Background: In ultrasonically guided percutaneous transhepatic biliary drai
nage, we often can recognize hyperechoic lines at the tip of the needle whe
n the duct is penetrated successfully. We evaluated the frequency of this p
henomenon and analyzed whether it was a useful sign for confirming successf
ul bile duct puncture.
Methods: In 65 patients with biliary tract diseases, 84 catheters were plac
ed in the course of 108 attempts at puncture. Results of puncture and the p
resence of hyperechoic lines were investigated prospectively.
Results: When the ultrasonographic findings showed hyperechoic lines, succe
ssful puncture was significantly more frequent than when the findings did n
ot show hyperechoic lines (53/55, 96%, vs. 31/59, 53%; p < 0.0001). When we
judged the hyperechoic lines as the sign of successful puncture, the sensi
tivity, specificity, positive predictive value, negative predictive value,
and accuracy were 63%, 93%, 96%, 48%, and 71%, respectively.
Conclusion: Hyperechoic lines are a useful confirmatory sign of successful
puncture. However, absence of these lines was not invariably associated wit
h unsuccessful puncture.