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A wide range of interventional procedures can only be safely performed with accurate imaging guidance. The aim of this chapter is to outline the basic principles of imaging-directed intervention. Ultrasound, computed tomography and fluoroscopy have complementary roles; individual circumstances dictate the optimal modality.
Ultrasound is ideal for many biopsy and drainage procedures and allows the procedure to be visualized in real-time. Use ultrasound if it clearly demonstrates the target and a suitable approach. Usually, this is achieved in solid organs or for larger abdominal collections. As a basic principle, use the highest-frequency probe that gives a good image from the skin to the target site. Use a 7.5-MHz probe for superficial structures and a 3.5–5-MHz probe for deeper structures. It is exceedingly helpful to have a probe with a small footprint, as this improves access.
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