Liver Biopsy (cont.)
David C. Wolf, M.D., FACP, FACG, AGAF
IN THIS ARTICLE
Percutaneous Liver Biopsy
The word "percutaneous" means "through the skin." Percutaneous liver biopsies are typically performed by physicians who specialize in gastroenterology/hepatology, interventional radiology or surgery. Traditionally, biopsies were performed using a "blind" technique. With this technique, the physician percusses (i.e. taps) the skin overlying the chest and abdominal wall over the liver in order to identify an optimal site for biopsy. Typically, the site is located between the 8th and 9th ribs on the patient's right side or located below the edge of the rib cage in the right upper abdomen. At present, many physicians use ultrasound to confirm the ideal site to perform the biopsy.
As noted above, the diagnosis of a mass lesion may require the performance of a so-called "guided" biopsy. In guided biopsy, the patient undergoes an ultrasound or CT scan to identify the location of the mass. The physician performing the biopsy, typically an interventional radiologist, uses the results of the scan to guide the biopsy needle into the mass. Typically, the technique for CT-guided biopsy of a mass lesion entails:
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