Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Eur Radiol. 2021 Sep;31(9):6736-6746. doi: 10.1007/s00330-021-07804-1. Epub 2021 Feb 26.
To compare the safety, effectiveness, and feasibility of contrast-enhanced ultrasound (CEUS) versus conventional ultrasound-guided percutaneous nephrolithotomy (PCNL) in patients with nondilated collecting system.
Between July 2018 and July 2020, 160 kidney stone patients with nondilated collecting system planned for PCNL were randomly assigned into two groups, CEUS with retrograde ureteral contrast injection and conventional ultrasound with retrograde ureteral normal saline injection. Patient's demographics, the success rate of puncture, success rate of a single-needle puncture, number of punctures, puncture time, perioperative outcomes, stone-free rate, and incidence of complications were compared.
The success rate of a single-needle puncture for CEUS-guided PCNL was higher than that in the conventional ultrasound group (88.5% vs. 73.7%, p = 0.02). Patients performed with CEUS-guided PCNL required less needle passes (p = 0.02), shorter needle puncture time (p = 0.031), and shorter channel establishment time (p = 0.04) than those guided with conventional ultrasound. The postoperative hemoglobin decrease in the CEUS-guided PCNL group was less than that of the control group (p = 0.02). There was no significant difference in operating time, length of hospital stays, kidney function change, and complications between the two groups (p > 0.05). The 1-month stone-free rate was 94.9% in the CEUS group and 90.8% in the control group (p > 0.05).
Compared with conventional ultrasound, CEUS-guided PCNL may facilitate ultrasound-guided PCNL for patients without hydronephrosis, and benefited with a higher success rate of a single-needle puncture, less needle passes, shorter puncture time, and lower postoperative Hb drop.
Chinese Clinical Trial Registry: ChiCTR1800016981 KEY POINTS: • Compared with conventional ultrasound, CEUS-guided PCNL is a safe and efficacious procedure for kidney stone patients with nondilated collecting system. • Compared with conventional ultrasound, CEUS-guided PCNL benefited with a higher success rate of a single-needle puncture, less needle passes, shorter puncture time, and lower postoperative Hb drop. • CEUS-guided PCNL associated with the more accurate needle puncture and acceptable complications.
比较对比增强超声（CEUS）与传统超声引导经皮肾镜取石术（PCNL）在非扩张集合系统患者中的安全性、有效性和可行性。
2018 年 7 月至 2020 年 7 月，160 例非扩张性集合系统肾结石患者拟行 PCNL，随机分为两组，CEUS 逆行输尿管造影组和传统超声逆行输尿管生理盐水注射组。比较两组患者的一般资料、穿刺成功率、单次穿刺成功率、穿刺次数、穿刺时间、围手术期结果、结石清除率和并发症发生率。
CEUS 引导 PCNL 的单次穿刺成功率高于传统超声组（88.5% vs. 73.7%，p = 0.02）。CEUS 引导 PCNL 组所需的穿刺针数更少（p = 0.02）、穿刺时间更短（p = 0.031）、通道建立时间更短（p = 0.04）。与传统超声组相比，CEUS 引导 PCNL 组术后血红蛋白下降更少（p = 0.02）。两组手术时间、住院时间、肾功能变化及并发症发生率差异无统计学意义（p > 0.05）。CEUS 组术后 1 个月结石清除率为 94.9%，对照组为 90.8%（p > 0.05）。
与传统超声相比，CEUS 引导 PCNL 可能有利于无肾积水患者的超声引导 PCNL，具有更高的单次穿刺成功率、更少的穿刺次数、更短的穿刺时间和更低的术后 Hb 下降。
中国临床试验注册中心：ChiCTR1800016981
与传统超声相比，CEUS 引导 PCNL 是一种安全有效的非扩张性集合系统肾结石患者的治疗方法。
与传统超声相比，CEUS 引导 PCNL 具有更高的单次穿刺成功率、更少的穿刺次数、更短的穿刺时间和更低的术后 Hb 下降。
CEUS 引导 PCNL 与更准确的穿刺针和可接受的并发症相关。
