Abstract：Objective To investigate the anatomical parameters involved in positioning the tip of peripherally inserted central catheter(PICC).Methods Imaging data of 334 patients underwent contrast-enhanced thin-slice chest CT scan in the Affiliated Cancer Hospital of Xiangya School of Medicine of Central South University from June 2013 to January 2015 were retrospectively analyzed. Absolute value of anatomical parameters including distance between the upper margin of the right clavicular notch(RSCJ)and atriocaval junction (ACJ), distance between RSCJ and pericardial reflection(PR), distance between carina and ACJ, distance between carina and PR, distance between right tracheobronchial angle (RTBA)and ACJ, distance between RTBA and PR ,and the length of superior vena cava were calculated respectively. Each absolute value of anatomical parameter was divided by the height of the sixth thoracic vertebra body unit (T6 unit), denoted as relative value of anatomical parameters correspondingly.Results The ACJs were identified at the level of T6 or T7 in 82%(274/334) of patients. The PRs were found at the level of T5 or T6 in 79.3%(265/334) of patients. The absoulute distance and relative distance (mean±SD) of carina-to-ACJ, carina-to-PR, RSCJ-to-ACJ, RSCJ-to-PR, RTBA-to-ACJ and RTBA-to-PR were (38.4±8.8),(21.9±9.2),(50.7±9.1),(34.2±9.4),(110.2±15.9),(93.7±16.3 )mm, and (1.85±0.43), (1.05±0.44), (2.44±0.45),(1.64±0.45), (5.30±0.75),(4.50±0.75), respectively. The correlation analysis showed the absolute values of anatomic parameters were highly related with the patients’ heights (P<0.01), while the relative values were significantly weakened with the patients’ heights and the partial relative values of anatomic parameters were not related with the patients’ heights(P>0.05).Conclusions Both carina and right tracheobronchial angle might serve as relatively reliable imaging landmarks for positioning the tip of PICC. Imaging landmark guided estimating the position of PR may be relatively difficult due to the varied position of PR.
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