Neonatal abdominal radiograph (supine view)

AP supine radiograph for neonates is a mobile examination performed on the neonatal unit. It can be taken as a standalone projection or as part of a series including a left lateral decubitus x-ray in cases of suspected perforation. 

Patient position

• the patient is supine, lying on their back in the incubator
• remove any radiopaque items (e.g. ECG dots, diaper)
• the patient should be free from rotation; both shoulders and hips equidistant from the incubator
• take the x-ray in full inspiration

Technical factors

• AP projection
• centering point
  • the midsagittal plane (xiphisternum) at the level of the iliac crest
• collimation
  • laterally to the lateral abdominal wall
  • superior to the diaphragm
  • inferior to the inferior pubic rami
• orientation
  • portrait
• detector size
  • 24 cm x 30 cm
• exposure
  • 60 - 65 kVp
  • 1.6 - 3.2 mAs
• SID
  • 100 cm
• grid
  • no

Image technical evaluation

• include the
  • lateral abdominal wall
  • inferior pubic rami inferiorly
  • diaphragm superiorly
• the abdomen should be free from rotation with symmetry of the:
  • ribs (superior)
  • iliac crests (middle)
  • obturator foramen (inferior)
• no blurring of the bowel gas due to respiratory motion

Practical points

It is important for the image to be free from movement artifact and rotation. It may be necessary for a nurse to hold the patient in position.

Exposure will need to be adjusted according to imaging system (CR or DR) and patient size. Where possible the mAs should be manipulated to ensure adequate image density and appropriate image contrast.