Department of Anesthesiology and Intensive Care Medicine, University Hospital Marburg, Marburg, Germany.
Reg Anesth Pain Med. 2013 Sep-Oct;38(5):452-5. doi: 10.1097/AAP.0b013e31829730d5.
Needle visualization in ultrasound-guided regional anesthesia can be improved by using needles of echogenic design with higher rate of reflection of ultrasound waves. Imaging solutions such as compound imaging might further improve imaging of both needle and tissue; these effects have not yet been studied. We hypothesized that compound imaging would significantly improve needle visibility, regardless of the insertion angle or needle type used. The effects of compound imaging on needle artifacts and tissue imaging were also investigated.
A total of 200 video clips of in-plane needle insertions were obtained in embalmed cadavers with a conventional needle and an echogenic needle at 5 different insertion angles, with both conventional B-mode ultrasound imaging and compound imaging technology. Visibility of the needle shaft and needle tip as well as the needle artifact rate were assessed by a blinded investigator on a 4-point ordinal scale. The effects on tissue image quality and speckle artifacts were also assessed. Stepwise linear regression was performed to differentiate effects on needle visibility scores.
Imaging of the needle shaft and tip was significantly enhanced when compound imaging technology was used (P < 0.0001). Use of echogenically designed needles or shallow needle insertion angles improved visibility of both shaft and tip (both P < 0.0001). With compound imaging, there are fewer needle artifacts, and tissue imaging quality and speckle artifact rate are significantly improved.
Compound imaging technology enhances needle imaging with both echogenic and conventional needles. Tissue imaging and speckle artifacts are also optimized. Echogenic needle design results in better needle visibility scores in both B-mode and compound imaging.
在超声引导下的区域麻醉中，通过使用具有更高超声波反射率的声反射设计的针，可以改善针的可视化效果。成像解决方案，如复合成像，可能会进一步改善针和组织的成像效果；这些影响尚未被研究过。我们假设复合成像无论插入角度或使用的针类型如何，都将显著提高针的可视性。还研究了复合成像对针伪影和组织成像的影响。
在 200 个平面内针插入的视频剪辑中，使用常规针和超声反射设计的针，在 5 个不同的插入角度下，使用常规 B 模式超声成像和复合成像技术，在防腐尸体中获得。由一位盲法观察者使用 4 分等级量表评估针轴和针尖的可视性以及针伪影率。还评估了对组织图像质量和斑点伪影的影响。进行逐步线性回归以区分对针可视性评分的影响。
当使用复合成像技术时，针轴和针尖的成像明显增强（P < 0.0001）。使用超声反射设计的针或较浅的针插入角度可以提高针轴和针尖的可视性（均 P < 0.0001）。使用复合成像，针伪影较少，组织成像质量和斑点伪影率显著提高。
复合成像技术增强了使用超声反射设计和常规针的针成像。组织成像和斑点伪影也得到了优化。超声反射设计的针在 B 模式和复合成像中都能获得更好的针可视性评分。
