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35. Image-guided biopsies. Cyst puncture, drainage (biliary, renal, bladder etc.)
- Needle size
- Measured in gauges (G)
- More gauges -> thinner needle
- 20G is thinner than 18G
- Image-guided biopsies
- Fine needle aspiration biopsy
- Tissue loses organization
- 20 – 22G needle
- Indications
- Breast biopsy
- Thyroid biopsy
- Lymph node biopsy
- Core biopsy = trucut biopsy
- Tissue maintains organization
- Ultrasound or CT guided
- Trucut needle is used
- 18G needle
- Bigger than FNAB needle
- Drainage and puncture
- Drainage = Long-term tube placement/emptying of fluid
- Puncture = one-time sample acquisition
- Can be guided by US or CT
- Indications
- Abscess
- Exudate
- Transudate
- Haematoma
- Can be
- Diagnostic (determine composition of pleural effusion)
- Therapeutic (abscess)
- Percutaneous transhepatic cholangiography (PTC)
- To visualize anatomy of biliary tract
- Percutaneous transhepatic biliary drainage (PTBD)
- To relieve pressure in bile ducts due to blockage
- Ultrasound-guided