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实时计算机断层扫描透视引导下经皮穿刺引流腰大肌脓肿

Percutaneous drainage of psoas abscess under real-time computed tomography fluoroscopic guidance.

作者信息

Yamagami Takuji, Terayama Koshi, Yoshimatsu Rika, Matsumoto Tomohiro, Miura Hiroshi, Nishimura Tsunehiko

机构信息

Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan.

出版信息

Skeletal Radiol. 2009 Mar;38(3):275-80. doi: 10.1007/s00256-008-0608-3. Epub 2008 Nov 12.

Abstract

OBJECTIVES

The goal of our study was to determine the usefulness of percutaneous abscess drainage under guidance of computed tomography (CT) fluoroscopy.

MATERIALS AND METHODS

Our subjects were 21 patients (seven women, 14 men; mean age 64 years; age range 30-87 years) who had undergone percutaneous drainage of 26 psoas abscess lesions under CT fluoroscopic guidance between May 2001 and January 2008. Drainage methods involved a needle puncture, insertion of a guidewire, serial dilations, and the exchange of the needle with a drainage tube. The procedures were guided by use of a helical CT scanner that provided real-time fluoroscopic reconstruction.

RESULTS

Percutaneous drainage under real-time CT fluoroscopic guidance was successfully performed in every procedure. Use of real-time CT fluoroscopy allowed rapid assessment of needle, guidewire, and catheter placement. No patient had serious complications related to the drainage procedure. The mean procedure time required to drain one lesion was 35.6 +/- 13.6 min. Mean period after the drainage procedure until complete disappearance of the abscess as confirmed by CT was 12.4 +/- 10.0 days (range 3-46 days).

CONCLUSION

CT fluoroscopy is useful in achieving accurate and safe drainage of abnormal psoas fluid collections.

摘要

目的

我们研究的目的是确定在计算机断层扫描(CT)透视引导下经皮脓肿引流的有效性。

材料与方法

我们的研究对象为21例患者(7名女性,14名男性;平均年龄64岁;年龄范围30 - 87岁),这些患者在2001年5月至2008年1月期间于CT透视引导下对26个腰大肌脓肿病变进行了经皮引流。引流方法包括穿刺针、插入导丝、逐步扩张以及将穿刺针换成引流管。操作过程由提供实时透视重建的螺旋CT扫描仪引导。

结果

在实时CT透视引导下的经皮引流在每个操作中均成功完成。使用实时CT透视能够快速评估穿刺针、导丝和导管的位置。没有患者出现与引流操作相关的严重并发症。引流一个病变所需的平均操作时间为35.6 +/- 13.6分钟。经CT确认脓肿完全消失前的平均引流后时间为12.4 +/- 10.0天(范围3 - 46天)。

结论

CT透视有助于实现对腰大肌异常积液的准确、安全引流。

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