Ahn Sanghyun, Chung Jae Hee
Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul - Korea.
J Vasc Access. 2015 Sep-Oct;16(5):399-402. doi: 10.5301/jva.5000393. Epub 2015 Apr 27.
In this study, we analyzed the thin-section pulmonary computed tomographic (CT) angiogram scans of pediatric patients to determine the normative length of superior vena cava (SVC) and the distance between carina and cephalad of SVC or cavocatrial junction.
Consecutive child patients, under 13 years of age in whom the central catheters were inserted under ultrasound guidance from December 2004 to April 2005 were evaluated retrospectively.
In the 14 cases, the mean age was 7.2 ± 4.21 years. The mean length and diameter of the SVC in the pediatric patients were 45.6 ± 23.03 and 13.7 ± 3.62 mm, respectively. The distance from the carina to the cavoatrial junction was 22.0 ± 9.98 mm. The mean distance from the superior margin of the SVC to the carina was 23.7 ± 16.70 mm. The mean distance from the carina to the catheter tip was 38.9 ± 18.60 mm. In no case was the cavoatrial junction cephalad with respect to the carina. Carina to cavoatrial junction junction was significantly associated with age, height, and weight, respecitively (r = 0.750; p = 0.005, r = 0.763; p = 0.004; r = 0.777; p = 0.003).
The carina is a good landmark for the upper border of the cavoatrial junction. Length of carina to cavoaterial juction was associated with age. The rates of malposition and re-intervention and the patient's exposure to radiation can be reduced by using ultrasound during the catheter insertion.
在本研究中，我们分析了儿科患者的薄层肺部计算机断层扫描（CT）血管造影扫描，以确定上腔静脉（SVC）的标准长度以及隆突与SVC头端或腔房交界处之间的距离。
回顾性评估2004年12月至2005年4月期间在超声引导下插入中心导管的13岁以下连续儿童患者。
14例患者的平均年龄为7.2±4.21岁。儿科患者SVC的平均长度和直径分别为45.6±23.03和13.7±3.62mm。从隆突到腔房交界处的距离为22.0±9.98mm。SVC上缘到隆突的平均距离为23.7±16.70mm。从隆突到导管尖端的平均距离为38.9±18.60mm。在任何情况下，腔房交界处相对于隆突均不在头端位置。隆突到腔房交界处与年龄、身高和体重分别显著相关（r = 0.750；p = 0.005，r = 0.763；p = 0.004；r = 0.777；p = 0.003）。
隆突是腔房交界处上缘的良好标志。隆突到腔房交界处的长度与年龄相关。在导管插入过程中使用超声可降低错位和再次干预的发生率以及患者的辐射暴露。
