Abstract
An ultrasonic needle-actuating device for tissue biopsy and regional anaesthesia offers enhanced needle visibility with color Doppler imaging. However, its specific performance is not yet fully determined. This work investigated the influence on needle visibility of the insertion angle and drive voltage, as well as determined the accuracy and agreement of needle tip localization by comparing color Doppler measurements with paired photographic and B-mode ultrasound measurements. Needle tip accuracy measurements in a gelatin phantom gave a regression trend, where the slope of trend is 0.8808; coefficient of determination (R2) is 0.8877; bias is −0.50 mm; and the 95% limits of agreement are from −1.31 to 0.31 mm when comparing color Doppler with photographic measurements. When comparing the color Doppler with B-mode ultrasound measurements, the slope of the regression trend is 1.0179; R2 is 0.9651; bias is −0.16 mm; and the 95% limits of agreement are from −1.935 to 1.605 mm. The results demonstrate the accuracy of this technique and its potential for application to biopsy and ultrasound guided regional anaesthesia.
Highlights
The ultrasound guidance of needle-based regional anaesthesia and tissue biopsy is widely used clinically [1,2]
An inaccurate needle placement increases the risk of adverse results, such as inadequate anaesthesia, bleeding and nerve damage during regional anaesthesia, as well as mis-sampling and misdiagnosis during biopsy [9,10]
The benefits of utilizing color Doppler imaging with the ColorMark device (ColorMark, EchoCath Inc., Princeton, NJ, USA) in percutaneous needle procedures were reported in the studies of Feld and Jones [18,19,20]
Summary
The ultrasound guidance of needle-based regional anaesthesia and tissue biopsy is widely used clinically [1,2]. Echogenic needles were designed and fabricated to increase the intensity of backscattering ultrasound echoes [10] All of these technologies have shown specific advantages to improve needle visibility, but they all suffer from limitations and require further development. The benefits of utilizing color Doppler imaging with the ColorMark device (ColorMark, EchoCath Inc., Princeton, NJ, USA) in percutaneous needle procedures were reported in the studies of Feld and Jones [18,19,20] They reported that color Doppler generated a color image of a vibrating biopsy needle and its tip, as well as improved confidence in detecting a needle, compared with real-time B-mode imaging. The ultrasound-actuated needle with color Doppler imaging is a promising solution for poor needle visibility, but its specific performance is not yet fully determined, for instance the variation of needle visibility caused by the insertion angle. The primary aim of this work was to investigate the influence on needle visibility of the insertion angle and drive voltage, as well as to determine the needle tip accuracy under color Doppler guidance
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