Takatani J, Takeshima N, Okuda K, Uchino T, Hagiwara S, Noguchi T
Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan.
Anaesth Intensive Care. 2012 Sep;40(5):856-60. doi: 10.1177/0310057X1204000514.
The ultrasound software package Enhanced Needle Visualization (ENV) has been reported to provide improved ultrasound imaging of needles even at steep insertion angles. ENV has three settings: shallow, medium and steep. However, the angles are unknown. We examined the advantages and indications of ENV in an in vitro study. A 22-gauge needle was inserted into pork meat using the in-plane technique. The needle was positioned at zero, 30, 45 and 60 degree angles, and 1, 2, 3 and 4 cm in-depth from the probe. The ultrasound visibility in each ENV setting was objectively evaluated and graded as 'not visible', 'poor', 'visible', 'good' and 'excellent' in ascending order. At zero degrees we found no advantage of ENV. At 30 degrees, the needle exhibited better visibility with 'good' or above grade in the shallow setting at all depths and in the medium setting at depths of 1, 2 and 3 cm than in the off position. At 45 degrees, needle visibility significantly increased from 'not visible' in the off position to 'visible' or above in the steep settings at depths of 1, 2 and 3 cm. At 60 degrees the objective visibility was 'not visible' in the off position and significantly increased to 'poor' in the steep setting. We recommend selecting the shallow setting for needles with an insertion angle of 30 degrees and the steep setting for 45 degrees within the advantageous area. This technique may allow safer ultrasound procedures for various unprecedented approaches.
据报道，超声软件包增强针可视化（ENV）即使在陡峭的插入角度下也能提供更好的针超声成像。ENV有三种设置：浅、中、陡。然而，这些角度并不明确。我们在一项体外研究中考察了ENV的优势和适用情况。使用平面内技术将一根22号针插入猪肉中。针的角度设置为0度、30度、45度和60度，距离探头的深度为1厘米、2厘米、3厘米和4厘米。对每个ENV设置下的超声可视性进行客观评估，并按升序分为“不可见”“差”“可见”“良好”和“优秀”。在0度时，我们发现ENV没有优势。在30度时，与关闭状态相比，在所有深度的浅设置以及在1厘米、2厘米和3厘米深度的中设置下，针的可视性表现为“良好”或更高等级。在45度时，在1厘米、2厘米和3厘米深度的陡设置下，针的可视性从关闭状态下的“不可见”显著提高到“可见”或更高等级。在60度时，关闭状态下的客观可视性为“不可见”，在陡设置下显著提高到“差”。我们建议在有利区域内，对于插入角度为30度的针选择浅设置，对于45度的针选择陡设置。这种技术可能会使各种前所未有的操作进行更安全的超声检查。
