Abstract
This chapter describes the technique of ultrasound (US)-guided aspiration of cysts and other fluid collections. In addition to its use on simple cysts, which are rarely aspirated today except when they cause symptoms, US-guided aspiration can be performed on non-simple cysts, including inspissated cysts, septated cysts, cysts with an intracystic neoplasm, oil cysts, and galactoceles. Other fluid collections that can be aspirated and drained include postoperative hematomas and seromas, lymphoceles, periprosthetic collections, and abscesses.
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References
Fornage BD, Coan JD, David CL. Ultrasound-guided needle biopsy of the breast and other interventional procedures. Radiol Clin North Am. 1992;30(1):167–85.
Tabar L, Pentek Z, Dean PB. The diagnostic and therapeutic value of breast cyst puncture and pneumocystography. Radiology. 1981;141(3):659–63.
Álvarez-FernÁndez D, Gonzalez J, Ayala-Luna J, Rodriguez-Moran M, Guerrero-Romero F. Injection of absolute alcohol into cysts cavities, after cyst aspiration, for treating and reducing the rate of recurrence of benign breast cysts. Gynecol Surg. 2010;7:285–8.
Ozgen A. Effectiveness of single-session ultrasound-guided percutaneous ethanol sclerotherapy in simple breast cysts. Diagn Interv Radiol. 2016;22(3):220–3.
Gomes C, Amaral N, Marques C, Borralho R, de Oliveira CF. Sclerosis of gross cysts of the breast: a three-year study. Eur J Gynaecol Oncol. 2002;23(3):191–4.
Fornage BD. Breast sonography. In: Shirkoda A, editor. Variants and pitfalls in body imaging: thoracic, abdominal and women's imaging. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 723–59.
Amir LH, Forster D, McLachlan H, Lumley J. Incidence of breast abscess in lactating women: report from an Australian cohort. BJOG. 2004;111(12):1378–81.
Karstrup S, Nolsoe C, Brabrand K, Nielsen KR. Ultrasonically guided percutaneous drainage of breast abscesses. Acta Radiol. 1990;31(2):157–9.
Ulitzsch D, Nyman MK, Carlson RA. Breast abscess in lactating women: US-guided treatment. Radiology. 2004;232(3):904–9.
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Ultrasound-guided therapeutic drainage of a painful simple cyst. The needle is visible during the entire aspiration until the complete collapse of the cyst. The absence of residual fluid is documented (MOV 4556 kb)
Ultrasound-guided drainage of a simple cyst. Care is taken to continue the aspiration until there is no residual fluid in the cystic cavity (MP4 5236 kb)
Ultrasound-guided aspiration of an inspissated cyst. Only a small amount of thick material could be aspirated. (See also Fig. 7.15) (MP4 11220 kb)
Color Doppler examination of the inspissated cyst shown in Fig. 7.16. A few typical twinkling artifacts are seen projecting inside the questionable solid mass (MOV 12359 kb)
Power Doppler examination of the inspissated cyst shown in Fig. 7.16. Careful examination reveals the downward streaming of a few echoes on the right lateral aspect of the mass, thereby supporting the diagnosis of an inspissated cyst rather than a mucinous cancer (MOV 5848 kb)
Ultrasound-guided fine-needle aspiration of a cluster of microcysts. Each individual microcyst measures only 1–2 mm. Care is taken to aspirate them all (MOV 13997 kb)
A cluster of microcysts with fine septa and ducts. This finding is benign and does not require a needle biopsy (MP4 5119 kb)
Inflamed cyst. On grayscale imaging, the palpable cyst has a diffusely thickened wall, a layer of sediment, and multiple slowly moving internal echoes. Activation of Power Doppler imaging shows the increased vascularity of the wall. Note the streaming artifact in the central portion of the lumen (MP4 16767 kb)
Inflamed cyst. Power Doppler ultrasound shows the marked vascularity that has developed around the cyst. The cyst collapses during aspiration. Cytopathology confirmed acute inflammation, but cultures remained sterile (MOV 19809 kb)
Multiseptated postoperative collection. Drainage done with an 18-gauge needle requires piercing the numerous septa. About 16 ml of straw-colored fluid was aspirated (MOV 9916 kb)
Large retroareolar mass with inflammatory changes in a diabetic patient. Ultrasound-guided fine-needle aspiration (FNA) was performed to differentiate between inflammatory breast cancer and abscess. Dynamic maneuvers (compression and lateral motion) show the echogenic fluid moving inside the mass. The abscess was readily confirmed by FNA (MP4 5929 kb)
Abscess in a patient with granulomatous mastitis (see Fig. 7.36). Dynamic maneuvers (rocking the probe laterally) make the echogenic pus shift from side to side within the abscess cavity (MOV 2506 kb)
Large (6-cm) retroareolar abscess. Rocking the probe laterally causes echogenic pus to be squeezed from side to side in the cavity, virtually confirming the abscess (MOV 5440 kb)
Large (6-cm) retroareolar abscess. Power Doppler ultrasound shows intense hypervascularity in the solid component of the abscess (MOV 3895 kb)
Large (6-cm) retroareolar abscess. Percutaneous drainage of the abscess is attempted using a 13-gauge trocar (MOV 15036 kb)
Large (6-cm) retroareolar abscess. Drainage is facilitated by repeat irrigations with sterile saline. Eventually the large abscess had to be drained surgically (MOV 12188 kb)
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Fornage, B.D. (2020). Fine-Needle Aspiration of Cysts and Other Fluid Collections. In: Interventional Ultrasound of the Breast. Springer, Cham. https://doi.org/10.1007/978-3-030-20829-5_7
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DOI: https://doi.org/10.1007/978-3-030-20829-5_7
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