Role of Doppler Navigation in Minimally Invasive Procedures under Ultrasound Guidance

Abstract

Aim: To highlight the possibilities of Doppler methods to optimize navigation and control of percutaneous echo-controlled minimally invasive interventions. Study Design: 25,543 diagnostic and therapeutic minimally invasive interventions were carried out on organs and tissues of different localizations. Place and Duration of Study: Department of Oncology and Radiology, M. Gorky Donetsk National Medical University, Ukraine. 25,543 diagnostic and therapeutic minimally invasive interventions (2004-2013). Methodology: Ten years of experience in carrying out percutaneous minimally invasive interventions under ultrasound guidance using Doppler modes. Fine needle aspiration and core needle biopsy, drainage, etc of different organs and tissues, effectiveness of optimization methods of visualization and analysis of results of their use in minimally invasive treatment of liver abscesses under US control, comparative analysis of main and control groups were carried out using student t-test and chi square - χ2. Ultrasound scanners used: Dornier AI 5200, Philips HDI 5000, Toshiba Aplio 500), probes - linear (7.5 MHz), convex (3.5-5.0 MHz). Paramount was the safety of minimally invasive procedure in visualizing instrument used. Results: It was established that optimal was the power Doppler mode for navigation in percutaneous interventions, prevent hemorrhagic complications, select a safe acoustic window, which improved the location of fluid motion in the hollow needle and visualization of the biopsy instrument based on initiation of twinkling artifact. The use of developed methods to improve ultrasound visualization in minimally invasive treatment of liver abscesses significantly reduced pain - 12.9%, avoided haemorrhage and leakage of pus into peritoneal cavity, reduced the number of inadequate drainages - 36.6%, reduced the duration of inpatient treatment - 2.2 times. Conclusion: It was established that use of power Doppler mode enhances the effectiveness and safety of percutaneous ultrasound-guided interventions. Thus, the studies confirmed the clinical use of optimization techniques of visualization in minimally invasive procedures under ultrasound guidance.