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Software biopsies under ultrasound guidance

The article was professionally consulted with Master, Doctor Trinh Van Dong - Radiologist - Department of Diagnostic Imaging - Vinmec Ha Long International Hospital.
A soft tissue biopsy is a technique often performed before a doctor decides to treat a soft tissue tumor. Under the guidance of ultrasound, software biopsies will be performed more safely, accurately and effectively.

1. In which cases is a software biopsy under ultrasound guidance indicated?


Biopsy is the technique of taking a small sample of tissue from a suspected body site. The tissue sample will then be used as a histological examination to find structural and functional abnormalities. The test results help to accurately diagnose the disease that the patient is having.
When a patient has soft tissue tumors, a soft tissue biopsy is a technique often performed before the doctor decides on treatment. Software biopsies are often performed under the guidance of diagnostic imaging facilities to increase accuracy and limit complications.
Not only is a means of imaging and diagnosis, ultrasound is also a means of choice to locate and guide a number of superficial interventional procedures, including soft tissue biopsies. The development of high-frequency transducer ultrasound helps to biopsies superficial soft tissue structures effectively, reducing the risk of complications, especially those involving large blood vessels.
Rối loạn đông máu
Bệnh nhân rối loạn đông máu chống chỉ định thực hiện phương pháp này
The ultrasound-guided soft tissue biopsy technique is widely indicated for all types of suspicious soft tissue lesions that can be examined under ultrasound. Ultrasound-guided soft tissue biopsy is contraindicated in uncooperative patients (infants, lethargy, delirium, coma, psychosis), coagulopathy, or other medical conditions. systemic disorders such as respiratory, cardiovascular disorders,...

2. Prepare for ultrasound-guided software biopsy


The implementation team includes specialist doctors, assistant doctors and nurses. The necessary facilities include:
Ultrasound machine with specialized probes; image storage system, photo printer, printing paper Local anesthetic, antiseptic solution for skin and mucous membranes; anti-shock medicine box Aspiration needles, specialized biopsy needles; normal syringe, cotton, bandage, alcohol, gauze, physiological saline, sterile intervention kit. On the side of the patient, to prepare for the biopsy, the patient will be carefully explained by the medical staff, the purpose of the procedure, the possible risks, the steps to take to coordinate with the doctor during the procedure. presently. Ultrasound-guided software biopsies are performed only when the patient or family signs a consent form for the procedure.
Máy siêu âm
Máy siêu âm với các đầu dò chuyên dụng được chuẩn bị trước khi sinh thiết phần mềm dưới hướng dẫn siêu âm

3. Steps to conduct software biopsies under ultrasound guidance


The patient is instructed to lie on the intervention table. The team installs an intravenous line, installs a machine to monitor breathing, pulse, blood pressure, electrocardiogram, SpO2, then disinfects the skin and covers it with a sterile towel with holes. The doctor may prescribe sedation if the patient is too excited to lie still.
The doctor will use ultrasound to select the site of the biopsy entrance. The principles are to choose the location closest to the tumor, the safest, the biopsy needle must avoid locations that can be identified by ultrasound. Depending on the size of the tissue sample to be taken, the doctor may use one of two methods of sampling as follows:

3.1. Soft tissue biopsy with fine needle aspiration


The small needle is attached to the syringe and guided by ultrasound into the foci. The doctor will pull back the plunger of the syringe to create negative pressure and move the needle back and forth in the lesion to draw the specimen into the needle.
After the specimen is obtained, remove the syringe and fine needle, remove the syringe from the needle, and draw some air into the syringe. Reattach the needle to the syringe and push the plunger to push the specimen in the needle onto the slide for pathology. Sampling must be done at least twice because different locations need to be sampled.
Sinh thiết kim nhỏ
Hình ảnh chọc hút kim nhỏ trong sinh thiết phần mềm

3.2. Tissue biopsy


Tissue biopsy is used to take large, undistorted specimens to study tissue structure.
Under ultrasound guidance, the doctor uses a large needle to move to the outer edge of the pathology, then the biopsy gun is activated, the needle core with the inner defect core enters the cavity about 23mm (this is the distance for the needle type). 1.2mm in diameter). The outer barrel is then also activated forward to cut and retain the concave inner column of tissue. After the tissue has been cut, the doctor withdraws the needle and separates the needle from the biopsy gun, using a fine needle to bring the column of tissue out of the biopsy concave.
The biopsy will be done in different directions at the periphery of the lesion, the number of tissue samples is usually 3 samples. Satisfactory biopsy samples must be obtained from lesions, at least 1cm in length, and not broken when put in formalin solution.

4. Complications that can occur during soft tissue biopsy under ultrasound guidance

4.1. Bleed


If the patient has bleeding after the biopsy, the doctor will evaluate the location and severity of the bleeding. Use compression to stop bleeding if possible. Discontinue anticoagulants if necessary and safe for the patient. Depending on the patient's condition, the doctor will consider the level of intervention including embolization procedures, preparing the appropriate arterial stent size,...

4.2. Infection

If the person has signs of infection, the doctor will assess whether it is a local infection or a systemic infection. Take samples for culture and prescribe appropriate antibiotics for the patient.
Tự mua thuốc kháng sinh uống sau khi hút thai
Kháng sinh giúp điều trị tai biến nhiễm trùng có thể xảy ra

4.3. Damage to other organs


When biopsy may cause damage to other organs, if the patient is suspected of having damage to the gastrointestinal tract, it is necessary to monitor peritonitis and use antibiotics. If pleural injury is suspected, the chest should be given a chest X-ray.
If there is suspicion of damage to solid organs such as internal bleeding, it is necessary to give the patient a computed tomography scan and closely monitor the patient's blood loss in clinical practice.
A soft tissue biopsy is a technique often performed before a doctor decides to treat a soft tissue tumor. Accordingly, under the guidance of ultrasound will help doctors evaluate diseases and lesions effectively.
Depending on each soft tissue mass, the doctor will advise that the biopsy can be done as soon as possible or it can be delayed.
Vinmec system is fully equipped with modern equipment dedicated to biopsy techniques under ultrasound guidance (with or without a needle).
Doctors who perform biopsy techniques under the guidance of ultrasound have solid skills, many years of experience and are required to have certificates of training at home and abroad.
Customers are consulted, thoroughly checked before performing the procedure with absolute aseptic procedures to minimize complications such as infection, bleeding...
For the above reasons, customers You can completely trust and feel secure when performing ultrasound-guided biopsy procedures at Vinmec.

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