Liver Biopsy Marking
Patient position:
- Patient must be totally flat on the stretcher
- Right arm must be raised over the patient’s head
The patient should be marked (with a permanent marker) at end expiration to avoid hitting the lung.
The sonographer must ensure the patient can hold their breath consistently.
The ultrasound transducer must be held parallel to the bed so there is no guessing about angle of entry.
The mark must be placed between the ribs.
The mark must be in the mid portion of the liver. Not close to the diaphragm or inferior liver edge.
Leave at 2cm distance from any major vessel.
Pictures of the liver mark will be sent to the ultrasound PACS
- The picture(s) will show the liver mark (including calipers) and will include the entire liver.
The follow distances will be reported:
- Distance from the skin to the liver capsule
- Distance from the skin to the overall safe biopsy distance into the liver parenchyma
- Sonographer marking patient
Print a photo of the biopsy mark and attach it to a progress note. Report distances as described above on form. Give the progress note to the patient so they can give it to the hepatologist or place the note in the patient’s chart.
All biopsy marks must be done by an experienced sonographer after appropriate training and supervision has been completed. All junior sonogrpahers must perform these procedures under supervision until experienced staff are saticfied with their performance.
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