体外随机比较标准和新型超声引导肾靶向的超声造影针。

In vitro randomized comparison of a standard and novel echogenic needle for ultrasonography-guided renal targeting.

机构信息

Department of Urology, University of California , Irvine, Orange, California.

出版信息

J Endourol. 2013 Oct;27(10):1277-81. doi: 10.1089/end.2013.0292. Epub 2013 Sep 14.

DOI:10.1089/end.2013.0292

PMID:23799803

Abstract

BACKGROUND AND PURPOSE

Urologists are becoming increasingly aware of the importance of pretreatment percutaneous renal biopsy of small renal cortical neoplasms. A barrier to the routine performance of ultrasonography-guided percutaneous renal biopsy has been the technical challenges associated with the procedure. We evaluated a new modified needle, which incorporates an echogenic needle tip designed to improve the needle tip's visibility under ultrasonographic visualization. We evaluated and compared the ultrasonographic imaging quality of the echogenic needle (EN) and a standard needle (SN).

METHODS

Forty-eight participants were recruited to perform ultrasonography-guided needle targeting and drainage of a simulated cyst within a phantom model. The simulated cysts were embedded in an opaque gel mold. Each participant was blinded to the type of needle being deployed and was asked to identify and aspirate the simulated cyst with each needle under ultrasonography guidance. Each needle was tested at three ultrasound-aiming angles, (0, 15, and 30 degrees). The quality of needle visibility under ultrasonographic imaging was assessed via a questionnaire, including needle preference and a visibility score (1-10) at each aiming angle. Participants were stratified by level of ultrasound experience.

RESULTS

For each angle tested, the EN received higher visibility ratings. The mean visibility scores for the EN vs the SN were 6.44 vs 5.52 at 0 degrees (P=0.001), 7.77 vs 6.96 at 15 degrees (P=0.0004) and 8.33 vs 7.54 at 30 degrees (P=0.0001). Participants reported significantly greater comfort using the EN needle compared with the SN (P=0.001). These results held true regardless of the sequence of needle tested first. Also, there was a significant difference in visibility scores by angle (P=0.0001). Larger angles (30>15>0) resulted in higher scores.

CONCLUSIONS

In this in vitro trial, the application of the EN improved needle visibility for users of all levels of experience. Clinical correlation is pending.

摘要

背景与目的

泌尿科医生越来越意识到对小肾皮质肿瘤进行术前经皮肾活检的重要性。常规进行超声引导下经皮肾活检的一个障碍是与该操作相关的技术挑战。我们评估了一种新的改良针，其采用了设计用于改善超声可视化下针尖可视性的回声针尖。我们评估和比较了回声针（EN）和标准针（SN）的超声成像质量。

方法

招募了 48 名参与者进行超声引导下的模拟囊肿的靶向和引流。模拟囊肿被嵌入不透明的凝胶模具中。每个参与者对使用的针类型都不了解，并要求在超声引导下使用每种针识别和抽吸模拟囊肿。在三个超声瞄准角度（0、15 和 30 度）下测试了每种针。通过问卷调查评估了超声成像下针尖可视性的质量，包括对每种针的偏好和在每个瞄准角度的可视性评分（1-10）。根据超声经验水平对参与者进行分层。

结果

在每个测试的角度，EN 的可视性评分都更高。EN 与 SN 的平均可视性评分分别为 0 度时 6.44 与 5.52（P=0.001）、15 度时 7.77 与 6.96（P=0.0004）和 30 度时 8.33 与 7.54（P=0.0001）。与 SN 相比，参与者报告使用 EN 针时舒适度显著提高（P=0.001）。这些结果无论首先测试哪种针都成立。此外，可视性评分也存在角度差异（P=0.0001）。角度越大（30>15>0），评分越高。