RadioGraphics, Vol 16, 747-754, Copyright © 1996 by Radiological Society of North America
Interpreting the results of pediatric central venous catheter studies
FM Kim, PE Burrows, FA Hoffer and T Chung
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.
Radiographic evaluation of central venous catheters (CVCs) with contrast
material is a commonly performed procedure in pediatric radiology, but the
criteria for interpreting the results of such studies are not well
described in the literature. Careful evaluation of the images from a
contrast material-enhanced CVC study frequently demonstrates a cause of CVC
malfunction. In a series of 166 contrast- enhanced CVC studies performed in
children, 112 studies (67%) demonstrated abnormal results. The most common
abnormalities were mural thrombus, catheter tip thrombus, catheter tip
against the vessel wall, and sleeve thrombus. Other causes of catheter
malfunction include reservoir thrombus, catheter break, and catheter
malposition. When catheter malfunction is due to catheter thrombus
formation, the patient is usually treated with urokinase (bolus injection
or infusion). Short catheters that ended in the innominate or subclavian
vein had a much higher frequency of abnormalities than longer catheters
that ended in the superior vena cava or right atrium.
