Medical devices in the thorax

Changed by Daniel J Bell, 16 Oct 2017
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Medical devices in the thorax are regularly observed by radiologists on radiographwhen reviewing radiographs and CT reportingCTs.

Extrathoracic devices

  • tubingstubing, clamps, syringes lying on or under the patient
  • rubber sheets, foam mattresses, clothing, hair braids, nipple piercings etc may also be visible.

These devices are mostly unimportant for imaging purposes.  

The following are more important to be recognised by the radiologist:

Pleural devices

  • thoracostomy tubes
    • usually placed anterosuperiorly to drain pneumothorax, and posteroinferiorly to drain pleural effusion
    • a well-positioned tube should lie between visceral and parietal pleura, and there should not be any kinking
    • to check the correct positioning, frequently AP and lateral views are required. Supplemental CT scan may also be supplementedperformed.
    • should not enter the interlobar fissure, else it may be blocked 1; tip should not be within the lung parenchyma or subcutaneous tissue
  • pigtail catheter: used in empyema drainage
  • Heimlich valve: it is a one-way valve used for pleural space drainages, which prevents the return of gases or fluids into the pleural space
  • plombage: "ping-pong" ball" plombage and wax plombage (was used for tuberculosis, not used nowadays)

Tracheal, bronchial and oesophageal devices

Vascular devices

  • dialysis catheters
  • peripherally inserted central catheters (PICC): distal tubingcentral portion only
  • central venous catheters: distalcentral tip ideally positioned at the cavoatrial junction and should not enter the right atrium 
    • temporary non-tunnelled lines: internal jugular and subclavian lines
    • tunnelled lines: e.g. Hickman line, Broviac line
    • permanent, implantable access line with subcutaneous ports: e.g. Port-A-Cath, Infus-a-Port
  • Swan-Ganz catheter (pulmonary artery catheter)
  • left atrial catheter
  • right atrial line often used post paediatric-paediatric cardiac surgery
  • thoracic aortic stent
  • superior vena caval stent
  • superior vena cava filter
  • carotid artery clamps
  • cannulas of extracorporeal membrane oxygenation devices
    • in the right jugular vein (in case of peripheral cannulation) rarely in the left jugular vein
    • in case of central cannulation both cannulas are placed directly via central vessels into the atria

Cardiac devices

Miscellaneous

See also

  • -<p><strong>Medical devices in the thorax </strong>are regularly observed by radiologists on radiograph and CT reporting.</p><h4>Extrathoracic devices</h4><ul>
  • -<li>tubings, clamps, syringes lying on or under the patient</li>
  • -<li>rubber sheets, foam mattresses, clothing, hair braids etc may also be visible.</li>
  • +<p><strong>Medical devices in the thorax </strong>are regularly observed by radiologists when reviewing radiographs and CTs.</p><h4>Extrathoracic devices</h4><ul>
  • +<li>tubing, clamps, syringes lying on or under the patient</li>
  • +<li>rubber sheets, foam mattresses, clothing, hair braids, nipple piercings etc may also be visible.</li>
  • -<li>external pacemaker-defibrillator (typically seen in cardiac patient transported by helicopter or ambulance) <sup>1</sup>
  • +<li>external pacemaker-defibrillator (typically seen in a cardiac patient transported by helicopter or ambulance) <sup>1</sup>
  • -<li>to check the correct positioning, frequently AP and lateral views are required. CT scan may also be supplemented</li>
  • +<li>to check the correct positioning, frequently AP and lateral views are required. Supplemental CT scan may also be performed.</li>
  • -<a href="/articles/plombage">plombage</a>: "ping-pong" ball plombage and wax plombage (was used for tuberculosis, not used nowadays)</li>
  • +<a href="/articles/plombage">plombage</a>: "ping-pong ball" plombage and wax plombage (was used for tuberculosis, not used nowadays)</li>
  • -<li>nasogastric tube/feeding tube/<a href="/articles/dobhoff-tube">Dobhoff tube</a>
  • +<li>nasogastric tube/feeding tube / <a href="/articles/dobhoff-tube">Dobhoff tube</a>
  • -<a href="/articles/ph-probe">pH probe</a> (seen just above GE junction)</li>
  • +<a href="/articles/ph-probe">pH probe</a> (seen just above gastro-oesophageal junction)</li>
  • -<li>tracheo-esophageal voice prosthesis</li>
  • -<li>bronchial stents/<a href="/articles/tracheobroncial-stents">tracheobronchial stents</a> (in lung transplant patients or due to obstructing tumours)</li>
  • +<li>tracheo-oesophageal voice prosthesis</li>
  • +<li>bronchial stents / <a href="/articles/tracheobroncial-stents">tracheobronchial stents</a> (in lung transplant patients or due to obstructing tumours)</li>
  • -<a href="/articles/peripherally-inserted-central-catheters-1">peripherally inserted central catheters (PICC)</a>: distal tubing only</li>
  • +<a href="/articles/peripherally-inserted-central-catheters-1">peripherally inserted central catheters (PICC)</a>: central portion only</li>
  • -<a href="/articles/central-venous-catheter">central venous catheters</a>: distal tip ideally positioned at the cavoatrial junction and should not enter the right atrium <ul>
  • +<a href="/articles/central-venous-catheter">central venous catheters</a>: central tip ideally positioned at the cavoatrial junction and should not enter the right atrium <ul>
  • -<a href="/articles/right-atrial-line">right atrial line</a> often used post paediatric cardiac surgery</li>
  • +<a href="/articles/right-atrial-line">right atrial line</a> often used post-paediatric cardiac surgery</li>
  • -<a href="/articles/vertebroplasty">vertebroplasty </a>related</li>
  • -<li>spinal rods, transpedicular screws</li>
  • +<a href="/articles/vertebroplasty">vertebroplasty</a>-related</li>
  • +<li>spinal rods, transpedicular screws, disc spacers</li>

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