Pilot study of noninvasive detection of venous occlusions from central venous access devices in children treated for acute lymphoblastic leukemia
Related Experiment Video
Updated: Aug 16, 2026
The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
S C Kaste1, S A Gronemeyer, F A Hoffer
1Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, USA.
Insights
Magnetic resonance angiography (MRA) may help screen for central venous abnormalities in childhood acute lymphocytic leukemia (ALL) survivors, unlike ultrasound. Further research is needed for a sensitive, noninvasive method to detect venous occlusion from central venous access devices (CVADs).
Area of Science:
- Vascular imaging
- Pediatric oncology
- Cardiovascular radiology
Background:
- Childhood acute lymphocytic leukemia (ALL) survivors face risks of venous occlusion linked to central venous access devices (CVADs).
- Current noninvasive screening methods like ultrasound (US) have limitations in visualizing critical central veins.
- Magnetic resonance angiography (MRA) presents a potential noninvasive alternative for screening these patients.
Purpose of the Study:
- To evaluate the suitability of ultrasound (US) and magnetic resonance angiography (MRA) for identifying venous occlusion.
- To assess MRA's utility in detecting central venous abnormalities in pediatric ALL survivors with a history of CVAD use.
Main Methods:
- MRA and ultrasound examinations were performed on 11 pediatric patients treated for ALL.
- Patients had a history of central venous access device (CVAD) placement, removed years prior.
- 2D time-of-flight magnetic resonance angiography (TOF MRA) was also conducted on two healthy control subjects.
Main Results:
- MRA indicated central venous abnormalities in 8 out of 11 ALL survivors.
- MRA also detected abnormalities in both healthy control subjects.
- Ultrasound (US) yielded negative results for all 11 ALL survivors.
Conclusions:
- Further investigation is required to develop a sensitive and specific noninvasive method for detecting venous occlusion.
- This method should specifically target complications arising from prior central venous access device (CVAD) use.
- Developing such a technique would facilitate prospective studies on this complication in pediatric ALL survivors.
Background:
Survivors of childhood acute lymphocytic leukemia (ALL) are at risk of venous occlusion induced by central venous access devices (CVADs). A sensitive, noninvasive screening technique to identify the magnitude of this problem is needed. Ultrasound (US) cannot always adequately image the innominate veins or the superior vena cava. Magnetic resonance angiography (MRA) can be noninvasive and may be useful for screening these patients.
Objective:
We examined the suitability of US and MRA to identify venous occlusion.
Materials And Methods:
We used MRA and ultrasound to examine 11 pediatric patients previously treated for ALL. CVADs had been in place a median of 2.5 years (range, 0.4-2.8 years) and removed a median of 2.1 years (range, 0.6-2.9 years) previously. We also performed 2D time-of-flight magnetic resonance angiography (TOF MRA) on two healthy young adult women with no history of venous abnormality or CVAD use.
Results:
MRA suggested central venous abnormalities in 8 of the 11 ALL survivors and in both healthy control subjects. US results were negative in all 11 survivors.
Conclusion:
Further investigation is warranted to develop a sensitive and specific noninvasive method for identifying venous occlusion caused by prior CVAD use. Such a method would allow prospective studies of this complication in pediatric ALL survivors.
