Korean Journal of Nephrology 1997;16(3):426-433.

경피적 신생검에서 전향적 무작위 추출을 통한 Mabual Biopsy 와 Automated Biopsy 결과의 비교

구성현 , 김흥수 , 오윤정 , 마경애 , 신석균 , 신규태 , 지훈 , 이은주 , 임현이 , 김도현

Abstract

Objectives: Percutaneous renal biopsy may be carried out in several ways. Recently, the use of a spring-loaded biopsy gun has become popularized. There have been much controversies on the tissue adequacy and the incidence of complications when cornpared to the manual biopsy. The present study was performed to compare tissue adequacy and the incidence of complications between manual biopsy and automated biopsy. Methods - We have studied 10S patients in whom the method of renal biopsy was assigned to one of the two methods[14G Tru-cut needle manual bx (group I) and 18G automated gun biopsy(group II)] according to their national resident's identification number in a randomized and prospective manner. Results: There were 50 patients in group I and 58 patients in group II. There was no difference in gender, age, hemoglobin, prothrombin time, partial thromboplastin time, diastolic and systolic blood pressure pre-biopsy in group I and II. Indications for biopsies were proteinuria accompained by hematuria (37%), proteinuria(34.3%), acute renal failure (9.3%), SLE (8.3%), chronic renal failure (5.6%), hematuria only (5.6%). In Group I the number of passes was 2.4±0.8, the glomeruli obtained were 25.3±13.2 and the number of glomeruli per pass were 11.6±6.5, and in Group II 3.4±1.1, 19.4±10.8, and 6.8±4.0, respectively. These showed a significant difference (p<0.05). In all cases pathological diagnosis were possible. The histology showed IgA nephropathy in 27.8%, MCNS in 14.8%, lupus nephritis in 11.1, MGN in 11.1%, MPGN in 7.4%, and others. The incidence and area of perinephric hernatoma demon- strated on ultrasound 24 hours post-biopsy was increased in group I (24%, 937.7 ± 640.0mm compared to 10.3%, 372.4±327.4mm in group II) although no statistically significant difference existed. There was no significant difference in gender, age, prothrombin time, partial thmmboplastin time, sys- tolic and diastolic blood pressure between the group with and without hematomas. Hematocrit levels be- fore & after biopsy showed a significant difference (34.5±8.2, 33.5±8.1, p<0.05) in group I, but no signi ficant difference was observed in group II (34.7±6.4, 34.8±6.4). Conclusion: Both techniques rendered adequate tissue sampling, but the extent of bleeding seems to be more severe with manual 14G Tru-cut needle biopsy.