Abstract
Chest radiographs (CXRs) are the most common imaging investigations undertaken because of their value in evaluating the cardiorespiratory system. They play a vital role in intensive care units for evaluating the critically ill. It is therefore very common for the radiologist to encounter tubes, lines, medical devices and materials on a daily basis. It is important for the interpreting radiologist not only to identify these iatrogenic objects, but also to look for their accurate placement as well as for any complications related to their placement, which may be seen either on the immediate post-procedural CXR or on a follow-up CXR. In this article, we discussed and illustrated the routinely encountered tubes and lines that one may see on a CXR as well as some of their complications. In addition, we also provide a brief overview of other important non-cardiac medical devices and materials that may be seen on CXRs.
Highlights
Among the various imaging modalities available for assessing the cardiothoracic system, the chest radiograph (CXR) is the most commonly used
The objective of this article is to provide a comprehensive review of the numerous tubes, lines and non-cardiac medical devices or materials that may be seen on CXRs, their appearance on CXRs and how to evaluate for their accurate placement, as well as to be aware of associated complications that need to be considered
Other extra cardiac stimulators that may be seen on CXRs include deep brain stimulation (DBS) devices, bone, diaphragmatic and spinal cord stimulators.[22]
Summary
Among the various imaging modalities available for assessing the cardiothoracic system, the chest radiograph (CXR) is the most commonly used. Some of the complications associated with ICD tubes that may be seen on CXRs include: malpositioning (commonest complication), tube kinking, subcutaneous emphysema, pneumothorax and retained catheter fragment.[8] A properly placed tube for pneumothorax (Figure 4a) should orient antero-superiorly, and an adequately positioned tube for pleural fluid evacuation should be directed posterior-inferiorly. A malpositioned PAC tip within the right ventricle increases the risk for ventricular arrhythmias and cardiac perforation.[11,15,16] Other complications related to PAC insertion that may be seen on chest radiographs include pneumothorax, haematoma and catheter migration.[16]. Radiologists need to recognise them, be aware of their function and look for any related complications
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