Percutaneous transhepatic contrast-enhanced cholangio-ultrasonography:methodology and significances / 中华超声影像学杂志

ABSTRACT

Objective To establish the method and assess the safety，feasibility and clinical efficacies of percutaneous transhepaticcontrast-enhancedcholangio-ultrasonography(PTCECUS).Methods Twenty-one patients aged(58.5±16.65)years(range 27-93)with biliary obstruction or stricture underwent percutaneous transhepatic cholangiodrainage or ch01ecystodrainage.A dose of more than 50 ml of 0.94% Sono Vue(Bracco，Itay)solution was injected into their bile ducts(n=17)and cholecysts(n=4)through the drainage catheter.Their biliary tracts，cholecysts and duodenums were scanned under contrast pulsed sequencing mode(CPS，Sequoia 512，Siemens)to achieve related contrast-enhanced ultrasonograms.Severity of biliary obstruction were assessed according to the PTCECUS findingswith a comparison toconventionalultrasonography(CVUS)，magnetic resonance cholangiopancreatography(MRCP)and percutaneous transhepatic cholangiography(PTC)in a part of the patients.Results①PTCECUS gave rise to good-quality contrast-enhanced uhrasonograms of biliary tracts.②PTCECUS was superior to CVUS and in consistence with MRCP and PTC in evaluating the severity of biliary tract obstruction.This method helped to make a proper design for biliary drainage.③PTCECUS was more efficient than PTC in that PTC had the patients receive transhepatic puncture and cholangiography in separated departments.④Neither any complications immediate from transhepatic puncture and administration of SonoVue inall the 21 patients，nor those 1 to 8 months late during ultrasound follow up in 14 patients were found.Conclusions PTCECUS，characterized in bettering the display of biliary tracts，especially the severity of obstruction of biliary tracts，is safe through the procedure and valuable in supervising biliary drainage against obstructive jaundice.