Flat detector cone beam CT-guided nephrostomy using virtual navigation in patients with iatrogenic ureteral injury.

PURPOSE

To evaluate the feasibility of flat detector cone beam computed tomography (CBCT)-guided nephrostomy using virtual navigation in patients with iatrogenic ureteral injury.

MATERIALS AND METHODS

A retrospective review of percutaneous nephrostomy (PN) revealed the use of CBCT with 3D virtual navigation guidance in 42 procedures (40 patients) for patients with iatrogenic ureteral injury. All procedures were shown as second-line interventions after failed ultrasound-guided nephrostomy. Data on technical success rate, procedure time, puncture performance, radiation exposure, complications, and clinical success were collected.

RESULTS

The technical success rate was 95.2% (40/42). The mean puncture performance score was 4.4 ± 1.0, and the procedure time was 25.2 ± 3.1 min, resulting in a mean effective exposure dose of 5.9 ± 2.3 mSv. There were no serious complications. During the mean follow-up periods of 11.4 months (range 6-19), clinical success rates following drainage were 72.5% (29/40), and ten cases (25%) had secondary surgical treatments.

CONCLUSION

CBCT with 3D virtual navigation is a feasible technique for PN with reasonable exposure dose and can serve as a second-line intervention after failed ultrasound guidance.