Gervais / Sabharwal Interventional Radiology Procedures in Biopsy and Drainage

1. Auflage 2010
ISBN: 978-1-84800-899-1
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 199 Seiten

Reihe: Techniques in Interventional Radiology

The Techniques in Interventional Radiology series of handbooks describes in detail the various interventional radiology procedures and therapies that are in current practice. The series comprises four titles, which in turn cover procedures in angioplasty and stenting, transcatheter embolization and therapy, biopsy and drainage and ablation. Forthcoming are volumes on pediatric interventional radiology and neurointerventional radiology. Each book is laid out in bullet point format, so that the desired information can be located quickly and easily. Interventional radiologists at all stages, from trainees through to specialists, will find this book a valuable asset for their practice. Interventional Radiology Procedures in Biopsy and Drainage presents the full array of operations using these techniques. The book is split into two sections - one dedicated to biopsy procedures and the other to drainage procedures. Dr. Debra Gervais is Director of Pediatric Imaging and Associate Director of Abdominal Imaging and Intervention at Massachusetts General Hospital, Boston, Massachusetts, USA. Dr. Tarun Sabharwal is a Consultant Interventional Radiologist at Guy's and St Thomas' Hospital, London, UK.

Dr. Debra Gervais is Director of Pediatric Imaging and Associate Director of Abdominal Imaging and Intervention at Massachusetts General Hospital, Boston, Massachusetts, USA. Dr. Tarun Sabharwal is a Consultant Interventional Radiologist at Guy's and St Thomas' Hospital, London, UK.

Autoren/Hrsg.

Sabharwal, Tarun

Gervais, Debra A.

Inhaltsverzeichnis

1;Foreword;6
2;Preface from the Series Editors;8
3;Preface from the Editors;9
4;Contents;10
5;Contributors;12
6;General Principles of Biopsy and Drainage;14
6.1;Patient and Procedure Selection;14
6.1.1;Diagnostic;14
6.1.2;Therapeutic;14
6.2;Consent;15
6.3;Sedation;15
6.3.1;Benzodiazepines;15
6.3.2;Anesthetic Input for Conscious Sedation;15
6.4;Analgesia;16
6.4.1;Local;16
6.4.2;Systemic;16
6.5;Antibiotics;16
6.6;Hemostasis;16
6.6.1;Factors Influencing This Include;16
6.6.2;Procedures May Be Graded into Low, Moderate and Significant Bleeding Risk;17
6.6.2.1;Laboratory Values;17
6.6.2.2;Medication;17
6.6.2.3;Embolization;17
6.7;Complications and Management;18
6.7.1;Bleeding: Management;18
6.7.2;Infection: Management;18
6.7.3;Unintended Transgression of Organ: Management;18
6.8;Imaging Guidance, Access and Planning;19
6.9;Abscess/Cavity Drainage Tools and Techniques;20
6.10;Biopsy Tools and Techniques;21
6.10.1;Puncture Site Plugging;22
6.11;Conclusion;23
6.11.1;Key Questions to Address;23
6.12;Suggested Reading;23
7;Liver Biopsy;24
7.1;Clinical Features;24
7.2;Diagnostic Evaluation;24
7.2.1;Clinical;24
7.2.2;Laboratory;25
7.2.3;Imaging;25
7.3;Indications;25
7.4;Contraindications;25
7.5;Alternative Therapies;25
7.6;Anatomy;26
7.6.1;Normal Anatomy;26
7.6.2;Aberrant Anatomy;26
7.7;Equipment;26
7.7.1;Biopsy Needles;26
7.8;Medication;27
7.9;Procedure;27
7.9.1;Ultrasound-Guidance;27
7.9.2;CT Guidance;28
7.9.3;Planning an Access Route;29
7.10;Technique;30
7.10.1;Tissue Preparation;31
7.10.2;Immediate Post-procedure Care;32
7.11;Follow-up and Post-procedure Medications;32
7.12;Results;32
7.13;Complications;32
7.14;Suggested Reading;33
8;Chest Biopsy;34
8.1;Clinical Features;34
8.2;Diagnostic Evaluation;34
8.2.1;Clinical;34
8.2.2;Laboratory;34
8.2.3;Imaging;35
8.2.3.1;CXR;35
8.2.3.2;CT;35
8.2.3.3;PET;35
8.2.3.4;US;35
8.3;Lung Needle Biopsy Indications;35
8.4;Lung Needle Biopsy Contraindications;35
8.4.1;Absolute;35
8.4.2;Relative;36
8.5;Relevant Anatomy;36
8.6;Aberrant Anatomy;36
8.7;Patient Preparation;36
8.8;Equipment/Tools;37
8.8.1;Needle Types;37
8.9;Results;37
8.10;Pre-procedure Medication/Sedation/Analgesia;37
8.11;Procedure;38
8.11.1;Planning an Access Route;38
8.12;Image Guidance;38
8.13;Performing the Procedure;38
8.13.1;Technique;38
8.13.2;End Point;39
8.13.3;Immediate Post-procedure Care;40
8.13.4;Follow-up and Post-procedure Medication;40
8.14;Alternative Procedures;40
8.15;Complications: How to Avoid and Manage;40
8.16;Suggested Reading;43
9;Mediastinal Biopsy;44
9.1;Clinical Features;44
9.2;Diagnostic Evaluation;44
9.2.1;Laboratory;44
9.2.2;Imaging;44
9.3;Indications;45
9.4;Alternative Therapies (Listed in Order of Least to Most Invasive);45
9.5;Contraindications (Relative);45
9.6;Specific Complications;45
9.7;Anatomy;47
9.7.1;Normal Anatomy;47
9.7.2;Aberrant Anatomy;47
9.8;Equipment;48
9.8.1;Imaging Modality for Guidance;48
9.8.2;Biopsy Technique;49
9.8.3;Needles;49
9.9;Medication;49
9.10;Biopsy;50
9.10.1;Patient Position;50
9.10.2;Biopsy Approaches to the Mediastinum;50
9.11;Clinical Scenarios;55
9.12;Aftercare;55
9.12.1;Follow-up;55
9.13;Suggested Reading;56
10;Bone Biopsy;59
10.1;Introduction;59
10.2;Aim;59
10.3;Indications;59
10.4;Contraindications;60
10.5;Clinical presentation;60
10.6;Pre-procedure laboratory investigations;60
10.7;Equipment;60
10.8;Anesthesia;61
10.9;Image Guidance;61
10.10;Procedure;62
10.11;Post Biopsy Care;64
10.12;Complications;64
10.13;Results;64
11;Adrenal Biopsy;65
11.1;Clinical Features;65
11.1.1;Incidence;65
11.1.2;Differential Diagnosis for an Adrenal Mass;65
11.2;Diagnostic Evaluation;65
11.2.1;Imaging Features;65
11.3;Contraindications;66
11.4;Indications;66
11.5;Alternatives;66
11.6;Pre-procedure;67
11.7;Relevant Anatomy;67
11.8;Procedure Technique;67
11.8.1;Patient Positioning;67
11.8.2;Equipment and Biopsy;68
11.8.3;Results and Complications;69
11.9;Suggested Reading;70
12;Renal Biopsy;71
12.1;Clinical Features;71
12.2;Indications;71
12.3;Contraindications;72
12.4;General Principles;72
12.4.1;Patient Preparation;72
12.4.2;Access;72
12.4.3;Image Guidance;72
12.4.4;Sedation-Analgesia;73
12.4.5;Technique;73
12.4.6;General Complications and Management;74
12.5;Tools for Biopsy;74
12.5.1;Needle Types;74
12.5.2;Specimen Handling;74
12.5.3;FNA Versus Core;74
12.6;Alternatives;75
12.7;Post-Procedure Care and Follow Up;75
12.8;Key Points;75
12.9;Other Clinical Scenarios: Non-focal Renal Biopsies;75
12.9.1;Indications;75
12.9.2;Contraindications;76
12.9.3;Relevant Anatomy;76
12.10;General Principles;76
12.10.1;Patient Preparation;76
12.10.2;Access;76
12.10.3;Image Guidance;76
12.10.4;Sedation-Analgesia;76
12.10.5;Technique;76
12.10.6;General Complications and Management;76
12.11;Tools for Biopsy;77
12.11.1;Needle Types;77
12.11.2;Specimen Handling;77
12.12;Post-Procedure Care;77
12.13;Suggested Reading;77
13;Pancreatic Biopsy;78
13.1;Clinical Features;78
13.2;Therapy Options;78
13.3;Laboratory Evaluation;78
13.4;Imaging;79
13.5;Indications;79
13.6;Alternatives;79
13.7;Contraindications;80
13.7.1;Absolute Contraindications;80
13.7.2;Relative Contraindications;80
13.8;Organ Anatomy;80
13.9;Anesthesia and Sedation;80
13.10;Image Guidance;80
13.11;Access;81
13.12;Needles and Tissue Sampling;81
13.13;Complications;82
13.14;Aftercare and Follow-Up;82
13.15;Suggested Reading;83
14;Lymph Node Biopsy;84
14.1;Clinical Features;84
14.2;Diagnostic Evaluation;84
14.2.1;Discontinuation of Anticoagulants;84
14.3;Indications;85
14.4;Specific Complications;85
14.5;Anatomy-Specific Considerations;85
14.6;Equipment;88
14.6.1;Needles;88
14.7;Procedure;88
14.7.1;Techniques;88
14.7.2;Modality;89
14.7.3;FNA Versus Core;89
14.8;Suggested Reading;90
15;Splenic Biopsy;91
15.1;Clinical Features;91
15.2;Diagnostic Evaluation;91
15.2.1;Laboratory;91
15.2.2;Discontinuation of Anticoagulants;91
15.2.3;Indications;93
15.2.4;Specific Complications;93
15.3;Anatomy;93
15.4;Equipment;93
15.4.1;Needles;93
15.4.2;Medications;94
15.5;Procedure;94
15.5.1;Access;94
15.5.2;Modality;94
15.6;Aftercare;95
15.6.1;Followup;95
15.7;Suggested Reading;96
16;Thyroid Biopsy;97
16.1;Clinical Features;97
16.2;Indications;97
16.3;Contraindications;98
16.4;Relevant Anatomy;98
16.5;General Principles;98
16.5.1;Patient Preparation;98
16.5.2;Access;98
16.5.3;Image Guidance;98
16.5.4;Sedo-analgesia;99
16.5.5;Technique;99
16.5.6;General Complications and Management;100
16.6;Tools for Biopsy;100
16.6.1;Needle Types;100
16.6.2;Specimen Handling;100
16.6.3;FNA Versus Core;100
16.7;Alternatives;100
16.8;Suggested Reading;101
17;Prostate Biopsy;102
17.1;Clinical Features;102
17.2;Diagnostic Evaluation;102
17.2.1;Clinical;102
17.2.2;Laboratory;102
17.2.3;Imaging;103
17.2.4;Indications;103
17.2.5;Contraindications;103
17.2.6;Patient Preparation;103
17.2.7;Anatomy;103
17.2.8;Equipment;104
17.2.9;Pre-procedure Medications;104
17.2.10;Procedure;104
17.2.11;Immediate Post-Procedure Care;104
17.2.12;Immediate Post-Procure Care CT-guided Transgluteal Prostate Biopsy;106
17.2.13;Complications;106
17.2.14;Alternative Procedures/Future Directions;106
17.3;Suggested Reading;107
18;Drainage of Abdominal Fluid Collections;108
18.1;Diagnostic Evaluation;108
18.2;Patient Preparation;109
18.3;Relevant Anatomy;109
18.4;Procedure;111
18.4.1;Planning an Access Route;111
18.5;Performing the Procedure;111
18.5.1;Technique;111
18.5.2;Tips;112
18.6;Follow-Up and Post-Procedure;112
18.6.1;Abscess–Fistula Complex;114
18.7;Removal of Drain;114
18.8;Causes of Failure;115
18.9;How to Avoid;115
18.10;Suggested Reading;116
19;Drainage of Pelvic Fluid Collections;117
19.1;Clinical Features;117
19.2;Diagnostic Evaluation;117
19.2.1;Clinical;117
19.2.2;Laboratory;117
19.2.3;Imaging;118
19.2.4;Indications;118
19.2.5;Contraindications;118
19.2.6;Alternative Therapies;118
19.3;Patient Preparation;118
19.4;Relevant Anatomy;119
19.4.1;Normal;119
19.4.2;Aberrant/Altered;119
19.5;Equipment;119
19.6;Procedure;119
19.6.1;Technique;119
19.6.2;Planning an Access Route;120
19.7;Routes of Pelvic Drainage (Fig. 1a);120
19.7.1;Transgluteal Approach;120
19.7.2;Anterior Approach;121
19.7.3;Transrectal or Transvaginal Access (Figs. 4 and 5);122
19.7.4;Transperineal Approach;122
19.7.5;Endpoint;124
19.8;Results;125
19.9;Follow Up;125
19.9.1;Catheter Management;125
19.10;Suggested Reading;126
20;Drainage of Intrathoracic Fluid Collections;127
20.1;Clinical Features;127
20.2;Diagnostic Features;127
20.2.1;Imaging Appearance;127
20.2.2;Thoracentesis;128
20.2.3;Percutaneous Catheter Drainage;128
20.2.4;Indication for Chest Catheter Drainage;129
20.2.5;Indicators of Successful Drainage;130
20.3;Clinical Scenarios;130
20.3.1;Parapneumonic Effusions and Empyema;130
20.3.2;Pneumothorax;130
20.3.3;Lung Abscess;132
20.3.4;Mediastinal Abscess;132
20.3.5;Pleurodesis;132
20.4;Normal Anatomy;133
20.4.1;Aberrent/Altered Anatomy;133
20.5;Complications;134
20.6;Suggested Reading;134
21;Liver Cyst / Abscess Drainage;135
21.1;Clinical Features;135
21.2;Diagnostic Evaluation;135
21.2.1;Laboratory;135
21.2.2;Imaging;136
21.2.3;Indications/Contraindications;136
21.2.3.1;Simple Cyst;136
21.2.3.2;Hydatid Cyst;136
21.2.3.3;Liver Abscess;137
21.2.4;Patient Preparation;137
21.2.5;Equipment;137
21.2.6;Pre-proceure Medications;137
21.2.7;Procedure;137
21.2.7.1;Planning an Access Route;137
21.2.7.2;Procedure;137
21.2.8;Simple Cyst;138
21.2.9;Hydatid Cyst;139
21.2.10;Liver Abscess;139
21.2.10.1;Immediate Post-proceure Care;139
21.2.10.2;Follow-up and Postprocedure Medications;142
21.2.10.2.1;Simple cyst;142
21.2.10.2.2;Hydatid cyst;142
21.2.10.2.3;Liver abscess;142
21.3;Results;142
21.3.1;Simple Cyst;142
21.3.2;Hydatid Cyst;143
21.3.3;Liver Abscess;143
21.4;Alternative Therapies;143
21.5;Complications;143
21.5.1;Simple Cyst;143
21.5.2;Hydatid Cyst;143
21.5.3;Liver Abscess;144
21.6;Suggested Reading;144
22;Drainage of Pancreatic Abscess and Fluid Collections;145
22.1;Clinical-Pathologic Features;145
22.2;Imaging;145
22.3;Indications/Contraindications;146
22.3.1;Pseudocysts;146
22.3.2;Pancreatic Necrosis;146
22.3.3;Pancreatic Abscess;146
22.4;Image Guidance-Access Route;146
22.5;Technique;148
22.5.1;Pancreatic Abscess-Infected Necrosis;148
22.5.2;Pseudocysts;148
22.6;Aftercare;149
22.7;Endpoint;149
22.8;Alternative Therapies;149
22.9;Suggested Reading;150
23;Percutaneous Biliary Drainage and Stenting;151
23.1;Clinical Features;151
23.2;Diagnostic Evaluation;151
23.2.1;Clinical;151
23.2.2;Laboratory;151
23.2.3;Imaging;152
23.3;Indications;152
23.4;Alternative Therapies;152
23.5;Contraindications;152
23.6;Specific Complications;152
23.7;Patient Preparation;153
23.8;Anatomy;153
23.8.1;Normal Anatomy;153
23.8.2;Aberrant Anatomy;153
23.9;Equipment;153
23.10;Pre/Peri-procedure Medications;154
23.11;Procedure;154
23.12;Planning an Access Route;154
23.13;Performing the Procedure;156
23.13.1;Technique;156
23.13.2;Endpoint;157
23.14;Immediate Post-procedure Care;157
23.15;Follow-up and Post-procedure Medications;158
23.16;Results;158
23.16.1;Metallic Stenting;158
23.17;Complications;159
23.18;How to Avoid Complications;159
23.19;Medication;160
23.19.1;Follow-up;160
23.20;Suggested Reading;160
24;Percutaneous Cholecystostomy and Cholecystolithotomy;162
24.1;Percutaneous Cholecystostomy;162
