Ultrasound-Guided Biopsies of the Abdomen

Ultrasound is the most useful imaging technique for guiding biopsies and fine-needle aspirations that are performed percutaneously. It is a safe and accurate method to guide needles using real-time imaging into abdominal and pelvic organs and masses. Its advantages over computed tomography-guided biopsies are that it can be done portably, is less expensive, and does not use ionizing radiation. Even lesions as small as 1 cm can be biopsied assuming the procedure can be performed safely and the mass can be visualized sonographically. This review article discusses the different components of performing percutaneous biopsies in adult patients including review of the patients imaging studies, coagulation status, and medications. We explain when and how we do core biopsies versus fine-needle aspirations to obtain a diagnosis depending on the suspected diagnosis and organ/mass being biopsied. We also describe how we take care of the patient after biopsy. Ultrasound can be used safely and successfully to perform biopsies and fine-needle aspirations in solid organs of the abdomen and pelvis including the retroperitoneum and abdominal wall. This technique allows adequate tissue sampling with real-time monitoring during placement of the biopsy needle. Postprocedure complications are extremely rare with the vast majority of our patients requiring only a short recovery time of 2 hours following the biopsy.