Interventional Ultrasound – A Practical Guide and Atlas PDF
23.96 MB PDF
Interventional ultrasound procedures have revolutionized clinical practice in recent decades. The advantages of ultrasound-guided interventions include an unsurpassed sharpness of detail and excellent controllability due to the real-time visual display, the wide availability of ultrasound equipment, and a simple and straight forward practical technique. This makes it all the more surprising that a standard textbook of interventional ultrasound has not previously been published.
The editors have accessed a wealth of experience from their expert contributors, who present the subject matter as concretely as possible and offer vivid descriptions of practical techniques. Particular attention is given to clinical significance.
The practice-oriented approach may have caused some instruments to be emphasized over other tested and proven devices, with the result that some reputable companies and their products were not given due attention.
The experience presented here, while proven, is often highly individualized. In future editions, it is intended that the content will be enhanced by input from ultrasound interventionalists who have not contributed to this book so that we may achieve a fuller and more balanced presentation. The advantage of a concrete, detailed chapter format is obvious, and the editors hope to see this work used as a “cookbook” in the everyday practice of interventional ultrasound.
The book consists of two main parts. Part I deals with general aspects of interventional ultrasound, Part II with specific ultrasound-guided procedures. Part I begins with a historical review, which is necessary for the understanding of some current techniques. Next come chapters that present essential basic information on interventional materials, issues of informed consent, equipment requirements, on-site material processing, microbiological aspects, and issues relating to hygiene and management of complications. The importance of assisting personnel is too often overlooked: this is addressed in a separate chapter and under specific subheads. Particularly in oncology, histologic (and/or cytologic) confirmation is essential for planning a highly specialized and differentiated modern treatment strategy. Up-to-date immunohistochemical and immunocytologic staining methods and proliferation indices are essential aids to directing the treatment of gastrointestinal stromal tumors and other lesions. Lymphomas are classified hematologically as low-grade, aggressive, or highly aggressive lesions, with each type having its own therapeutic implications. The knowledge of contraindications, complication management, and how to weigh risks against benefits forms the basis for the chapters presented.
Part II deals with pulmonary biopsy techniques and thoracic interventions as well as diagnostic and therapeutic interventions involving the thyroid gland, urogenital tract, and musculoskeletal system. Endosonographic interventions are described in detail. Other topics relate to combined radiologic and sonographic interventions as well as critical-care and emergency-room interventions including cardiologic and anesthesiologic procedures. Part II also explores interventions in children and takes a look at new techniques and future perspectives. Symptom-orientedpalliative care interventions represent avery topical issue that rounds out the chapter. Therapeutic abscess drainage, interventional tumor ablation techniques, and interventional treatments for parasitic diseases (PAIR [puncture, aspiration, injection, reaspiration] for echinococcosis) enrich our daily practice, as do established therapeutic procedures such as percutaneous transhepatic cholangiography and drainage (PTCD), nephrostomy, and the drainage of pancreatic pseudocysts. In the matter of interventional guidance and approach, it is often necessary to decide between the competing modalities of CT guidance and other imaging techniques, which in some case can and should be used to complement or supplement one another. The role of ultrasound contrast agents in the preparation, support, and guidance of interventional procedures is also addressed.
This book is an expression of interdisciplinary and multi professional viewpoints, some of which represent different approaches; this reflects reality in all its diversity. The principle of “do no harm” is expressed in repeated urgings to apply the techniques judiciously in everyday practice and not to become fascinated with technology for its own sake. The decision to proceed with an intervention is always an individual one and should be measured by its benefit for the patient.
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