Therefore, the availability of an accurate and non-invasive marker to replace the need for liver biopsy
, both in routine practice and in a clinical trial setting, is a major breakthrough for children, parents and healthcare professionals.
Eligible studies included clinical studies investigating complications associated with image-guided liver biopsy
. Studies were limited to between Level Ib (randomized clinical trial) and Level III (retrospective observational study).
Diagnostic accuracy of splenic artery pulsatility index in predicting fibrosis associated with chronic hepatitis C as shown by liver biopsy
is presented in table-II.
Lefkowitch (9) devotes a single paragraph to these biopsies in his 9th edition of Scheuer's Liver Biopsy
Interpretation under the heading of "non-specific reactive changes." The paragraph mentions changes including Kupffer cell hypertrophy, focal hepatocellular necrosis, steatosis, and portal and lobular inflammation.
If the FibroScan score is 7 kiloPascals or more, he considers liver biopsy
, since that's the threshold for detection of earlier, potentially reversible stage 2 fibrosis.
At autopsy, the pathologist concluded that the cause of death was "[c]omplications of hemoperitoneum (blood in the peritoneal cavity) following a recent liver biopsy
procedure in a patient with liver cirrhosis." He noted a capsular tear of 1.1 cm in length with varied depths of 0.3 to 1.2 cm in the anterior, right liver.
To avoid invasive liver biopsy
and to stratify patients according to disease stages, further studies combining scoring systems and novel biomarkers are required for viral hepatitis, NASH, and other hepatic disorders.
Around 20% to 30% Patient with chronic HCV infection have normal ALT level.3 It is a generally considered that Patients with normal ALT have lesser degree of inflammation and fibrosis and slower progression of disease as compared to cases with higher liver enzymes.4 Majority of the HCV carrier with normal ALT have normal to mild inflammation and fibrosis on liver biopsy
while some studies have shown contradictory observations like so called "Healthy HCV Carrier" may have advanced fibrosis or even cirrhosis and Hepatocellular Carcinoma.5
During the discussion it was stated that not all patients will go for liver biopsy
. At present we do not have good pharmacotherapy, and we do not give it either.
A Cox regression model was used to investigate histological factors at baseline as well as fibrosis progression per se and their association with mortality after the second liver biopsy
. These analyses were adjusted for the same confounders as in the logistic regression model.
Abbreviations CHB: Chronic hepatitis B CI: Confidence interval DOR: Diagnostic odds ratio LB: Liver biopsy
LR: Likelihood ratio QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2 SF: Significant fibrosis SROC: Summary receiver-operating curves TE: Transient elastography AUROC: Area under receiver-operating curve.
findings were not presented in these cases.