Liver Biopsy in Chronic Aggressive Hepatitis

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Abstract
For the purpose of evaluating the reproducibility of the main diagnosis in liver needle biopsies and estimating the size of the specimen required for an acceptable accuracy, 100 liver specimens selected from the daily routine, all 25 mm or more in length, were investigated. The material consisted of specimens from 50 patients with chronic aggressive hepatitis (CAH; including 37 without and 13 with suspicion of cirrhosis), 6 with macronodular cirrhosis, 5 with micronodular cirrhosis, 10 with acute viral hepatitis (including 3 with suspicion of chronicity), 10 with primary biliary cirrhosis, 6 with chronic persistent hepatitis, and 13 with other diagnoses. The specimens were investigated without knowledge of clinical data in five sessions with an increasing amount of tissue made visible. The predictive value of a diagnosis present (diagnostic specificity) and a diagnosis absent (diagnostic sensitivity) was used in evaluating the efficiency of the diagnosis made on the visible part of the biopsy. For CAH (with and without suspicion of cirrhosis) the number of biopsies with the correct diagnosis increased significantly with increasing amounts of tissue visible (p < 0.01), and the required length for an acceptable accuracy of CAH was 15 mm. The diagnostic sensitivity for CAH was very high (94%) with only 5 mm tissue available and constant through all sessions.