Interventional procedures

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Interventional ultrasonographic procedures have been in common use in humans since the early 1980s and provide samples safely and with a high diagnostic yield. In veterinary practices with diagnostic ultrasound equipment, percutaneous fine-needle aspiration and core tissue biopsy should be routine procedures in order to make a diagnosis. This chapter considers indications, equipment, sampling techniques and potential complications.

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4.1 Chiba (top) and Franseen (bottom) biopsy needles. Note the centimetre markings and adjustable needle stop to set the depth.
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4.2 Close-up of Chiba (top) and Franseen (bottom) biopsy needles. Note the crown-shaped tip of the latter for bone sampling.
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4.3 Close-up of a Tru-Cut type biopsy needle showing the sample notch and echo-enhancing coating (arrowed).
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4.4 Disposable semi-automatic biopsy device. The sample notch is adjustable to 9.5 or 19 mm. Disposable automatic biopsy device. Note the safety button on top to avoid inadvertent firing.
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4.5 Sterilizable fully automated biopsy gun with disposable needle placement shown in the opened instrument.
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4.6 Ultrasonogram of the liver with diverging stippled guidelines, indicating the direction that needle angulation will take when using a transducer needle guide adaptor for cholecystocentesis. Numbered graduations on the side of the guidelines indicate a centimetre scale, which can be used to determine the correct depth of needle insertion.
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4.7 Technique of rocking the transducer to fan the ultrasound beam so that the beam is aligned with the needle. Note the needle guide adaptor attached to the transducer. (Reproduced from with permission from ).
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4.8 Sagittal ultrasonograms of the left liver lobe demonstrating the CTB technique. The linear hyperechoic biopsy needle can be seen at the periphery of the liver prior to firing of the biopsy gun. Firing the biopsy gun causes the needle to advance further into the hepatic parenchyma as the sample is collected. White arrows indicate the needle tip.
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4.9 CTB sample being placed in a biopsy cassette prior to placement in formalin.
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