Value of projectional imaging relative to cross-sectional imaging to assess catheter tip position in the superior vena cava: evaluation of reader variability.

Détails

Ressource 1Télécharger: tqae218.pdf (1529.50 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_5B13D72E5C1C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Value of projectional imaging relative to cross-sectional imaging to assess catheter tip position in the superior vena cava: evaluation of reader variability.
Périodique
The British journal of radiology
Auteur⸱e⸱s
Gullo G., Rotzinger D.C., Frossard P., Colin A., Saliou G., Qanadli S.D.
ISSN
1748-880X (Electronic)
ISSN-L
0007-1285
Statut éditorial
Publié
Date de publication
01/02/2025
Peer-reviewed
Oui
Volume
98
Numéro
1166
Pages
237-245
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The cavo-atrial junction (CAJ) is the most appropriate central venous catheters CVC tip location to reduce complications. Among chest X-ray (CXR) landmarks for tips assessment, only the pericardial reflection lies in the same plane as the vascular structures. We aimed to evaluate the observer variability to determine tip positioning on CXR, using CT as a gold standard.
We retrospectively analyzed 107 CT scans of patients with port catheters (January-December 2021). The tip to CAJ distance (DCAJ) was measured on both projectional (PJ) and cross-sectional (CS) CT images by 2 × 2 observers (within and between evaluations). Observational statistics included paired t-tests, repeatability coefficients (RC), and intraclass correlation coefficients (ICC), with data visualized using Bland-Altman plots.
All ICC were >0.9, indicating excellent reliability. The mean difference between observers comparing CS and PJ was 0.13 ± 0.80 cm (P = .10) with outer 95% confidence limits of 1.92 cm and -2.17 cm and an RC of 1.79 cm.
CXR provides a reliable method for CVC tip localization, though assessment variability is ±2 cm.
CXR assessment of CVC tips shows both intra- and inter-individual variability, due to challenges in identifying the CAJ and catheter tip . While considering the 3 cm anatomical zone around the CAJ acceptable, operators should be aware of the 2 cm variability resulting from CXR assessment. To account for this variability and avoid the risk of positioning the tip beyond 3 cm from the CAJ, operators should reduce the CXR-based acceptable zone to 1 cm around the CAJ, impacting approximately 30% of procedures.
Mots-clé
Humans, Vena Cava, Superior/diagnostic imaging, Retrospective Studies, Female, Male, Central Venous Catheters, Middle Aged, Tomography, X-Ray Computed/methods, Observer Variation, Catheterization, Central Venous/methods, Aged, Reproducibility of Results, Radiography, Thoracic/methods, Adult, X-ray computed, central venous catheters, consensus, observer variation, radiography, superior, thoracic, tomography scanners, vena cava
Pubmed
Web of science
Open Access
Oui
Création de la notice
01/11/2024 15:33
Dernière modification de la notice
07/02/2025 7:29
Données d'usage