Intracavitary Contrast-enhanced Ultrasound in Ultrasound-guided Percutaneous Management of Abdominal Fluid Collections/abscesses by a Single Clinician: an Example of Point-of-care Ultrasound

Overview

Journal J Ultrasound

Publisher Springer

Specialty Radiology

Date 2020 May 4

PMID 32361920

Citations 5

Authors

Giampiero Francica

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses.

Methods: In 43 patients (27 M/16 F, median age 68 years, range 35-91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0.1-0.2 mL of SonoVue in 20 mL of saline) was carried out during catheter/needle placement and during the follow-up for catheters left in place.

Results: Immediate IC-CEUS allowed to verify the (1) correct positioning of the needle/catheter inside the target in all cases and (2) communication with adjacent structures so as to choose a proper treatment in 21% of the cases. Follow-up IC-CEUS aided in the management of 40 catheters left in place. Appropriate treatment was implemented in 19.3% of the cases because of the presence of biliary fistulas and gallbladder perforation. IC-CEUS helped the physician with the appropriate timing of catheter removal by providing information on catheter malfunction (due to obstruction/dislodgement) and the size of residual undrained cavities. No side effects were registered following IC-CEUS.

Conclusion: Even if not strictly performed at bedside, IC-CEUS may represent an example of point-of-care ultrasound since it allows an interventional clinician to assess needle/catheter placement success, make treatment decisions, and choose the optimal timing for catheter removal with low costs and without side effects.

Citing Articles

Intraluminal Contrast-Enhanced Ultrasonography Application in Dogs and Cats.

Chhoey S, Kim S, Kim E, Lee D, Kang K, Keo S Vet Sci. 2024; 11(9).

PMID: 39330822 PMC: 11436020. DOI: 10.3390/vetsci11090443.

Utility of Contrast-Enhanced Ultrasound in Optimizing Hepatic Abscess Treatment and Monitoring.

Dobek A, Kobierecki M, Kosztowny K, Grzasiak O, Fabisiak A, Falenta K J Clin Med. 2024; 13(17).

PMID: 39274258 PMC: 11396598. DOI: 10.3390/jcm13175046.

The Diagnosis and Treatment of Acute Cholecystitis: A Comprehensive Narrative Review for a Practical Approach.

Mencarini L, Vestito A, Zagari R, Montagnani M J Clin Med. 2024; 13(9).

PMID: 38731224 PMC: 11084823. DOI: 10.3390/jcm13092695.

Critical Advances for Democratizing Ultrasound Diagnostics in Human and Veterinary Medicine.

El Kaffas A, Vo-Phamhi J, Griffin J, Hoyt K Annu Rev Biomed Eng. 2024; 26(1):49-65.

PMID: 38166185 PMC: 11238906. DOI: 10.1146/annurev-bioeng-110222-095229.

Update in Contrast-Enhanced Ultrasound.

Beckmann S, Simanowski J Visc Med. 2021; 36(6):476-486.

PMID: 33447604 PMC: 7768106. DOI: 10.1159/000511352.

References

Sidhu P, Cantisani V, Dietrich C, Gilja O, Saftoiu A, Bartels E . The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Short Version). Ultraschall Med. 2018; 39(2):154-180. DOI: 10.1055/s-0044-101254. View

Sabatino V, Caramia M, Curatola A, Vassallo F, Deidda A, Cinicola B . Point-of-care ultrasound (POCUS) in a remote area of Sierra Leone: impact on patient management and training program for community health officers. J Ultrasound. 2020; 23(4):521-527. PMC: 7588568. DOI: 10.1007/s40477-019-00426-w. View

Francica G, Meloni M, de Sio I, Terracciano F, Caturelli E, Riccardi L . Biopsy of Liver Target Lesions under Contrast-Enhanced Ultrasound Guidance - A Multi-Center Study. Ultraschall Med. 2017; 39(4):448-453. PMC: 6405338. DOI: 10.1055/s-0043-122496. View

Meloni M, Smolock A, Cantisani V, Bezzi M, DAmbrosio F, Proiti M . Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors. Eur J Radiol. 2015; 84(9):1666-74. DOI: 10.1016/j.ejrad.2015.06.004. View

Girlich C, Buttner R, Schacherer D, Klebl F . [Contrast-enhanced sonographic drainage control: a feasibility study]. Z Gastroenterol. 2011; 49(11):1470-4. DOI: 10.1055/s-0031-1281579. View

