心嚢・胸水・腹水ドレナージのtips

Tips for pericardial, pleural, and ascites drainage

画像ガイド下穿刺ドレナージは，非侵襲的な治療として，施設ごとに各医師の裁量に基づき施行される比較的一般的な手技である。しかし，明確に確立された技法は存在せず，詳細な技術に関するガイドラインも存在しないため，手技内容には施設間格差を生じているのが現状である。

Drainage of pericardial, pleural, and ascites effusions is often performed in various departments, but since unexpected complications sometimes occur, it is necessary to acquire correct puncture techniques based on an understanding of imaging anatomy. For more difficult procedures, it is important for interventional radiologists to learn safe and effective techniques with fewer complications, and to improve the quality of care as a leader at each facility. In principle, so-called “blind puncture,” in which puncture is performed using the body surface as a merkmal, should be avoided except in emergency situations. This article outlines the TIPS of image-guided puncture drainage techniques, device selection, and the usefulness of the imaging equipment used, especially CT-guided puncture drainage, according to the clinical condition, with appropriate imaging.