Feasibility and Usefulness of Intra-Cavitary Contrast-Enhanced Ultrasound in Percutaneous Nephrostomy.
The aim of this study was to evaluate the feasibility and utility of intra-cavitary contrast enhanced ultrasound (ICCEUS) in guiding percutaneous nephrostomy (PCN) and assessing complications. Forty-five ultrasound-guided PCNs were performed in 35 patients with hydronephrosis resulting from urinary tract obstruction. Ultrasound contrast agent (0.1 mL diluted in 20-30 mL saline) was injected through the puncture needle and the drainage tube to precisely locate the device and obstruction, with the fluoroscopy results considered the gold standard. ICCEUS was performed again the next day to assess complications. All 45 PCNs were successfully performed under the guidance of ultrasound. With ICCEUS, we could confirm the correct insertion of needle and catheter and locate the obstruction in all 35 patients, with fluoroscopic results as the gold standard. Catheter dislodgement was diagnosed by administration of ultrasound contrast agent in 5 patients. Hematoma (1 patient) and urine leakage (1 patient) were also observed. With the advantages of lack of exposure to radiation, performance in real time and bedside availability, ICCEUS has the potential to become a new modality to guide PCN and assess catheter-related complications.
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany.
Xin-Wu
XW
Cui
Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany.
Andre
A
Ignee
Department of Urology, Caritas Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany.
Tiberius
T
Maros
Department of Urology, Caritas Krankenhaus, Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany.
Bernd
B
Straub
Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Jian-Guo
JG
Wen
Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Wuerzburg, Wuerzburg, Germany; Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Electronic address: christoph.dietrich@ckbm.de.
Christoph F
CF
Dietrich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007089:Image Enhancement / Q000379:methods*; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*; D014570:Urologic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
D003287:Contrast Media
Complication; Contrast agents; Kidney; Percutaneous nephrostomy; Ultrasound