WFUMB Course Book

Interventional Ultrasound (INVUS) - Chapter 31 Media Library

Chapter Images

Fig 31.1a Needle guide attached to a transducer
Fig 31.1b Needle guide attached to a transducer - on US image the theoretical needle path is displayed as double line
Fig 31.2a Free hand technique - in plane
Fig 31.2b Free hand technique. US guided parenchymal liver biopsy
Fig 31.3 Free hand technique - out of plane
Fig 31.4a Bleeding after a liver biopsy - intrahepatic haematoma (note that in early phases after bleeding the blood is hyper or isoechoic in respect to the liver)
Fig 31.4b Bleeding after a liver biopsy - perihepatic blood (note that in early phases after bleeding the blood is hyper- or isoechoic in respect to the liver)
Fig 31.5 Types of fine aspiration needles for puncture and FNA
Fig 31.6a Automatic gun with TruCut needle
Fig 31.6b TruCut principle
Fig 31.6c Redish specimen in the distal notch
Fig 31.7 Anechoic structure inside the liver. Diagnostic puncture with aspiration. The tip of the needle is seen inside the lesion and almost the whole shaft
Fig 31.8 US guided biopsy of a hepatic tumor
Fig 31.9 US guided biopsy of a retroperitoneal tumor
Fig 31.10 Liver biopsy with CEUS guidance in a large necrotic lesion
Fig 31.11a Treatment of a small liver abscess with needle puncturing
Fig 31.11b Treatment of a small liver abscess with needle puncturing - aspiration and lavage
Fig 31.11c Treatment of a small liver abscess with needle puncturing. The result of the treatment is a small echogenic residual lesion
Fig 31.12 8 Fr pigtail catheter with internal fixation (string)
Fig 31.13a Large liver abscess treated by catheter drainage
Fig 31.13b Large liver abscess treated by catheter drainage - residual image after 10 days drainage
Fig 31.14 US guided drainage for an infected ascites. The pigtail of the catheter is well seen in the infected ascites
Fig 31.15a US guided external biliary drainage. Puncture of a dilated peripheral bile duct
Fig 31.15b US guided external biliary drainage. The guide wire is seen inside the left hepatic duct
Fig 31.15c US guided external biliary drainage. The catheter inside the dilated common bile duct
Fig 31.16 Percutaneous nephrostomy. The catheter (>) is well seen in the dilated calyx
Fig 31.17a Acute calculous cholecystitis. One step percutaneous cholecystomy using a 10 F pigtail catheter
Fig 31.17b Acute calculous cholecystitis. US aspect after drainage
Fig 31.18a RFA ablation of a small HCC in segment 6
Fig 31.18b RFA ablation of a small HCC - an echogenic cloud is seen covering the lesion
Fig 31.19a MWA ablation of a 2.2 cm liver met located in segment 6 - US image
Fig 31.19b MWA ablation of a 2.2 cm liver met located in segment 6 - US image during ablation with the echogenic cloud
Fig 31.19c MWA ablation of a 2.2 cm liver met located in segment 6 - CEUS performed 5 min after the procedure showing a 3.9/2.5 cm unenhanced necrotic area
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