of the kidney of the medium-sized dog. J Vet Med Sci 53(2), 345-346 PubMed.
  • McNamara M P Jr (1989) Percutaneous procedures guided by color-flow Doppler sonography. AJR Am J Roentgenol 152(5), 1123-1125 PubMed.
  • Smith S (1989) Ultrasound-guided biopsy. Semin Vet Med Surg (Small Anim) 4(1), 95-104 PubMed.
  • Smith S (1985) Ultrasound-guided biopsy. Vet Clin North Am Small Anim Pract 15(6), 1249-1262 PubMed.


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