Improvement of Sonographic Needle Visibility in Cirrhotic Livers during Transjugular Intrahepatic Portosystemic Stent-Shunt Procedures with Use of Real-Time Compound Imaging

The visibility of a transjugular intrahepatic portosystemic stent-shunt (TIPS) puncture needle was assessed with use of real-time compound imaging and single-line ultrasonography (US). In vitro and in vivo, needle–tissue contrast was calculated. With an increasing angle of incidence, the decrease in needle visibility was more pronounced for single-line US than for compound imaging. At angles of incidence of more than 30°, the needle was barely visible with either technique. Subjective evaluation during TIPS procedures in 10 patients proved that the needle tip was significantly better seen with compound imaging. Therefore, real-time compound imaging significantly improved contrast and subjective visibility of the needle.