[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture

Objective: To assess the efficiency of dynamic contrast-enhanced ultrasonography (DCE-US) for percutaneous nephrolithotomy (PCNL) puncture, as in recent years US contrast agents (microbubbles) have been used safely for cardiovascular and liver diseases diagnosis, and also to identify complex renal c...

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Autor principal:	Jawad Feghali
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/b046c86b11524398a534b3eae8885252
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spelling	oai:doaj.org-article:b046c86b11524398a534b3eae88852522021-12-02T10:11:40Z[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture2090-598X10.1016/j.aju.2018.10.083https://doaj.org/article/b046c86b11524398a534b3eae88852522018-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18301773https://doaj.org/toc/2090-598XObjective: To assess the efficiency of dynamic contrast-enhanced ultrasonography (DCE-US) for percutaneous nephrolithotomy (PCNL) puncture, as in recent years US contrast agents (microbubbles) have been used safely for cardiovascular and liver diseases diagnosis, and also to identify complex renal cysts, thus could be used to better delineate the pyelocalyceal system during PCNL puncture and reduce the radiation exposure for medical staff and patients. Methods: A 40-year-old man with a history of thalassaemia trait, renal cysts, and bilateral renal staghorn stones was scheduled for right PCNL. A 6-F ureteric catheter was placed at the beginning of the procedure. Using a curvilinear US probe (frequency 4 Hz, mechanical index 0.4) and 18-G EchoTip® needle, renal access was established for the patient in prone position under general anaesthesia whilst slowly injecting three doses of 1.5 mL US contrast agent (Sonovue; prepared by mixing 5 mL sodium chloride 0.9% with 25 mg lyophilised powder) each followed by 5 mL physiological saline flush through the ureteric catheter to delineate the collecting system. Afterwards, pneumatic and ultrasonic lithotripsies were used. Results: The PCNL procedure was successful. The collecting system was successfully accessed through a lower calyx puncture. No blood transfusion was needed during or after the procedure (haemoglobin op <1 g/dL). The puncture time was 1.2 min, operating time 141 min, and fluoroscopy time was 3.1 min. There were no major complications or adverse effects. The patient was discharged 48 h after the procedure. Conclusion: DCE-US is a safe innovative technique that might be a good method to improve PCNL puncture, reduce radiation, and possibly reduce the risk of bleeding. Further randomised studies are needed to evaluate its benefits.Jawad FeghaliTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss , Pp S18- (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Jawad Feghali [36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
description	Objective: To assess the efficiency of dynamic contrast-enhanced ultrasonography (DCE-US) for percutaneous nephrolithotomy (PCNL) puncture, as in recent years US contrast agents (microbubbles) have been used safely for cardiovascular and liver diseases diagnosis, and also to identify complex renal cysts, thus could be used to better delineate the pyelocalyceal system during PCNL puncture and reduce the radiation exposure for medical staff and patients. Methods: A 40-year-old man with a history of thalassaemia trait, renal cysts, and bilateral renal staghorn stones was scheduled for right PCNL. A 6-F ureteric catheter was placed at the beginning of the procedure. Using a curvilinear US probe (frequency 4 Hz, mechanical index 0.4) and 18-G EchoTip® needle, renal access was established for the patient in prone position under general anaesthesia whilst slowly injecting three doses of 1.5 mL US contrast agent (Sonovue; prepared by mixing 5 mL sodium chloride 0.9% with 25 mg lyophilised powder) each followed by 5 mL physiological saline flush through the ureteric catheter to delineate the collecting system. Afterwards, pneumatic and ultrasonic lithotripsies were used. Results: The PCNL procedure was successful. The collecting system was successfully accessed through a lower calyx puncture. No blood transfusion was needed during or after the procedure (haemoglobin op <1 g/dL). The puncture time was 1.2 min, operating time 141 min, and fluoroscopy time was 3.1 min. There were no major complications or adverse effects. The patient was discharged 48 h after the procedure. Conclusion: DCE-US is a safe innovative technique that might be a good method to improve PCNL puncture, reduce radiation, and possibly reduce the risk of bleeding. Further randomised studies are needed to evaluate its benefits.
format	article
author	Jawad Feghali
author_facet	Jawad Feghali
author_sort	Jawad Feghali
title	[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
title_short	[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
title_full	[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
title_fullStr	[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
title_full_unstemmed	[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
title_sort	[36] dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/b046c86b11524398a534b3eae8885252
work_keys_str_mv	AT jawadfeghali 36dynamiccontrastenhancedultrasonographyforbetterpercutaneousnephrolithotomypuncture
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[36] Dynamic contrast-enhanced ultrasonography for better percutaneous nephrolithotomy puncture

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