Mayooran Kandasamy, Stanley Xue, Nigel McGregor, Hao Xiang
{"title":"通过将腔房交界位置与胸部 X 光地标进行比较,优化中心静脉导管的放置:使用 CT 胸部重建的横断面研究。","authors":"Mayooran Kandasamy, Stanley Xue, Nigel McGregor, Hao Xiang","doi":"10.1111/1754-9485.13741","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Central venous catheter (CVC) tip placement guided by chest X-ray (CXR) landmarks is currently prone to inconsistency and malpositioning. This study aims to better define the relationship between the cavoatrial junction (CAJ) and selected X-ray landmarks.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Chest CTs of 100 patients were retrospectively assessed. CT images were converted to a ‘virtual CXR’ using a digital workstation, enabling simultaneous localisation of the CAJ and evaluation of CXR landmarks. Vertical distances between the CAJ and selected landmarks were measured for each patient. Measurements were assessed for correlation with age and compared between age groups and sexes.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean vertical distance of the following landmarks above the CAJ was found: the carina (46.2 mm), the intersection of the bronchus intermedius and the right heart border (7.6 mm) and the superior inflection of the right heart border (Sup-RHB) (13.0 mm). The maximum lateral bulge of the right heart border (Lat-RHB) was 18.4 mm below the CAJ. A new landmark: the mid-superior right heart border, defined as the mid-point between the Sup-RHB and Lat-RHB, was the closest to the CAJ, lying 2.6 mm below the CAJ.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>We propose that the CVC tip can be placed at the mid-superior right heart border landmark.</p>\n </section>\n </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"667-672"},"PeriodicalIF":2.2000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimising central venous catheter placement by comparing cavoatrial junction position to chest X-ray landmarks: A cross-sectional study using CT chest reconstruction\",\"authors\":\"Mayooran Kandasamy, Stanley Xue, Nigel McGregor, Hao Xiang\",\"doi\":\"10.1111/1754-9485.13741\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Central venous catheter (CVC) tip placement guided by chest X-ray (CXR) landmarks is currently prone to inconsistency and malpositioning. This study aims to better define the relationship between the cavoatrial junction (CAJ) and selected X-ray landmarks.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Chest CTs of 100 patients were retrospectively assessed. CT images were converted to a ‘virtual CXR’ using a digital workstation, enabling simultaneous localisation of the CAJ and evaluation of CXR landmarks. Vertical distances between the CAJ and selected landmarks were measured for each patient. Measurements were assessed for correlation with age and compared between age groups and sexes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The mean vertical distance of the following landmarks above the CAJ was found: the carina (46.2 mm), the intersection of the bronchus intermedius and the right heart border (7.6 mm) and the superior inflection of the right heart border (Sup-RHB) (13.0 mm). The maximum lateral bulge of the right heart border (Lat-RHB) was 18.4 mm below the CAJ. A new landmark: the mid-superior right heart border, defined as the mid-point between the Sup-RHB and Lat-RHB, was the closest to the CAJ, lying 2.6 mm below the CAJ.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>We propose that the CVC tip can be placed at the mid-superior right heart border landmark.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16218,\"journal\":{\"name\":\"Journal of Medical Imaging and Radiation Oncology\",\"volume\":\"68 6\",\"pages\":\"667-672\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Imaging and Radiation Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1754-9485.13741\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Imaging and Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1754-9485.13741","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Optimising central venous catheter placement by comparing cavoatrial junction position to chest X-ray landmarks: A cross-sectional study using CT chest reconstruction
Introduction
Central venous catheter (CVC) tip placement guided by chest X-ray (CXR) landmarks is currently prone to inconsistency and malpositioning. This study aims to better define the relationship between the cavoatrial junction (CAJ) and selected X-ray landmarks.
Methods
Chest CTs of 100 patients were retrospectively assessed. CT images were converted to a ‘virtual CXR’ using a digital workstation, enabling simultaneous localisation of the CAJ and evaluation of CXR landmarks. Vertical distances between the CAJ and selected landmarks were measured for each patient. Measurements were assessed for correlation with age and compared between age groups and sexes.
Results
The mean vertical distance of the following landmarks above the CAJ was found: the carina (46.2 mm), the intersection of the bronchus intermedius and the right heart border (7.6 mm) and the superior inflection of the right heart border (Sup-RHB) (13.0 mm). The maximum lateral bulge of the right heart border (Lat-RHB) was 18.4 mm below the CAJ. A new landmark: the mid-superior right heart border, defined as the mid-point between the Sup-RHB and Lat-RHB, was the closest to the CAJ, lying 2.6 mm below the CAJ.
Conclusion
We propose that the CVC tip can be placed at the mid-superior right heart border landmark.
期刊介绍:
Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.