COMPARATIVE EVALUATION OF ULTRASOUND GUIDED RENAL BIOPSY USING 14 AND 16 GAUGE TRU-CUT BIOPSY NEEDLES IN ADULT DOGS.
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Date
2005
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AAU, Anand
Abstract
An experiment was conducted on ultrasound guided renal biopsy using 16 gauge (Group I, n=12) and 14 gauge (Group IL n =5) needles in 17 clinically healthy dogs of either sex. The biopsy procedure was carried out under general anaesthesia using combination of ketamine (10 mg/kg bodyweight, i.v.) and diazepam (0.5 mg/kg body weight, i.v.) and premedication with acepromazine @ 0.05 mg/kg body weight, i.m. The renal biopsy was performed by routine ultrasound guided technique. The biopsy sample in group I was obtained by 16 gauge Tru-cut biopsy needle and in group II by 14 gauge Tru-cut biopsy needle with spring loaded gun. Pre-biopsy, immediate post-biopsy and 48 hrs. post-biopsy arterial blood and urine samples were obtained from animals of either groups for biochemical study and urinanalysis. Clinical observations and biopsy samples quality was recorded following biopsy in both the groups. Under post-biopsy clinical observation, general health, appetite, water intake and urination were found normal in all 17 animals. The anaesthetic protocol was found safe with smooth induction and uncomplicative recovery. The ultrasound images in either group were observed with use of 5.0 MHz Mechanical Sector Transducer with B-Mode. Renal cortex was having intermediate echogenicity, medulla was seen hypoechoic and renal pelvis was highly echognic. The cortex was hyperechoic relative to the medulla and a distinct demarcation between them was present and echogenic rim separated cortical from the rnedullary tissue. The needle were seen parallel to the dotted line in hyperechoic image. The biochemical study with arterial blood sample revealed a nonsignificant alteration in the determinants of glomerular filtration rate such as blood urea nitrogen and plasma creatinine and also in arterial blood gases like blood pH, partial pressure of oxygen and carbon dioxide, total carbon dioxide and haemoglobin oxygen saturation percentage in either groups after biopsy. The plasma electrolytes such as sodium and chloride in group II and potassium in group I revealed a significant decrease and increase at 48 hrs. post-biopsy, respectively. The urinanalysis in both the groups recorded non-significant variations in urine pH and specific gravity, urine creatinine, urinary sodium and protein as well as in urine protein/urine creatinine ratio and urinary fractional excretion of sodium after biopsy. A significant increase in enzymuria like urinary N-acetyl-beta-DGlucosaminidase in either groups and urinary alanine aminopeptidase in group II was observed at immediate and 48 hrs. post-biopsy. Urinary gamma glutamyltransferase non-significantly increased at immediate post-biopsy in either groups followed by a non-significant decrease observed in group I at 48 hrs. post-biopsy. The histopathological findings revealed that the samples obtained using 16 gauge needle (Group I) yielded an average of 10.77 number of glomeruli per sample while the samples using 14 gauge needle (Group II) yielded an average of 7.75 number of glomeruli per sample. The cell morphology of the samples in both the groups was found to be normal. The average size of the biopsy sample obtained by using 16 gauge needle (Group I) was 1 X 0.1 cm. and biopsy sample obtained by using 14 gauge needle (Group 11) was 0.75 X 0.1 cm. The medulla content obtained in samples using 16 gauge needle (Group I) was 5 to70 per cent and samples obtained using 14 gauge needle (Group II) were found have 70, 50, 30, 20 per cent of medulla. Samples analyzed histopathologically for crushing and fragmentation of tissue obtained. One sample crushing using 16 gauge needle (Group I), while four sample obtained using 14 gauge needle (Group II) were found to reveal either crushing (1), fragmentation (1) or both (2) samples. The present study concludes that using ultrasound guided renal biopsy technique, 16 gauge Tru-cut biopsy needle still gives adequate quality biopsy sample, cell morphology and glomeruli number with less renal injury as compared to 14 gauge needle, hence useful, especially in dogs with high risk for renal failure.
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VETERINARY SURGERY, EVALUATION