Usefulness of Real-Time Three-dimensional Ultrasound in Percutaneous Nephrostomy: An Animal Study.

Objectives To evaluate the effect of real-time three-dimensional (3D) ultrasonography (US) in guiding percutaneous nephrostomy (PCN). Materials and Methods A hydronephrosis model was devised in which the ureters of 16 beagles were obstructed. The beagles were divided equally into groups 1 and 2. In group 1, the PCN was performed using real-time 3D US guidance, while in group 2 the PCN was guided using two-dimensional (2D) US. Visualization of the needle tract, length of puncture time and number of puncture times were recorded for the two groups. Results In group 1, score for visualization of the needle tract, length of puncture time and number of puncture times were 3, 7.3 +/- 3.1 s and one time, respectively. In group 2, the respective results were 1.4 +/- 0.5, 21.4 +/- 5.8 s and 2.1 +/- 0.6 times. The visualization of needle tract in group 1 was superior to that in group 2, and length of puncture time and number of puncture times were both lower in group 1 than in group 2. Conclusions Real-time 3D US-guided PCN is superior to 2D US-guided PCN in terms of visualization of needle tract and the targeted pelvicalyceal system, leading to quick puncture. Real-time 3D US-guided puncture of the kidney holds great promise for clinical implementation in PCN.