• B Connolly, J B Mawson, C E MacDonald, P Chait, and H Mikailian.
• Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada. bairbre.connolly@sickkids.on.ca
• Pediatr Radiol. 2000 Oct 1; 30 (10): 692-5.

BackgroundVascular access devices are commonly placed under image guidance. The usual aim is to place the tip at the superior vena cava-right atrial junction (SVC-RA).ObjectiveTo identify a radiographic landmark for the SVC-RA junction that would be useful for accurate central venous catheter tip placement in children.Materials And MethodsImages from 56 children undergoing contrast studies of their upper limb venous systems were examined for location of the SVC-RA in relation to a radiographic landmark.ResultsMost patients (92.5%) showed the SVC-RA junction to lie at the sixth thoracic vertebral level or the interspace above or below. The SVC-RA junction lay lower than the right main bronchus and the notch on the right cardiomediastinal contour.ConclusionThe vertebral body provides a useful and radiographically visible landmark for accurate central catheter tip placement.

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