24.1.1;Introduction;162
24.1.2;Diagnostic Evaluation;162
24.1.2.1;Clinical;162
24.1.3;Laboratory;163
24.1.4;Imaging;163
24.1.5;Indications;163
24.1.6;Contraindications;163
24.1.6.1;Absolute Contraindications;163
24.1.6.2;Relative Contraindications;164
24.1.7;Relevant Anatomy and Approach;164
24.1.8;Advantages of Transhepatic Approach;164
24.1.9;Equipment;164
24.1.9.1;Imaging Guidance;164
24.1.10;Medication;164
24.1.11;Hardware Requirements;165
24.1.12;Procedure;165
24.1.13;The Seldinger Technique;165
24.1.14;Trocar Technique;166
24.1.14.1;Post-procedure Care;167
24.1.15;Complications;167
24.1.16;Outcomes;168
24.2;Percutaneous Cholecystolithotomy;168
24.3;Important Considerations;168
24.4;Hardware Requirements;169
24.5;Procedure;169
24.6;Results;169
24.7;Complications;170
24.8;Suggested Reading;170
25;Percutaneous Nephrostomy and Antegrade Ureteric Stenting;171
25.1;Percutaneous Nephrostomy;171
25.1.1;Clinical Features;171
25.1.2;Diagnostic Evaluation;171
25.1.3;Indications;172
25.1.4;Relative Contraindications;172
25.1.5;Patient Preparation;172
25.1.6;Relevant Anatomy;173
25.1.6.1;Normal Anatomy;173
25.1.6.2;Aberrant Anatomy;173
25.1.6.3;Transplant Anatomy;174
25.1.7;Equipment;174
25.1.8;Procedure;175
25.1.8.1;Imaging Guidance;175
25.1.8.2;Positioning the Patient;175
25.1.8.3;Planning an Access Route;175
25.1.8.4;Performing the Procedure;175
25.1.8.4.1;Technique;175
25.1.8.5;End-point;176
25.1.8.6;Immediate Post-Procedure Care;176
25.1.9;Follow-Up and Post-Procedure Medications;176
25.1.10;Results;177
25.1.11;Alternative Therapies;177
25.1.12;Complications;177
25.1.13;How to Avoid;177
25.2;Antegrade Ureteric Stenting;178
25.2.1;Indications;178
25.2.2;Contraindications;178
25.2.3;Patient Preparation;178
25.2.4;Equipment;179
25.2.5;Pre-procedure Medication;179
25.2.6;Procedure;179
25.2.6.1;Imaging Guidance;179
25.2.6.2;Positioning the Patient;179
25.2.6.3;Technique;179
25.2.7;Choosing the Stent;180
25.2.8;End-Point;181
25.2.9;Immediate Post-Procedure Care;181
25.2.10;Follow-Up and Post-Procedure Medication;181
25.2.11;Results;181
25.2.12;Alternative Therapies;182
25.2.13;Complications;182
25.2.13.1;Early Complications;182
25.2.13.2;Late Complications;182
25.2.14;How to Avoid;182
25.3;Suggested Reading;183
26;Fluoroscopy-Guided Percutaneous Renal Access for Treatment of Stone Disease;184
26.1;Clinical Features;184
26.2;Diagnostic Evaluation;184
26.2.1;Laboratory;184
26.2.2;Imaging;184
26.3;Indications;185
26.4;Alternative Therapies;186
26.5;Contraindications;186
26.6;Specific Complications;186
26.7;Anatomy;186
26.8;Equipment;187
26.9;Access Technique;188
26.10;Suggested Reading;189
27;Percutaneous Gastrostomy and Gastrojejunostomy;190
27.1;Clinical Features;190
27.2;Diagnostic Evaluation;190
27.2.1;Clinical;190
27.2.2;Laboratory;190
27.2.3;Imaging;191
27.3;Indications;191
27.4;Contraindictaions;191
27.4.1;Absolute;191
27.4.2;Relative;191
27.5;Patient Preparation;191
27.6;Relevant Anatomy;192
27.6.1;Aberrant Anatomy;192
27.7;Equipment;193
27.7.1;Gastrostomy Tube;193
27.7.2;Gastropexy Kit (T Fasteners);193
27.7.3;Stiff Guidewire;194
27.7.4;Medication;194
27.8;Procedure;195
27.8.1;Planning an Access Route;195
27.9;Performing the Procedure: Primary Button Gastrostomy;195
27.9.1;Gastropexy;195
27.9.2;Stomach Puncture;195
27.9.3;Measure Tract;196
27.9.4;Tube Insertion;196
27.9.5;Check Position;196
27.10;Performing the Procedure: Balloon- or Locking Pigtail-Retained Tubes;196
27.11;Performing the Procedure: “Endoscopic Type” Tubes;197
27.11.1;Immediate Post-Procedure Care;197
27.12;Gastrojejunostomy;197
27.12.1;Indications;197
27.13;Follow-Up;198
27.14;Alternative Therapies;198
27.14.1;Endoscopic Gastrostomy;198
27.15;Complications;198
27.16;Suggested Reading;199
28;Index;200