Contrast-Enhanced Ultrasound: A Real-Time, Noninvasive, Radiation-Free Method for Intraoperative Male Urethral Fistula Assessment

IF 2.1 4区医学 Q2 ACOUSTICS Journal of Ultrasound in Medicine Pub Date : 2024-08-03 DOI:10.1002/jum.16525

Qijie Lu MD, Wei Liu MBBS, Lei Chen PhD

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Abstract

Objectives

To evaluate the feasibility of intraoperative transurethral contrast-enhanced ultrasound for the assessment of male urethral fistulas.

Methods

Patients in a prospective database who underwent intraoperative two-dimensional ultrasound, transurethral saline-enhanced ultrasound, and contrast-enhanced ultrasound between January 2017 and July 2022 were included. All patients were clinically diagnosed with urethral fistulae (UF) in the outpatient setting based on clinical presentations, traditional two-dimensional ultrasound, and/or other imaging modalities and confirmed during surgical repair. Dynamic videos of the scans were independently analyzed by two experienced ultrasonologists.

Results

Thirty-nine patients with an average age of 51 years were included. The UF were located in the anterior urethra in 22 (56.4%) patients and in the bulbar urethra in 14 (63.6%) patients. UF were located in the posterior urethra in 17 (436%) patients and in the prostatic urethra in 13 (76.5%) patients. Contrast-enhanced ultrasonography revealed UF in all patients. In patients with anterior UF, saline-enhanced ultrasound images did not show a UF in 15 (68.2%, 15/22) patients, 13 (86.7%, 13/15) of whom had fistulae with diameters <3 mm. Saline-enhanced ultrasound images did not reveal posterior UF in 13 (76.5%, 13/17) patients. The fistula diameters in eight (61.5%, 8/13) patients were <3 mm. The duration for contrast-enhanced ultrasonography was approximately 3 minutes. The duration for surgical repair was approximately 2 hours.

Conclusions

Transurethral contrast-enhanced ultrasound is a real-time, noninvasive, and radiation-free method that allows intraoperative imaging and accurate assessment of male UF. Its sensitivity is higher than that of both two-dimensional ultrasound and transurethral saline-enhanced ultrasound. The location, size, and course of the fistulae can be clearly seen due to greater contrast during contrast-enhanced ultrasound.

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对比增强超声波：用于男性尿道瘘术中评估的实时、无创、无辐射方法。

目的：评估术中经尿道造影剂增强超声波评估男性尿道瘘的可行性：评估术中经尿道造影剂增强超声评估男性尿道瘘的可行性：纳入前瞻性数据库中2017年1月至2022年7月期间接受术中二维超声、经尿道盐水增强超声和造影剂增强超声检查的患者。所有患者均在门诊根据临床表现、传统二维超声和/或其他成像方式临床诊断为尿道瘘（UF），并在手术修复过程中得到确认。扫描的动态视频由两名经验丰富的超声波专家独立分析：共纳入 39 名患者，平均年龄 51 岁。22例（56.4%）患者的UF位于前尿道，14例（63.6%）患者的UF位于球部尿道。17例（436%）患者的尿道前列腺增生位于后尿道，13例（76.5%）患者的尿道前列腺增生位于前列腺尿道。对比增强超声波检查显示所有患者都有尿道前列腺增生症。在前尿道瘘患者中，15 名（68.2%，15/22）患者的盐水增强超声图像未显示尿道瘘，其中 13 名（86.7%，13/15）患者的瘘管直径得出结论：经尿道造影剂增强超声是一种实时、无创、无辐射的方法，可在术中成像并准确评估男性尿道瘘。其灵敏度高于二维超声和经尿道盐水增强超声。由于对比度增强超声波的对比度更高，因此可以清楚地看到瘘管的位置、大小和走向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound