Department of General Surgery, Gisborne Hospital, Gisborne, New Zealand.
Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand.
Clin Anat. 2019 Sep;32(6):778-782. doi: 10.1002/ca.23399. Epub 2019 May 15.
The aortic valve (AV) has been used as a surrogate marker for the superior vena cava-right atrium (SVC-RA) junction during the placement of central venous catheters. There is a paucity of evidence to determine whether this is a consistent finding in children. Eighty-seven computed tomography scans of the thorax acquired at local children's hospitals from April 2010 to September 2011 were retrospectively collected. The distance between the SVC-RA junction and the AV was measured by dual consensus. The cranio-caudal level of the junction and the AV were referenced to the costal cartilages (CCs) and anterior intercostal spaces (ICSs). The results confirmed that the SVC-RA junction has a variable relationship to the AV. The junction was on average 3.1 mm superior to the AV. This distance increased with age. In the <1-year-old age group, the junction was on average 1.3 mm superior to the AV (range: -6 to 11 mm). In the 1-2 years old age group: 3.5 mm (range: -8 to 15 mm). In the 3-6 years old: 3.8 mm (range: -9 to 13 mm). In the >7 years old age group: 4 mm (range: -11 to 16 mm). The surface anatomy of the SVC-RA junction was variable, ranging from the second ICS to sixth CC. The SVC-RA junction has a predictable relationship to the AV, and this can be used as an adjunct marker for accurate placement of central venous catheters except in the smallest neonates. Clin. Anat. 32:778-782, 2019. © 2019 Wiley Periodicals, Inc.
主动脉瓣 (AV) 一直被用作中心静脉导管放置时上腔静脉右心房 (SVC-RA) 交界处的替代标志物。但是，目前缺乏确定这是否是儿童中一致发现的证据。本研究回顾性收集了 2010 年 4 月至 2011 年 9 月当地儿童医院的 87 例胸部 CT 扫描。使用双重共识测量 SVC-RA 交界处与 AV 之间的距离。交界处和 AV 的头侧-尾侧水平参考肋软骨 (CC) 和前肋间空间 (ICS)。结果证实 SVC-RA 交界处与 AV 具有可变关系。交界处平均比 AV 高 3.1mm。该距离随年龄增加而增加。在 <1 岁年龄组中，交界处平均比 AV 高 1.3mm（范围：-6 至 11mm）。在 1-2 岁年龄组中：3.5mm（范围：-8 至 15mm）。在 3-6 岁：3.8mm（范围：-9 至 13mm）。在>7 岁年龄组中：4mm（范围：-11 至 16mm）。SVC-RA 交界处的表面解剖结构变化，从第二 ICS 到第六 CC。SVC-RA 交界处与 AV 具有可预测的关系，除了最小的新生儿外，它可以作为准确放置中心静脉导管的辅助标志物。临床解剖学 32:778-782, 2019. © 2019 Wiley Periodicals, Inc.
