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首页> 外文期刊>Arab Journal of Urology >[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
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[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture

机译：[36]动态对比增强超声检查可更好地经皮肾镜取石术穿刺

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ObjectiveTo assess the efficiency of dynamic contrast-enhanced ultrasonography (DCE-US) for percutaneous nephrolithotomy (PCNL) puncture, as in recent years US contrast agents (microbubbles) have been used safely for cardiovascular and liver diseases diagnosis, and also to identify complex renal cysts, thus could be used to better delineate the pyelocalyceal system during PCNL puncture and reduce the radiation exposure for medical staff and patients.MethodsA 40-year-old man with a history of thalassaemia trait, renal cysts, and bilateral renal staghorn stones was scheduled for right PCNL. A 6-F ureteric catheter was placed at the beginning of the procedure. Using a curvilinear US probe (frequency 4?Hz, mechanical index 0.4) and 18-G EchoTip? needle, renal access was established for the patient in prone position under general anaesthesia whilst slowly injecting three doses of 1.5?mL US contrast agent (Sonovue; prepared by mixing 5?mL sodium chloride 0.9% with 25?mg lyophilised powder) each followed by 5?mL physiological saline flush through the ureteric catheter to delineate the collecting system. Afterwards, pneumatic and ultrasonic lithotripsies were used.ResultsThe PCNL procedure was successful. The collecting system was successfully accessed through a lower calyx puncture. No blood transfusion was needed during or after the procedure (haemoglobin op <1?g/dL). The puncture time was 1.2?min, operating time 141?min, and fluoroscopy time was 3.1?min. There were no major complications or adverse effects. The patient was discharged 48 h after the procedure.ConclusionDCE-US is a safe innovative technique that might be a good method to improve PCNL puncture, reduce radiation, and possibly reduce the risk of bleeding. Further randomised studies are needed to evaluate its benefits.
机译：目的评估动态对比增强超声检查（DCE-US）在经皮肾镜取石术（PCNL）穿刺中的效果，因为近年来，美国的对比剂（微泡）已被安全地用于心血管和肝脏疾病的诊断，并鉴定出复杂的肾脏方法：拟定一名患有地中海贫血特征，肾囊肿和双侧肾鹿角结石病史的40岁男性，以更好地描绘PCNL穿刺过程中的胸膜局部腺系统，并减少放射线照射。适用于正确的PCNL。在手术开始时放置6-F输尿管导管。使用曲线US探头（频率4？Hz，机械指数0.4）和18-G EchoTip？在全身麻醉的情况下，为处于俯卧位的患者建立针头，同时缓慢注射三剂1.5？mL US造影剂（Sonovue;通过将5？mL氯化钠0.9％与25？mg冻干粉混合制备），然后通过输尿管导管冲洗5？mL生理盐水以描绘收集系统。之后，使用气动和超声碎石术。结果PCNL程序成功。通过较低的花萼穿刺成功地进入了采集系统。手术期间或之后无需输血（血红蛋白op <1？g / dL）。穿刺时间为1.2分钟，操作时间为141分钟，透视检查时间为3.1分钟。没有重大并发症或不良反应。手术后48小时出院。结论DCE-US是一种安全的创新技术，可能是改善PCNL穿刺，减少放射线并可能减少出血风险的好方法。需要进一步的随机研究以评估其益处。

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