Pericardial effusions in infants and children: injection of echo contrast medium enhances the safety of echocardiographically-guided pericardiocentesis

Optimal set-up for ultrasound guided punctures using new scanner applications: an in-vitro study

OBJECTIVE

To investigate if US-visualisation of the needle tip echo during US-guided punctures could be improved by use of new technological applications.

METHOD

an US-guided 18 G Trocar needle was inserted into targets of a puncture phantom. The punctures were performed in series of 10 using different settings of the US-scanner (GE Logic 700 Expert). At 7-cm of puncture depth the quality of the echo was tested using four different settings; normal (N), N + automatic tissue optimising (ATO), coded harmonic imaging (CHI), CHI + ATO and at 13-cm of puncture depths six different settings; N, N + ATO, coded excitation (CE), CE+ATO, CHI, CHI+ATO. In total 100 (40 + 60) images were randomly numbered and read independently by three radiologists with regard to scoring of the quality of the echoes from the needle tip, needle shaft and the target.

RESULTS

US visualisation of the needle tip was significantly (P < 0.005) improved as compared to normal settings (N) when the settings of ATO and CE were used. CHI resulted in the lowest score. A high agreement between observers was registered. Similar results were registered with regard to scorings from the needle shaft and target.

CONCLUSION

Not only changes of needle designs and puncture techniques can enhance echoes from the needle but also changes in the settings of the US-scanner with the use of new technological applications can improve visualisation of the needle echo.