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Study of a Comparison of Ultrasonography with Radiography to Localize the Umbilical Arterial Catheter

Journal of the Korean Pediatric Society 1998;41(12):1650-1659.
Published online December 15, 1998.
Study of a Comparison of Ultrasonography with Radiography to Localize the Umbilical Arterial Catheter
Byoung Min Choi, Young Kwan Park, Kee Hwan Yoo, Young Sook Hong, Joo Won Lee, Soon Kyum Kim
Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
신생아 제대동맥 도관의 위치판정에 있어서 단순 방사선촬영과 초음파검사의 유용성에 관한 연구
최병민, 박영관, 유기환, 홍영숙, 이주원, 김순겸
고려대학교 의과대학 소아과학교실
Correspondence: 
Byoung Min Choi, Email: 1
Abstract
Purpose
: This study was performed to observe the utilization of ultrasonography in locating the position of UAC and to compare the position with anatomical landmarks seen on radiography.
Methods
: Optimal position is when the catheter tip is located between T6-T10 or L3-L5 by anteroposterior radiography(AP-R) and above the diaphragm by cross-table lateral radiography(CTL-R). Ultrasonographic studies used a Hewlett Packard Sonos 1000 with 5 MHz scanner, the distance from the catheter tip to the origin of the celiac artery in high position and the distance from the catheter tip to the origin of the renal arteries and to the aortic bifurcation in low position were measured.
Results
: In 23 of 36 newborns, high type UAC was properly positioned by AP-R, but ultrasonographic examination showed that 3 UAC were malpositioned under 5mm above the origin of the celiac artery. Detection of properly positioned UAC by AP-R had a sensitivity of 80% and specificity of 72.7%. In 19 of 28 newborns, high type UAC was properly positioned by CTL-R, but ultrasonographic examination showed that 2 UAC were malpositioned under 5mm above the origin of the celiac artery. Detection of properly positioned UAC by CTL-R had a sensitivity of 81% and specificity of 71.4%. In 15 of 20 newborns, low type UAC was properly positioned by AP-R, and ultrasonographic examination showed that 1 UAC was malpositioned below the aortic bifurcation. Detection of properly localized UAC by AP-R had a sensitivity of 77.8% and specificity of 50%.
Conclusion
: Ultrasonographic catheter localization is a noninvasive technique that uses no ionizing radiation and has no known deterimental side effects, and allows direct visualization of the pertinent vascular anatomy, providing more information than traditional radiography.
Key Words: Ultrasonography, Radiography, Umbilical arterial catheter, Neonate


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