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      경질 초음파 유도생검 Translated title: Transvaginal Ultrasound-Guided Biopsy

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          Abstract

          경피적 초음파 유도생검은 진단 및 치료 계획을 정하기 위해 다양한 신체 병변에 대한 병리 확인에 유용한 시술이다. 하지만 깊은 골반 병변은 병리진단이 어려운데 장, 방광, 주요 혈관, 그리고 골반뼈로 인해 경피적 접근이 어렵고 위험하기 때문이다. 여성의 경우 질은 탄력적이고 골반의 내부 장기와 가깝다. 따라서 경질 초음파는 골반 병변에 대한 병리진단을 위해 효과적이고 안전한 길잡이 역할을 할 수 있다. 이 종설의 목적은 경질 초음파 유도생검의 적응증과 방법을 소개하고, 또한 보고된 진단 정확도 및 안정성을 기술하고자 한다.

          Translated abstract

          Percutaneous ultrasound-guided biopsy is useful for the pathologic confirmation of variable body lesions to establish diagnostic and therapeutic approaches. However, deep pelvic lesions are a challenge for pathologic diagnoses because of the presence of the bowel, bladder, major vessels, and pelvic bones which make a percutaneous approach difficult and dangerous. In female, the vagina is elastic and near the pelvic internal organs. Therefore, transvaginal ultrasound may serve as an effective and safe guide for the pathologic diagnosis of pelvis lesions. This review aimed to introduce the indications for, and the method of transvaginal ultrasound-guided biopsy, and to describe the reported diagnostic accuracy and safety.

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          Most cited references21

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          Prevention of Infection After Gynecologic Procedures

          (2018)
          Surgical site infection remains the most common complication of gynecologic procedures. Reducing surgical site infections has become a priority in the United States as part of a strong national commitment to measuring processes and improving outcomes of care for surgery. Implementing programs to reduce surgical site infections requires a collaborative approach that involves clinicians, nurses, and staff. The purpose of this document is to review the recommended interventions, including antibiotic prophylaxis, used to prevent infection after gynecologic procedures.
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            Antibiotic Prophylaxis for Gynecologic Procedures prior to and during the Utilization of Assisted Reproductive Technologies: A Systematic Review

            The use of assisted reproductive technologies (ART) has increased steadily. There has been a corresponding increase in the number of ART-related procedures such as hysterosalpingography (HSG), saline infusion sonography (SIS), hysteroscopy, laparoscopy, oocyte retrieval, and embryo transfer (ET). While performing these procedures, the abdomen, upper vagina, and endocervix are breached, leading to the possibility of seeding pelvic structures with microorganisms. Antibiotic prophylaxis is therefore important to prevent or treat any procedure-related infections. After careful review of the published literature, it is evident that routine antibiotic prophylaxis is generally not recommended for the majority of ART-related procedures. For transcervical procedures such as HSG, SIS, hysteroscopy, ET, and chromotubation, patients at risk for pelvic infections should be screened and treated prior to the procedure. Patients with a history of pelvic inflammatory disease (PID) or dilated fallopian tubes are at high risk for postprocedural infections and should be given antibiotic prophylaxis during procedures such as HSG, SIS, or chromotubation. Antibiotic prophylaxis is recommended prior to oocyte retrieval in patients with a history of endometriosis, PID, ruptured appendicitis, or multiple prior pelvic surgeries.
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              Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors.

              The goal of this study was to evaluate the accuracy and safety of ultrasound-guided tru-cut biopsy in patients with either primarily inoperable pelvic tumor, advanced tumor and compromised performance status, or recurrent pelvic tumor. Altogether, 90 patients were enrolled and only 4 were not suitable for tru-cut biopsy. The biopsy was taken either from pelvic tumor (54.6%), peritoneal visceral or parietal metastases (31.4%), or omental cake (14%). Samples were obtained transvaginally (53.5%) or transabdominally (46.5%). A diagnosis consistent with primary ovarian malignancy was made in 62.8%, metastatic ovarian involvement was found in 10.5%, and extraovarian tumor in 26.7%. The obtained tissue was adequate for histologic diagnosis in 80 out of 86 cases. In four cases, repeated biopsy was required to obtain a sufficient tissue sample. False-negative samples without tumor tissue were obtained in two cases, and those patients were referred for either laparoscopy or minilaparotomy. The diagnostic accuracy of ultrasound-guided tru-cut biopsy reached 97.7% (95% CI 91.85-99.72%). There was only one complication, a bleeding from tumor in a patient with mild thrombocytopenia, requiring laparotomy. In conclusion, ultrasound-guided tru-cut biopsy is safe, reliable, and cost-effective diagnostic method. It can be performed in an outpatient setting without the need for general anesthesia and provides an adequate specimen for histologic analysis, including immunohistochemical methods. It should, therefore, be considered as a method of choice for histologic verification of both advanced primary and recurrent abdomino-pelvic tumors.
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                Author and article information

                Journal
                J Korean Soc Radiol
                J Korean Soc Radiol
                JKSR
                Journal of the Korean Society of Radiology
                The Korean Society of Radiology
                2951-0805
                November 2023
                22 November 2023
                : 84
                : 6
                : 1233-1243
                Affiliations
                [1 ]충남대학교병원 영상의학과 [1 ]Department of Radiology, Chungnam National University Hospital, Daejeon, Korea.
                [2 ]충남대학교 의과대학 영상의학교실 [2 ]Department of Radiology, Chungnam National University College of Medicine, Daejeon, Korea.
                [3 ]성균관대학교 의과대학 삼성서울병원 영상의학과 [3 ]Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
                Author notes
                Corresponding author: Jung Jae Park, MD. Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel 82-42-280-8077, Fax 82-42-253-0061, jjskku@ 123456naver.com
                Article
                10.3348/jksr.2023.0092
                10721409
                38107698
                28c7f50f-7097-4d40-bbf7-62151ae41471
                Copyrights © 2023 The Korean Society of Radiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 August 2023
                : 29 August 2023
                : 16 September 2023
                Categories
                Biopsy in Urogenital Radiology
                Review Article

                female,pelvis,vagina,ultrasonography,image-guided biopsy
                female, pelvis, vagina, ultrasonography, image-guided biopsy

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