The Myriad Advantages of Ultrasonography in Image-Guided Interventions.

We will review and illustrate the multiple advantages of ultrasound as an image guidance tool, including real-time vessel visualization, multiplanar capability, portability/availability, and decreased procedure time and cost. We will demonstrate the unique advantages of the use of this imaging modality in the biopsy of small parenchymal lesions particularly those that are not visible with unenhanced computed tomography (CT) or not persistently visible with contrast-enhanced CT or those lesions not readily accessible by CT guidance, the use of direct probe compression to displace bowel away from biopsy targets, the use of direct probe compression to staunch intraprocedural bleeding observed with real-time visualization to minimize postprocedural bleeding complications, and the ability to biopsy masses in pediatric patients as a function of the inherent lack of ionizing radiation. Finally, we will review and illustrate how the use of preprocedural lesion characterization with ultrasound at times can serve as a problem-solving tool providing an alternative and reasonably confident diagnosis and thus avoiding unnecessary procedures and associated potential risks.