Hyperechoic lines as a sonographic confirmatory sign during percutaneous transhepatic biliary drainage.
BACKGROUND
In ultrasonically guided percutaneous transhepatic biliary drainage, we often can recognize hyperechoic lines at the tip of the needle when the duct is penetrated successfully. We evaluated the frequency of this phenomenon and analyzed whether it was a useful sign for confirming successful bile duct puncture.


METHODS
In 65 patients with biliary tract diseases, 84 catheters were placed in the course of 108 attempts at puncture. Results of puncture and the presence of hyperechoic lines were investigated prospectively.


RESULTS
When the ultrasonographic findings showed hyperechoic lines, successful puncture was significantly more frequent than when the findings did not show hyperechoic lines (53/55, 96%, vs. 31/59, 53%; p < 0.0001). When we judged the hyperechoic lines as the sign of successful puncture, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 63%, 93%, 96%, 48%, and 71%, respectively.


CONCLUSIONS
Hyperechoic lines are a useful confirmatory sign of successful puncture. However, absence of these lines was not invariably associated with unsuccessful puncture.
Tamada
K
K
Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi 329-0498, Japan.
Tomiyama
T
T
Wada
S
S
Ohashi
A
A
Satoh
Y
Y
Higashizawa
T
T
Gotoh
Y
Y
Ido
K
K
Sugano
K
K
D000368:Aged; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures; D014463:Ultrasonography