Adanan, Muhammad Suhairi (2022) Diagnostic accuracy of contrast-enhanced ultrasound with dextrose 50% in detecting supradiaphragmatic central venous catheter malposition. Masters thesis, Universiti Sains Malaysia.
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Abstract
Background: Central venous catheter (CVC) insertion is common in an in-patient medical setting. The usage varies from the administration of drugs, resuscitation, and haemodialysis. A standard practice to confirm CVC placement is by using a chest radiograph. Similarly, the usage of contrast-enhanced ultrasound (CEUS) can also detect catheter malposition, as shown by previous studies. Most studies used saline as a contrast, however it has been observed that using Dextrose 50% (D50%) as a contrast solution instead of saline results in better ultrasonic features. We explored the diagnostic accuracy of using D50% as a contrast solution to detect supradiaphragmatic central venous catheter malposition in Hospital Universiti Sains Malaysia (HUSM). Method: This is a cross-sectional study involving patients who had CVC inserted according to standard indication and clinical practice. Convenient sampling was used, and subjects were screened from in-patient ward HUSM. We compared catheter malposition detection using Rapid Atrial Swirl Sign (RASS) features by CEUS with D50% and central venous catheter tip on chest radiograph. Additionally, we compared the agreement between first and second investigators regarding RASS features. Result: In total, we included 99 patients. Seven catheter malpositions were detected by chest radiograph, and from this, only 1 was detected by CEUS. The sensitivity of detecting catheter malposition by CEUS D50% was 14.3%, and specificity was 95.5%. There was a moderate agreement between ultrasound and chest x-ray film with a Cohen’s Kappa coefficient of 0.533. Conclusion: In this study, CEUS using D50% cannot replace CXR to detect catheter malposition. However, it can determine the correct CVC position in the venous following insertion.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | catheter malposition, chest radiograph |
| Subjects: | R Medicine R Medicine > RC Internal medicine |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 11 May 2026 23:33 |
| Last Modified: | 12 Aug 2026 02:53 |
| URI: | http://eprints.usm.my/id/eprint/64149 |
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