Dietrich C, Goudie A, Chiorean L, Cui X, Gilja O, Dong Y . Point of Care Ultrasound: A WFUMB Position Paper. Ultrasound Med Biol. 2016; 43(1):49-58. DOI: 10.1016/j.ultrasmedbio.2016.06.021. View

Mauri G, Porazzi E, Cova L, Restelli U, Tondolo T, Bonfanti M . Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. Insights Imaging. 2014; 5(2):209-16. PMC: 3999370. DOI: 10.1007/s13244-014-0315-7. View

Kessner R, Nakamoto D, Kondray V, Partovi S, Ahmed Y, Azar N . Contrast-Enhanced Ultrasound Guidance for Interventional Procedures. J Ultrasound Med. 2019; 38(10):2541-2557. DOI: 10.1002/jum.14955. View

Sparchez Z, Mocan T, Hagiu C, Kacso G, Zaharie T, Rusu I . Real-Time Contrast-Enhanced-Guided Biopsy Compared with Conventional Ultrasound-Guided Biopsy in the Diagnosis of Hepatic Tumors on a Background of Advanced Chronic Liver Disease: A Prospective, Randomized, Clinical Trial. Ultrasound Med Biol. 2019; 45(11):2915-2924. DOI: 10.1016/j.ultrasmedbio.2019.07.678. View

10.

Arienti V, Camaggi V . Clinical applications of bedside ultrasonography in internal and emergency medicine. Intern Emerg Med. 2010; 6(3):195-201. DOI: 10.1007/s11739-010-0424-3. View

11.

Lorentzen T, Nolsoe C, Ewertsen C, Nielsen M, Leen E, Havre R . EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (long Version). Ultraschall Med. 2015; 36(5):E1-14. DOI: 10.1055/s-0035-1553593. View

12.

Ignee A, Schuessler G, Cui X, Dietrich C . [Intracavitary contrast medium ultrasound - different applications, a review of the literature ad future prospects]. Ultraschall Med. 2013; 34(6):504-25. DOI: 10.1055/s-0033-1335546. View

13.

Muller T, Blank W, Leitlein J, Kubicka S, Heinzmann A . Endocavitary contrast-enhanced ultrasound: a technique whose time has come?. J Clin Ultrasound. 2014; 43(2):71-80. DOI: 10.1002/jcu.22250. View

14.

Solomon S, Saldana F . Point-of-care ultrasound in medical education--stop listening and look. N Engl J Med. 2014; 370(12):1083-5. DOI: 10.1056/NEJMp1311944. View

15.

Ignee A, Jenssen C, Cui X, Schuessler G, Dietrich C . Intracavitary contrast-enhanced ultrasound in abscess drainage--feasibility and clinical value. Scand J Gastroenterol. 2015; 51(1):41-7. DOI: 10.3109/00365521.2015.1066423. View

16.

Claudon M, Dietrich C, Choi B, Cosgrove D, Kudo M, Nolsoe C . Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2012; 39(2):187-210. DOI: 10.1016/j.ultrasmedbio.2012.09.002. View

17.

Heinzmann A, Muller T, Leitlein J, Braun B, Kubicka S, Blank W . Endocavitary contrast enhanced ultrasound (CEUS)--work in progress. Ultraschall Med. 2011; 33(1):76-84. DOI: 10.1055/s-0031-1299056. View

18.

Nolsoe C, Nolsoe A, Klubien J, Pommergaard H, Rosenberg J, Meloni M . Use of Ultrasound Contrast Agents in Relation to Percutaneous Interventional Procedures: A Systematic Review and Pictorial Essay. J Ultrasound Med. 2017; 37(6):1305-1324. DOI: 10.1002/jum.14498. View

19.

Francica G, Meloni M, Riccardi L, de Sio I, Terracciano F, Caturelli E . Ablation treatment of primary and secondary liver tumors under contrast-enhanced ultrasound guidance in field practice of interventional ultrasound centers. A multicenter study. Eur J Radiol. 2018; 105:96-101. DOI: 10.1016/j.ejrad.2018.05.030. View

20.

Moore C, Copel J . Point-of-care ultrasonography. N Engl J Med. 2011; 364(8):749-57. DOI: 10.1056/NEJMra0909487. View