Kontrastmittelsonografische Drainagenkontrolle: eine Feasibility-Studie

Abstract

Liver abscesses still represent a life-threatening disease. Interventional abscess puncture and/or drainage are often the most adequate treatment. The aim of our study was the evaluation of drainage control with contrast-enhanced sonography. We included 15 patients in our feasibility study, three of whom had infected liver cysts, three had abscesses after liver resection or transplantation, six had intrahepatic abscesses and three had abscesses of other localisations. For drainage control with contrast-enhanced sonography we administered 1 mL of the contrast agent SonoVue® (Bracco, Germany) diluted in 10 mL of 0.9 % of NaCl through the indwelling drainage or an 18-G Chiba needle. A total of 28 sonographic controlled examinations was performed. The position of the drainage, as well as the size of the abscess itself could be demonstrated in all cases. Furthermore, possible septs or the communication of different abscess regions could be seen. Drainage remained in position for an average of 13.3 days. Assessment of drainage position and size of the abscess region is of clinical relevance. The main advantages of the described examination with contrast-enhanced sonography are the lack of radiation and the low costs due to the small amount of contrast medium used.

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)

“…Image-guided treatment of abscesses includes drainage with a needle or catheter, plus lavage [493]. Direct injection of a UCA through the needle or catheter has been reported to facilitate confirmation of correct needle or catheter position and allows evaluation of any communication between cavities in complex abscesses [493,513,536,537].…”

Intracavitary contrast-enhanced ultrasound in abscess drainage – feasibility and clinical value

“…Recently, the use of commercially available UCA (BR1 diluted in 10 ml of 0.9% of NaCl) was reported to monitor and guide abscess drainage (ICCEUS). Girlich et al reported the feasibility of this method to control the drainage in 2 patients with cysts and 13 patients with abscesses [19]. The current non-liver CEUS guideline of the European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) [3] refers to the method for abscess treatment.…”