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Parasagittal sonogram of the pelvis to the left of the midline shows a large fluid collection with numerous septations 25 days after a total abdominal hysterectomy and pelvic lymphadenectomy. This was drained under ultrasound Dowmload. Percutaneous fine-needle aspiration biopsy procedures for suspicious mass lesions can be performed under ultrasound and CT guidance.

These procedures can differentiate benign from malignant lesions, seen by either modality, with a high degree of accuracy. They are performed under local anesthesia, with or without sedation, using a 22- to 25-gauge needle.

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These procedures include CT-guided aspiration of chest masses; CT- or ultrasound-guided fine-needle aspiration of hepatic, retroperitoneal (see Fig.

49), abdominal (Fig. 64), and pelvic masses; TVUS-guided biopsies of pelvic masses (Fig.

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