Using contrast-enhanced ultrasound to guide a successful biopsy of a splenic sarcomatoid carcinoma

Abstract

Introduction Splenic lesions are uncommon and frequently cause a diagnostic dilemma, often with non-specific findings on both ultrasound and cross-sectional imaging with histological confirmation necessary. To reduce patient morbidity, primarily from haemorrhage and to increase diagnostic yield, precise imaging and biopsy targeting are needed. Case We present a case of an indeterminate complex splenic lesion, with areas of necrosis which required histological diagnosis. Contrast-enhanced ultrasound-guided percutaneous core needle biopsy was undertaken to provide real-time imaging guidance, increasing viable lesion targeting and helping to avoid areas of necrosis. Conclusion Contrast-enhanced ultrasound guidance of the percutaneous core needle biopsy allowed increased operator confidence in lesional targeting accuracy and reduced the number of passes required for biopsy, simultaneously maximising histological yield and minimising patient morbidity.

The Use of Ultrasound Contrast in Interventional Radiology

“…Potentially, this may decrease the number of passes required and improve sample integrity. 9 Drainage CEUS CEUS can be used via the intravascular or endocavity route to support US-guided drainage procedures. Grayscale appearances of collections may create diagnostic difficulty, with echogenic contents giving the impression of solid tissue, which may be further confounded if needle aspirate fails to yield fluid.…”

A pictorial review of the utility of CEUS in thoracic biopsies

“…The UCA is a pure blood pool agent with transpulmonary stability providing detailed capillary bed assessment. As a result, true vascularity, and particularly the absence of vascularity, can be determined [ 11 , 19 , 20 ]. Conventional ultrasound has been shown to be poor at demonstrating necrotic areas of tumours, with necrosis identified in 7% compared to 44% with CEUS [ 17 ].…”

“…CEUS has a well-documented utility in interventional procedures including biopsies [9][10][11]. At a macrovascular level CEUS allows visualisation of the larger vessels, whilst at a microvascular level, it allows lesional characterisation, increase lesion conspicuity which allows assessment and targeting of areas of active viable disease [9,10].…”

Sonographic Findings in patients of Hepatitis B & C

“…Both Hepatitis B and Hepatitis C virus have a tendency elect a-symptomatic until afterward periods. 6 Hepatitis B and Hepatitis C virus can finish within cancer, Fibrosis as well as Cirrhosis of liver. Hence, this description argues Hepatitis B and Hepatitis C virus individually, as well as recognizes split serious aspects to support their eradication.…”