Department of Radiology, Hallym University College of Medicine, Korea.
Published online: January 1, 2001.
ABSTRACT
PURPOSE: To evaluate the usefulness of ultrasound as a guiding tool in percutaneous catheter drainage (PCD) of intra-thoracic or abdominal fluid collections. MATERIALS & METHODS: Seventy three PCDs were performed for intrathoracic(n=44) and abdominal(n=29) abscesses or fluid collections by using ultrasound(US) as a sole guidance with free hand and modified Seldinger techniques. The losions were free pleural effusion in five cases, localized pleural effusion or empyema in 39, liver abscess or hematoma in 15, intraperitoneal abscess or localized fluid colloction in 10, massive ascites and retroperitoneal abscess in two, respetively. We evaluated the success rate of catheter insertion, the confirmation rate of catheter tip on post-procedure US, the complication and cure rates of drainage. RESULTS: Of the 73 cases, 72 catheters (98.7%) were successfully inserted. Among them, 67 catheter tips (91.8%) were confirmed on post-procedure US, which were seen as "parallel double lines" within fluid collections, however, five catheter tips (6.6%) were not visualized due to inoculated air bubbles during procedures. Catheter insertion was failed in one case(13%), in which the catheter tip was malpositioned through the small intestinal wall and seen as a "single dot" on post-procedure US. Complications were pain in two, hemorrhage and perforation in one, respetively. The duration of drainge ranged from 1 to 60 days(mean 10.9 days). Of the 73 cases, 57(78.1%) were cured, 9(12.3%) were partially improved, tow (2.7%) were failed to drain, and five were lost to follow-up. CONCLUSION: Ultrasound is an useful guiding tool with high success (98.7%) and low complication rates(5.4%), and comparable cure rate (78.1%) as compared with other guiding modalities in PCD.
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