CT guided renal biopsy

Case contributed by Dr Ian Bickle

Presentation

25 year-old with nephrotic syndrome and normal ultrasound kidneys.

Patient Data

Age: 25 years
Gender: Female
CT

The patient's body habitus did not permit ultrasound guided biopsy.

The steps for CT guided renal biopsy:   skin surface markers to choose site, following by infiltration needle and co-axial needle position prior to biopsy.

1. Local anaesthetic infiltration needle - to check position and aid angulation planning for co-axial needle.

2. Co-axial needle 'parked' in the ideal position prior to a 2cm biopsy core acquisition.

3. Bone windows allow for more accurate assessment of needle tip position, as artifact from needle reduced.

Case Discussion

CT guided non-focal renal biopsy for assessment of intrinsic renal pathology.

Ultrasound is most commonly used as truly dynamic and non-radiation required.

In larger patients CT guidance is required.

Note the angulated approach from the lateral position to prevent traversing paraspinal muscle.

As two cores are required, a co-axial needle - usually 18G - is used.

The other cortex is particularly targeted to acquire a large number of glomeruli.

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Case information

rID: 24170
Published: 30th Jul 2013
Last edited: 24th Mar 2018
Inclusion in quiz mode: Excluded

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