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CEUS-guided nephrostomy puncture. A CEUS and B grayscale images before access into the collecting system was obtained. The stylet of the access needle for nephrostomy puncture was removed and the lumen of the needle was pre-filled with a small drop of diluted microbubble UCA. C CEUS and D grayscale US images obtained immediately after the collecting system is punctured. Microbubbles are visualized in the renal collecting system (red arrow) the instance the successful puncture is made
