US-guided Localization and Removal of Soft-Tissue Foreign Bodies.

Abstract

US-guided foreign body removal is a nonsurgical highly effective technique used to manage symptomatic foreign bodies and should be considered as a first-line treatment procedure. The authors describe a technique used for US detection and US-guided removal of various types of foreign bodies and discuss the efficacy of the procedure. Soft-tissue foreign bodies can result from accidents or medical procedures, and they are a relatively frequent reason that patients obtain medical consultation. Foreign body objects include vegetal, metallic, and glass objects, and they may be medical devices such as contraceptive implants. Frequently, physical examination is not sensitive enough to detect the presence of a foreign body, and imaging is necessary. US has demonstrated high specificity and moderate sensitivity for detection of foreign bodies, and it has the advantage of depicting all types of materials. Thus, US has become the imaging technique of choice for evaluating suspected foreign bodies. Although the US features are dependent on the foreign body type and shape, all foreign bodies are echogenic and frequently demonstrate posterior shadowing or reverberation artifact. US has an added value in that it can be used to plan the removal of a foreign body and also guide the entire percutaneous removal procedure. Through a small incision in the skin, just wide enough for the foreign body to pass through, surgical forceps can be inserted and directed under US guidance to reach the foreign body and remove it. The effectiveness of US-guided percutaneous removal can be near 100%. Online supplemental material is available for this article. ©RSNA, 2020.