3D presentation can better visualize irregular shapes, local thickenings, and calcification of pseudocyst walls than classical 2D ultrasound scans. The use of subtraction in 3D scans of blood vessels increases the safety in performing biopsies. We have shown that 3D sonography collects extremely useful information about the status of the pseudocyst structure, and it should become a complementary method to classical ultrasonography. This technique when used on a routine basis should help us change the inclusion criteria for guided biopsies.

Background The aim of this study was to evaluate the efficacy of three‐dimensional (3D) sonography in liver biopsies. Primarily, the diagnosis of hepatic tumors is based on 2D sonography. This method allows the noninvasive evaluation of the anatomical structure and tumor localization. Interpretation difficulties emerge most often during the assessment of tumor boundaries and their relationships to the blood vessels. Methods The study included 19 patients, aged 40–75 years (average, 57.5 years) admitted to the Department of General Surgery due to diagnosed liver tumors. Results The livers of all the examined patients displayed focal changes. In order to obtain material for histopathologic examinations, percutaneous needle biopsies were performed, with no complications. Conclusions 3D sonography generated more information about hepatic changes, due to imaging of multiplanar reconstructions in oblique presentations (which are impossible to present in classical 2D), and thus facilitated design of the biopsy. Evaluation of the biopsy needle visualization inside the tumor with the use of both the 2D and the 3D presentations depends on the subjective approach of the examiner. Based on our knowledge and experience in ultrasonography‐guided needle biopsy, we believe 3D sonography‐guided biopsy has high efficacy.