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Fig. 13 In-plane and out-of-plane techniques in ultrasound-guided needle insertions
scanned images. But position tracking allows 3-dimensional visualization of both
the ultrasound and the needle, allowing accurate needle aiming regardless of the
ultrasound image orientation (Fig. 13 ).
11 Tracked Ultrasound Snapshot Technique
Simultaneous handling of the ultrasound transducer and the needle has two main
disadvantages. It requires significant hand coordination skills, and the transducer
physically limits the range of motion of the needle. The acoustic shadows of
vertebrae limit angles and positions of the ultrasound transducer. The ideal, shortest
path for the needle is often blocked by the transducer in real time ultrasound
guidance. Therefore, the operator may sacri
ce the ideal needle path for real time
imaging. But tracked ultrasound offers separation of imaging and needle insertion in
time. The optimal ultrasound image can be recorded relative to the patient anatomy.
This image can be displayed for navigation when the transducer is removed from
the patient, and the tracked needle can be guided along the recorded ultrasound
snapshot. This technique, called tracked ultrasound snapshot (TUSS) guidance
simpli
es the hand coordination task, because the operator has to do only one thing
at a time, imaging or needle insertion. TUSS also allows needle insertion at the
same location that was used for imaging.
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