Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
Radiol Med. 2017 Aug;122(8):557-563. doi: 10.1007/s11547-017-0751-9. Epub 2017 Mar 22.
To evaluate the feasibility of flat detector cone beam computed tomography (CBCT)-guided nephrostomy using virtual navigation in patients with iatrogenic ureteral injury.
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.
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.
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.
评估在医源性输尿管损伤患者中使用虚拟导航的平板探测器锥形束 CT（CBCT）引导经皮肾造瘘术的可行性。
回顾性分析了 40 例（42 例）因医源性输尿管损伤而行经皮肾造瘘术（PN）的患者，均采用 CBCT 联合 3D 虚拟导航引导。所有手术均为超声引导经皮肾造瘘术失败后的二线干预。收集了技术成功率、手术时间、穿刺性能、辐射暴露、并发症和临床成功率等数据。
技术成功率为 95.2%（40/42）。平均穿刺性能评分为 4.4±1.0，手术时间为 25.2±3.1 分钟，有效辐射剂量为 5.9±2.3 mSv。无严重并发症。在平均 11.4 个月（6-19 个月）的随访期间，引流后的临床成功率为 72.5%（29/40），10 例（25%）需要二次手术治疗。
CBCT 联合 3D 虚拟导航是一种可行的 PN 技术，具有合理的辐射剂量，可以作为超声引导失败后的二线干预措施。
