Document Detail


Central venous line placement in the superior vena cava and the azygos vein: differentiation on posteroanterior chest radiographs.
MedLine Citation:
PMID:  21427325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine, first, the accuracy with which radiologists reading posteroanterior chest radiographs differentiate whether a central venous line is in the superior vena cava or the azygos vein and, second, the circumstances in which radiologists may omit the lateral view to determine the position of a central venous line.
MATERIALS AND METHODS: Twenty-four radiologists evaluated 60 posteroanterior chest radiographs to determine the position of a central venous line in the superior vena cava or azygos vein. Investigators evaluated the appearance of the central venous lines to refine rules for determining central venous line position on a frontal radiograph and omitting the lateral view.
RESULTS: The accuracy of posteroanterior radiography for determining central venous line position was 90% at one study location and 85.5% at the other. No central venous line in the azygos vein extended more than 10.9 mm caudal to the cephalic edge of the right main bronchus. No central venous line in the superior vena cava had a down-the-barrel or curved appearance at the caudal edge.
CONCLUSION: For central venous lines extending at least 15 mm caudal to the cephalic edge of the right main bronchus and having no down-the-barrel or curved caudal appearance, categorization was nearly 100% accurate. Therefore, if desired to save radiation exposure and cost, it may be feasible to omit lateral views in radiography of patients with central venous lines extending at least 15 mm caudal to the cephalic edge of the right main bronchus in whom the caudal edge does not have a down-the-barrel or curved appearance.
Authors:
Tamara Miner Haygood; Patrick C Brennan; John Ryan; Jose-Miguel Yamal; Lindsay Liles; Paul O'Sullivan; Colleen M Costelloe; Nancy E Fitzgerald; William A Murphy
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  196     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-23     Completed Date:  2011-06-02     Revised Date:  2014-03-13    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  783-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Azygos Vein / radiography*
Catheterization, Central Venous*
Humans
Ireland
ROC Curve
Radiography, Thoracic*
Radiology Information Systems
United States
Vena Cava, Superior / radiography*
Grant Support
ID/Acronym/Agency:
P30 CA016672/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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