The use of ultrasound contrast agent in ultrasound guided puncture and drainage of abscess

Purpose: The aim of the study was to evaluate the value of ultrasound contrast agent (UCA) in ultrasound (US) guided puncture and drainage of abscesses and assessing complications.

Patients and methods: 6 needle aspirations and 50 percutaneous drainages were performed on 52 patients (30 males and 22 females, age 60 ± 23 [12 – 89] years). UCA (0.1 ml of SonoVue® in 20 ml saline) was injected through the needle or catheter to confirm the correct insertion, to check the communication of cavities, and assessing complications.

Results: Using UCA, the success rate of puncture and catheter placement was 100%. There were 11/52 (21%) patients with complex abscesses (with septa), and 4/52 (8%) patients with multiple (two or more) abscesses. Injecting the UCA into the cavity showed the communication of cavities in 10 complex abscesses, and no communication of cavities in 1 patient who received two drainages. Communication was also found in 2 patients with 2 abscesses but not in 2 patients (one with 2 lesions, and the other with 3 lesions). Catheter dislodgement requiring replacement was found in 2 patients.

Conclusion: Extravascular contrast enhanced ultrasound could be an additional method to guide needle insertion and catheter placement, examining the communication of abscesses or cavities and assessing catheter dislodgement.

Key words: Abscess, drainage, ultrasound, microbubbles, complication