Ultrasound-Guided Procedures

Ultrasound helps guide noninvasive procedures. Radiologists can use ultrasound to locate and examine fluid collection in tendons, muscles, cysts and soft-tissue masses, so that:

  • Fluid can be accurately extracted 
  • Biopsies can be accurately guided
  • Cysts and abscesses can be drained
  • Some kinds of tendinitis can be treated

Common Types of Ultrasound Procedures

Sonography, another word for ultrasound, guides the needles in all of the following procedures.

Thoracentesis

This procedure removes fluid from the space between the lining of the outside of the lungs and the chest wall. 

Thoracentesis involves the injection of a local anesthetic and the thoracentesis needle inserted above the rib. Fluid is withdrawn and collected and may be sent to the lab for analysis.

Paracentesis

A procedure in which a needle is inserted through the abdominal wall into the peritoneal cavity to obtain a sample of any fluid that is present. 

You may have the puncture site cleansed and shaved if necessary. You will be given an anesthetic. A needle is inserted one or two inches into the abdomen. Sometimes, a small incision is made to help insert the needle. The fluid will be withdrawn with a syringe and, if necessary, a dressing will be applied to the puncture site.

Biopsy 

A particularly effective way to evaluate an abnormality without surgically removing tissue, a biopsy needle removes tissue directly and sparingly.

Ultrasound-guided biopsy involves locating the mass with ultrasound and then using a core needle method to withdraw a piece for analysis. If you are having this procedure, you will be lying on your back or turned a bit. The radiologist will use an ultrasound probe to inject a numbing agent where the sample will be taken. Then, the probe will help guide the needle into the mass; a number of samples will be taken.

Hysterosonography

This minimally invasive ultrasound technique creates pictures of the inside of a woman’s uterus.

Hysterosonography allows doctors to investigate uterine abnormalities in women who experience infertility or multiple miscarriages.

This technique can also be valuable for evaluating unexplained vaginal bleeding that may be the result of uterine abnormalities such as:

  • Congenital defects
  • Masses
  • Adhesions (or scarring)
  • Polyps
  • Fibroids
  • Atrophy

The procedure involves injecting sterile saline into the uterus, distending or enlarging the uterus. The saline outlines the lesion and allows for easy visualization and measurement. Saline and air may also be injected. The cervix will be cleansed, and a catheter inserted into the uterine cavity. Once the catheter is in place, the speculum will be removed, and the trans-vaginal probe will be reinserted into the vaginal canal. Sterile saline will then be injected into the catheter as sonography is being performed.

TENEX  for Tendinopathy

TENEX™ is a minimally invasive procedure that removes scar tissue from your tendon. It is an ultrasound-guided percutaneous needle tenotomy (PCNT) for treating chronic tendon degeneration.