Interventional ultrasound

Abstract

During recent years interventional ultrasound has become widely used and has had a great impact on patient management with regard to diagnosis as well as therapy. Many surgical procedures have been replaced by more gentle and less time-consuming “needle therapy” to the benefit of the patient. Since material (in its broadest sense) can be removed from or deposited into the body under ultrasound guidance (for diagnostic and therapeutic purposes), “interventional ultrasound” includes a large number of different procedures. The first puncture transducer, which was based on the simple A-presentation principle, was described by Kratochwill in 1969 (personal communication). A few months later we performed abdominal needle biopsies guided by ultrasonic B-scanning using a “home-made” static scanner. The first punctures guided by dynamic scanning were performed sing a linear array scanner with a puncture attachment (Pedersen, 1977). Today a large number of dedicated puncture transducers exist, as well as puncture attachments for abdominal scanners and transluminal transducers. The scanner is moved until the target is seen on the monitor, then angled until the target is transected by the electronic puncture-line. A needle inserted through the needle-guiding device will now hit the target. A relatively strong needle tip echo indicates the position of the needle tip on its way to the target. An alternative to this puncture method may be applied: a so-called “free hand” technique without the use of a needle guide.