Skip to main content

Volume 3 Supplement 1


Ultrasound versus conventional chest radiography after ultrasound guided insertion of a central line


Central venous catheters (CVC's) are used frequently in modern medicine. After CVC insertion a conventional chest radiograph (CCR) is often ordered to detect complications and/ position There are reports that the use of ultrasound (US) might be better in detecting complications and correct or incorrect position and is more time efficient.


We conducted a prospective observational study in which we compared the use of US versus conventional chest radiograph (CCR) in patients receiving a CVC for the detection of post insertion complications and to confirm proper CVC position.


Adult patients in need for a CVC could be included. All CVC´s were inserted under direct in plane US guidance. After insertion US was used to screen for correct or incorrect CVC position (in the case of a CVC in the Internal Jugular Vein (IJV) the ipsilateral subclavian vein (SCV) and in case of a CVC in the SCV the ipsilateral IJV was examined. On the ipsilateral side the two upper "blue points" were examined to rule out a pneumothorax. Finally cardiac ultrasound (CUS) was used to chech correct or incorrect CVC position in the heart or inferior cava vein and with the use of 5 cc agitated saline the pattern of microbubbles in the right atrium was recorded to confrim proper position. The time needed to obtain a CCR was noted. The results of the CCR were compared to the US results in a 2 x 2 table (US correct and incorrect position versus CCR correct and incorrect position).


46 Patients were included: 3 SCV and 43 IJV CVC´s were inserted. The results of US and CCR in detecting pneumothorax were equal (n = 0). In 1 patient no CUS view could be obtained, in the other 45 the results of CCR and US were the same (correct position of the CVC). The sensitivity of US for detecting propper CVC position was 1,0 (0,9-1.0).

The mean time needed waiting for the result of the CCR was 20 (0-195) minutes. we excluded the waiting time for CCR in 1 patient during a hospital system faliure for 2 days.


US is comparable to CCR in detecting proper position and complications after CVC insertion and is more time efficient. If a mode of control after CVC insertion is wanted, US is the preferred method.


  1. Cortellaro F, Mellace L, et al: “Contrast enhanced ultrasound vs chest x-ray to determine correct central venous catheter position.”. Am J Emerg Med. 2013, 32 (1): 78-81.

    Article  PubMed  Google Scholar 

  2. Maury E, Guglielminotti J, et al: “Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion?”. Am J Respir Crit Care Med. 2001, 164 (3): 403-5. 10.1164/ajrccm.164.3.2009042.

    Article  PubMed  CAS  Google Scholar 

  3. Vezzani A, Brusasco C, et al: “Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax: an alternative to chest radiography.”. Crit Care Med. 2010, 38 (2): 533-8. 10.1097/CCM.0b013e3181c0328f.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blans, M., Bosch, F. Ultrasound versus conventional chest radiography after ultrasound guided insertion of a central line. ICMx 3 (Suppl 1), A606 (2015).

Download citation

  • Published:

  • DOI: