Kidney biopsy under computed tomography

This is an automatically translated article.

The article is professionally consulted by MSc, BS. Dang Manh Cuong - Doctor of Radiology - Department of Diagnostic Imaging - Vinmec Central Park International General Hospital. The doctor has over 18 years of experience in the field of ultrasound - diagnostic imaging.
Kidney biopsy procedure makes an important contribution to the diagnosis and treatment of kidney diseases, especially glomerular diseases. Take a small tissue from the kidney to study the damage, the deposition of immune components, and the renal ultrastructural damage.

1. What is a kidney biopsy under computed tomography?

The procedure of kidney biopsy under computerized tomography is to use a specialized biopsy needle to take samples under the guidance of computed tomography for histopathological diagnosis under optical and immunofluorescence microscopy. , immunohistochemistry, electron microscopy...
Applications of computed tomography in kidney biopsies have high positive diagnostic value, helping to limit painful nephrectomy, patients can quickly return to normal activities.

1.1 Designation

Patients with renal lesions, including:
Malignant extrarenal lesions, perform a biopsy to evaluate primary kidney damage or metastases to the kidney. Suspected chemical poisoning, due to drugs.. Small tumor, high probability of benign.

1.2 Contraindications

Kidney disease in late stage The patient has a blood clotting disorder. Diseases with respiratory or cardiovascular disorders. Patients have low platelets (,150,000 G/l), low Prothrombin rate (<70%).

2. Kidney biopsy procedure under computed tomography

2.1 Preparation

Performed by: Specialist Doctor Nursing staff Facilities: Ultrasound machine with specialized probes for biopsies. Photo printer, image storage system. Sterile nylon bag wrapped with ultrasound probe. Medicine: 2% lidocaine anesthetic: 04 ampoules Antiseptic solution for skin and mucous membranes. Medical supplies: Specialized needle for biopsy. Specialized biopsy needle. Syringe syringe 0.9% physiological saline Gloves, shirt, hat, surgical mask sterile sterile interventional equipment: knife, scissors, forceps, 4 metal bowls, bean tray, tool tray. Cotton, gauze, surgical tape.

Patient: Perform basic coagulation test before kidney biopsy. The patient should be explained about the biopsy procedure. Patients lying on the bed are placed intravenous lines, installed breathing machines, pulse, blood pressure, electrocardiogram, SpO2. Skin antiseptic In case the patient has a strong agitated reaction, does not lie still: need sedation... Test sheet: Medical record There is an approved order to perform the biopsy procedure. X-ray, CT scan, MRI (if any).

2.2 Steps to take

The doctor receives an order to perform a kidney biopsy from the patient. Check the tests that have been done, compare patient information. The patient was invited into the biopsy room. The doctor explains to the patient the upcoming procedure for the patient to understand. Test the response of the anesthetic. Monitor pulse and blood pressure before the procedure. The patient is assigned to lie prone on the table, with both legs extended. The doctor washes his hands and wears sterile gloves. Disinfects the skin on the back to be biopsied. Spread sheets and bandages. Locate the lesion by ultrasound Anesthetize the area to be biopsied, then wait 1 minute for the anesthetic to take effect. Under the guidance of ultrasound, the doctor inserted a biopsy needle into the lower pole of the transplanted kidney and cut out a piece of kidney tissue. Withdraw the biopsy gun, remove a piece of kidney tissue and place it in the position of a gauze soaked in physiological saline. Then sent to the Department of Pathology for immunofluorescence testing. After removing the biopsy gun and biopsy needle, the area where the biopsy needle was inserted must be firmly pressed to stop the bleeding.

A second biopsy will be sent to the Pathology Department for examination under an optical microscope. The doctor presses firmly to stop bleeding at the biopsy site for 5 minutes. After the biopsy was performed, ultrasound was used to confirm that there was no bleeding in the kidney and peritoneal cavity. Bandage the transplant site tightly and place the patient in a supine position for 24 hours. Patients need to be monitored pulse status, blood pressure, temperature, urine color. After the biopsy, the patient should have a urinalysis as soon as possible after urinating.

2.3. Commenting on the results

Assessment of the broken state of the biopsy piece: The biopsy piece must be at the lesion site, at least 1cm in length, and not be broken when put into the formalin solution.
Send results to the laboratory.

2.4. Complications and treatment

Bleeding is a complication in about 2% of biopsies. If there is a lot of pain at the biopsy site, pain relievers such as paracetamol, oral or injected nospa can be used. Low blood in urine: Infusion of sodium chloride 9% or glucose 5%, closely monitor pulse, blood pressure, temperature and general condition. However, complications after kidney biopsy are rare, so patients are completely assured.

Renal biopsy under computed tomography is a procedure that is considered reliable, has high diagnostic value and is being widely used. If the reader has any questions related to this issue, please contact the specialist directly for more specific answers.

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