Comparison of Various Needles in Renal Biopsy : Clinical and Animal Studies1

In-Hee Lee; Seung Hyup Kim; Kuk Myeong Choi; Hyun Beom Kim; Kyung-Mo Yeon

doi:10.3348/jkrs.1998.38.3.511

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Lee, Kim, Choi, Kim, and Yeon: Comparison of Various Needles in Renal Biopsy : Clinical and Animal Studies1

Original Article

J Korean Radiol Soc 1998;38(3):511-516.

Published online: 18 December 1998

DOI: https://doi.org/10.3348/jkrs.1998.38.3.511

Comparison of Various Needles in Renal Biopsy : Clinical and Animal Studies¹

In-Hee Lee, M.D., Seung Hyup Kim, M.D., Kuk Myeong Choi, M.D., Hyun Beom Kim, M.D., Kyung-Mo Yeon, M.D.

¹Department of Radiology, Seoul National University, College of Medicine

Address reprint requests to : Seung Hyup Kim, M.D., Department of Radiology, Seoul National University, College of Medicine, 828, Yongon-dong, Chongro-gu, Seoul 110-744Korea. Tel. 82-2-760-2584 Fax. 82-2-743-6385

Received 3 September 1997 Accepted 29 December 1997

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose :

To compare the efficacy of 14 gauge(G) Vim-Silverman needle biopsy with that of 16G automatic gun biopsy for kidneys and to determine the optimal needle size for renal biopsy.

Materials and Methods :

We retrospectively reviewed the pathologic and medical records of 119 (110 native, 9 allograft) patients who had undergone 14G Vim-Silverman needle biopsy and 71 (34 native, 37 allograft) who had undergone 16G automatic gun biopsy. The number of retrieved glomeruli and post-biopsy complications were compared between the two groups. Ex vivo renal biopsies of a dog were performed using an automatic gun mounted with 14G_ 20G needles and the numbers of retrieved glomeruli were compared.

Results :

The number (mean 土 standard deviation) of retrieved glomeruli per biopsy in native/allograft/total kidneys was 32.1 ±20.9/24.0± 15.2/31.5±20.6 in the 14G Vim-Silverman needle biopsy group, and 26.9±16.2/l4.3±10.l/20.9± 14.9 in the 16G automatic gun biopsy group. In the dog, the number of retrieved glomeruli per biopsy was 17.2±6.3/9.2±3.9/5.7±4.5/3.9±2.6 in the 14G/16G/ 18G/20G groups, respectively.

Conclusion:

Although significantly more glomeruli were retrieved in the 14G Vim-Silverman needle biopsy group, the number retrieved in the 16G automatic gun biopsy group was sufficient for adequate pathologic interpretation. Experimental study suggests that when an 18G automatic gun is used, sufficient glomeruli are retrieved.

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Keywords: Kidney, biopsy, Biopsies, complications Animals

REFERENCES

1.Manaligod JR., Pirani CL. Renal biopsy in 1985. Semin Nephrol. 1985. 5:237–239.

2.Kark RM. The development of percutaneous renal biopsy in man. Am J Kid Dis. 1990. 19:585–589.

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10.Hopper KD., Baird DE., Reddy VV, et al. Efficacy of automated biopsy guns versus conventional biopsy needles in the pygmy pig. Radiology. 1990. 176:671–676.

11.Corwin HL., Schwartz MM., Lewis EJ. The importance of sample size in the interpretation of the renal biopsy. Am J Nephrol. 1988. 8:85–89.

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Fig. 1.

Photomicrographs of histopathologic specimen in men. Both photomicrographs of histopathologic specimens with 14G Vim-Silverman needle (A) and 16G automatic gun biopsy system (B) demonstrate excellent quality of tissue cores. (HE, X 100)

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Fig. 2.

Photomicrographs of histopathologic specimens in a dog. Photomicrographs of histopathologic specimens show relative presence of glomeruli and resolution, tubules, blood vessels and interstitium. A. with 14G, B. 16G, C. 18G, D. 20G automatic gun biopsy system, respectively. (HE, X 40)

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Fig. 3.

Ultrasonogram revealed a large perirenal hematoma after the percutaneous renal biopsy using 14G Vim-Silverman needle in a 43-years-old female with diabetic nephropathy.

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Tabel 1.

Success Rate

	14G		16G
	Native (n=110)	Allograft (9)	Native (34)	Allograft (37)
Zero biopsies∗	8	1	0	0
Inadequate for	3	1	1	4
Pathologic DX.
Success rate	90.0%	77.8%	97.1%	89.2%
Total	89.1%		93.0%

Note.-Numbers in contents are numbers of patients. DX diagnosis

biopsy attempts from which no tissue was obtained

Table 2.

Numbers of Retrieved Glomeruli per Biopsy in 14G and 16G Groups

	14G	16G	p value
Native	32.1 ±20.9 (102)	26.9 土 16.2 (37)	0.1685
Allograft	24.0±15.2 (8)	14.3 ±10.1 (34)	0.0325
Total	31.5 士 20.6 (110)	20.9士14.9 (71)	0.0001

Note.-Numbers are mean :t standard deviation. Numbers in parentheses are numbers of patients.

Table 3.

Success Rate

	14G		16G
	Native (n=88)	Allograft (8)	Native (33)	Allograft (28)
Major Complications
Hematuria requiring	1	0	2	0
transfusion
Hematoma∗	5	0	1	0
Arteriovenous fistula	1	0	0	0
Pseudoaneurysm	0	0	2	0
Urinary retension⋇	1	0	0	1
Subtotal	9.1%	0%	15.2%	3.6%
Minor Complications
Gross hematuria	5	3	2	2
Subtotal	5.7%	37.5%	6.1%	7.1%
Total	16.7%		16.4%

Numbers in contents are numbers of patients.

^∗ perirenal (5 cases) and subcapsular (one case) location

⋇due to blood clot obstructing urinary tract

Table 4.

Result (Animal Study)

	Retrieved	Glomeruli per Section	Tukey Grouping∗
14G	17.2 土 6.3	A
16G	9.2 土 3.9	B
18G	5.7土4.5	B	C
20G	3.9 土 2.6		C

Note.-Numbers are mean 土 standard deviation. ∗Same character means no significant difference between the two groups, ie, significant difference between 14G and 16G, no significant difference between 16G and 18G, 18G and 20G

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