Kim F M, Burrows P E, Hoffer F A, Chung T
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.
Radiographics. 1996 Jul;16(4):747-54. doi: 10.1148/radiographics.16.4.8835968.
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.
使用造影剂对中心静脉导管（CVC）进行影像学评估是儿科放射学中常见的操作，但此类研究结果的解读标准在文献中并未得到充分描述。仔细评估造影剂增强的CVC研究图像常常能发现CVC故障的原因。在对儿童进行的一系列166项造影剂增强CVC研究中，112项研究（67%）显示结果异常。最常见的异常包括壁血栓、导管尖端血栓、导管尖端贴靠血管壁和袖套血栓。导管故障的其他原因包括储液器血栓、导管断裂和导管位置异常。当导管故障是由于导管血栓形成时，患者通常接受尿激酶治疗（推注或输注）。末端位于无名静脉或锁骨下静脉的短导管异常发生率远高于末端位于上腔静脉或右心房的长导管。
