CT-guided interventions:
At what location can you have a CT-guided intervention?
Guiding a biopsy or drainage with computed tomography greatly increases the accuracy of the procedure in question. The millimeter-precise movements also reduce the strain on our patients. You can have a professional CT-guided biopsy or drainage performed at several of our locations.
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Biopsy with CT support
CT-guided intervention biopsy is used when an unclear mass (suspected tumor, inflammatory changes, etc.) requires minimally invasive tissue collection for subsequent histological or microbiological examination to avoid open surgery.
Depending on the location of the structure to be punctured, the patient lies on the CT table in the supine, prone or lateral position. Then some planning photographs are made on the basis of which the access route is determined. The physician can plan with millimeter precision from which point to insert the needle in order to obtain an optimal sample without injuring other structures.
Before the actual puncture, the skin is disinfected and anesthesia is applied to the puncture area so that the actual puncture is felt as pressure but no longer as painful. If necessary, a sedative injection may also be administered before the procedure begins.
Biopsy procedure
After the explanatory talk and consent to the examination, the patient goes to the computer tomograph. Depending on the procedure and puncture site, it may be useful to specify the supine, lateral or prone position. To find the optimal position for the biopsy, the corresponding body region is examined with CT, the puncture site is marked and then the biopsy is started.
To make it more difficult for germs to enter the body, the site is disinfected and taped with sterile cloths. After local anesthesia of the puncture site, the puncture needle is inserted. The optimal position can be checked again by means of CT. The needle is used to remove pieces of tissue, and depending on the type of tissue, multiple samples can be taken from different locations.
After removal, the needle is removed and bleeding at the puncture site is prevented by means of pressure. After the outpatient puncture, the patients remain under our supervision for some time. Afterwards, they are free to go home again – we always recommend an accompanying person for the way home.
Risks and side effects
If the tissue to be examined is close to unaffected organs or vessels, injuries can occur despite all medical care. Immediate control of the puncture by CT greatly reduces this risk. In most cases, injury to the surrounding tissue is so minor that no complications requiring treatment occur at all.
During a lung biopsy, air may enter between the pleura and the lungs. The subsequent partial collapse of the lung is corrected with a drainage, which removes the infiltrated air and the lung unfolds completely again. In rare exceptional cases, the drainage remains temporarily on the lung until the tissue around the puncture has regenerated.
A rare side effect is intolerance of the x-ray contrast agent required for CT. In most cases, a temporary impairment of physical well-being occurs, such as itching, reddening of the skin, dizziness or mild nausea. If any intolerances are known, they will be discussed in advance with our medical team.
Drainage with CT support
CT-guided intervention of the drainage system is performed, for example, in the case of fluid accumulation in the abdominal cavity and is usually used for abscesses (pus accumulation). It is a gentle procedure for draining these abscesses and is minimally invasive under local anesthesia and can often replace major surgery. After computer tomographic imaging of the abscess, e.g. in the liver, a large-lumen drainage catheter specially developed for this purpose is inserted into the abscess cavity under local anesthesia and fixed to the skin.
The complete abscess material is aspirated and the abscess cavity is flushed with saline solution. A sample of the abscess contents is sent for microbiological workup and an antibiogram is obtained. Thus, targeted antibiotic therapy can be initiated.
In most cases, the signs of inflammation regress very quickly. After 8 to 14 days, the drainage can usually be removed. Due to the optimal control of the procedure by computed tomography, complications are rare.
Preliminary talk & contrast agent administration
At Radiologie München, every examination is preceded by a detailed preliminary discussion. Our specialists will explain the rest of the computer tomography procedure and the effects of the contrast medium used. In this conversation, you can express your fears about the examination. In the further procedure, a contrast agent containing iodine would be injected via the arm vein. The CT-guided intervention takes place in the supine position following the injection.
After the examination
You will remain for a period of time for outpatient monitoring. Meanwhile, the tissue removed during the CT-guided intervention is sent to the appropriate laboratory for testing, and you will receive the results from your attending physician(s). In the case of drains, a final discussion takes place on site about the further procedure and necessary behavior.
What are the risks of CT-guided intervention?
In addition to the wound healing complications discussed above, there is a small amount of radiation exposure and injection of an iodine-containing contrast agent, as with a conventional CT scan.
Radiation exposure risk
The CT scan involves radiation exposure to the body, which is higher than normal X-ray examinations. The amount of exposure depends on the dose administered, the duration of the examination, and the tissue being examined. In any case, dual-energy computed tomography should be performed only when needed by the physician to detect and type specific diseases.
Risk contrast agent
The contrast agent may cause headache, dizziness, nausea, diarrhea or abdominal pain in some cases. Here it is recommended to drink a lot of water after the treatment. If there is no improvement in the near future, you must contact us immediately. Allergic reactions can also occur unexpectedly, but these can be treated with medication.