Ultrasound Guided Biopsies

Ultrasound-guided biopsy is a procedure conducted on an outpatient basis to extract tissue samples from abnormalities detected during radiology scans. It represents the most prevalent type of image-guided biopsy, providing convenience and real-time dynamic monitoring while enabling precise placement.


A sonohysterogram is a unique type of ultrasound that allows your healthcare provider to examine the interior of your uterus. During a sonohysterogram, an ultrasound machine captures images of the structures and contours within your uterus while it is filled with saline solution.

This procedure assists your provider in identifying any problematic areas within your uterus and uterine lining (endometrium) that could be contributing to symptoms such as bleeding, pelvic pain, and infertility.

Healthcare practitioners use sonohysterography to help diagnose several medical conditions, including:

  • Uterine fibroids
  • Uterine polyps
  • Scarring inside the uterus
  • Abnormal shape of the uterus
  • Signs of endometriosis
  • Signs of endometrial cancer
  • Blockages in your fallopian tubes

Your doctor might advise this test if you have symptoms that suggest a problem with your uterus, such as:

  • Abnormal menstrual bleeding
  • Infertility
  • Repeated miscarriages
  • An abnormal pelvic exam


Who should not get a sonohysterogram:

You should not get a sonohysterogram if you’re pregnant or if you have pelvic inflammatory disease (PID).

When is a sonohysterogram performed?

The optimal time for a sonohysterogram is after your menstrual period has concluded but before ovulation, typically between days 6 – 11 of your menstrual cycle, starting from the first day of bleeding. During this phase, the uterine lining is at its thinnest, allowing your provider to observe it with greater clarity. If you are postmenopausal, the procedure can be conducted at any time. If your cycle is unpredictable or bleeding is prolonged, please discuss the procedure with your physician.

Who performs the Sonohysterogram?

During the procedure, an ultrasound technologist captures images while a Radiologist conducts the examination. Subsequently, the radiologist, will analyze the results and prepare a report detailing their findings. This report is then shared with your healthcare provider to communicate the results to you.

During the test:

1. An ultrasound will initially be performed by a technologist.

2. A Radiologist will be performing the procedure. The Radiologist will insert a speculum into the vagina.

3. A catheter will be inserted through the speculum into the cervix.

4. A tiny balloon at the tip of the catheter will act as a stopper while fluid is injected into the endometrium. This fluid will allow us to better visualize the uterine cavity and lining.

5. The sonographer will then re-insert the probe and document any findings.

Please refrain from intercourse from the time your period begins until after the exam is performed so there is no chance of pregnancy. If there is any chance you may be pregnant please perform a pregnancy test before the procedure.

To minimize pain and cramping during the procedure, we offer our patients ibuprofen and 5 mg of oxycodone 1 hour before the procedure. Please notify us of any allergies. We also suggest the patient take 600 mg of Ibuprofen at home 3 hours before the procedure.

To minimize the risk of post-procedural infection, we prescribe a short course of antibiotics (doxycycline) for 3 days post-procedure. Please take the pills with food and notify us of any allergies.

You must have someone to drive you home (you cannot drive after taking oxycodone).

Post Sonohysterogram Instructions

1. In the majority of cases, there is no discomfort except for mild cramping.

2. For relief, take nonsteroidal anti-inflammatory medications (e.g. Advil, Motrin, or Ibuprofen) or Tylenol. Nothing should be inserted into the vagina for 24 hours (no tampons or douching).

3. Avoid heavy lifting or exercise for 24 hours.

4. If you develop fever, pain (greater than normal menstruation pain), or excessive bleeding, please contact your doctor directly. This may be a sign of infection.

Ultrasound Guided Thyroid Biopsy

Nodules are frequently biopsied to rule out the presence of a cyst, an infection, a benign tumor or cancer.  A fine needle is inserted by a Radiologist into the nodule to extract a cell sample. This takes place within our office in a dedicated procedure room.  The procedure lasts around 30 minutes and carries minimal risks.  The needle biopsy will be performed using Ultrasound  guidance to accurately place the needle. Subsequently, the collected samples are sent to a laboratory for microscopic analysis.

  • Please wear loose-fitting clothing with no jewelry around the neck.
  • Please have a bath or shower the morning of the procedure as you will not be able to have a bath or shower again until the day after the procedure.
  • Blood thinners: Please stop ASA (aspirin) 5 days prior to your procedure.
  • Please bring a list of your current medications, supplements, and allergies with you.
  • You can have a light breakfast the morning of the procedure.
  • Please come 15 minutes before your procedure time.


During the procedure, you will lie on your back with support under your neck and shoulders.

  • The technologist and physician will use ultrasound to localize the area of concern for the biopsy.
  • Your skin will be cleaned with an antiseptic solution.
  • A small amount of lidocaine (freezing) may be injected to help reduce pain during the procedure.
  • Using the ultrasound for guidance, the physician will insert a very fine needle and take one to three samples from the area of concern.
  • You may feel some pressure on your neck from the ultrasound transducer, mild discomfort, or pain as the needle is inserted into the area of concern.
  • Your referring doctor will receive the results directly from the specimen processing laboratory.
  • Once the procedure is complete, pressure will be applied to the area of the biopsy to minimize bleeding and bruising.
  • A band-aid will be applied.

After Procedure Care:

Most patients typically feel well after a thyroid biopsy. You may return to normal activity 3 hours after the procedure, but avoid strenuous activities for 3 hours after the procedure.

  • You may drive after the procedure.
  • Eat and drink as normal. No alcoholic beverages (including beer) for 24 hours.
  • Some people have mild discomfort at the site following the biopsy. You may wish to take some Tylenol and apply an ice pack to the area for up to 48 hours.
  • Take your usual, prescribed medications, unless instructed otherwise.
  • Your referring doctor will likely receive the results in 10‐14 days following the procedure from the lab. If you do not hear from your referring doctor’s office in 2 weeks, please call your referring doctor’s office.
  • Please note that an aspiration procedure may occasionally need to be repeated to obtain more tissue samples.
  • Thyroid fine needle aspiration is a very safe procedure but does carry some slight risks:
    • Bleeding at the biopsy site.
    • Slight bruising of the neck.
    • Infection.

Ultrasound Guided Breast Biopsy

On your most recent breast ultrasound examination, a spot was identified within the breast that may have been a mass or area of abnormal tissue of uncertain significance

To determine the nature of the area of abnormality, small samples of the tissue will be taken by the radiologist doctor using a hollow core needle, under local anesthesia (“freezing”), positioned using the ultrasound machine. The doctor may perform a fine needle aspiration procedure using a very thin needle to remove fluid from an abnormal area or cyst.

The sample will be sent to a laboratory for analysis and your referring doctor will receive a result from the lab directly.


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