Overview Of Ultrasound Needle Guidance

Overview of Ultrasound Needle Guidance

When using ultrasound-guided needles for percutaneous puncture surgery, a variety of techniques can be used. Generally speaking, ultrasound guided procedures can be divided into indirect methods and direct methods. In the indirect method, ultrasound is used to identify the target and determine the depth, and then mark the skin that directly covers the target. Remove the transducer and point the needle perpendicular to the skin towards the target. This method may be suitable for large superficial targets, but it is very limited because the needle is never directly visualized in the target, and real-time evaluation during surgery is impossible. The direct method is better than the indirect method because the needle is identified within the target, which ensures higher accuracy and lower complication rate.

A variety of techniques can be used when using the direct method, including needle guidance or freehand techniques. One option that is not commonly used in musculoskeletal surgery is to use a needle guide that is physically connected to the ultrasound transducer. Since most musculoskeletal surgeries are relatively superficial and take into account the extra steps required when using a needle guide, they tend to be performed with bare hands. When using the freehand direct method, there are two ways to guide the pointer relative to the transducer and the sound beam: in-plane and out-of-plane. When using a planar approach, the needle is pointed below the long axis of the transducer and the sound beam, and the entire needle, including its tip, is always visible during the operation. This can correct the angle and depth in real time when the needle is inserted. In most cases, the in-plane method is the preferred method because the continuous visualization of the entire needle, including the needle tip and target, minimizes complications and maximizes accuracy.

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