Abstract: Objective  X-ray examination has some limitations in the tip positioning of peripherally inserted central catheter(PICC) in children, especially in patients with ectopic tip in right heart. The purpose of this study is to explore the value of echocardiography in improving the display of ectopic tip of PICC in right heart system in children.
Methods  A total of 96 patients who underwent PICC catheterization successfully were selected. Self-control trial was applied and chest X-ray and echocardiography were used respectively to confirm the tip position of PICC. The value of echocardiography in improving the evaluation of ectopic tip of PICC in right heart system was observed.
Results  The detection rate of ectopic tip of PICC in right heart by echocardiography and chest X-ray was 22.9% and 7.3% respectively. The results of Chi-square test showed that there was significant difference in dispersion between two methods(χ2=9.13, P=0.003). The detection rate of ectopic tip of PICC in right heart system by echocardiography was higher than that by chest X-ray. The consistency result of Kappa test showed that the consistency of the two methods was low(Kappa=0.16). The sensitivity of echocardiographic localization of ectopic tip of PICC in right heart system was 79%, the area under ROC 〖JP2〗curve was 0.830(P＜0.05) and the 95% confidence interval was(0.692-0.968). 〖JP〗
Conclusion  Echocardiography can significantly improve the detection rate of ectopic tip of PICC in right heart in children.During PICC catheterization in children, routine echocardiographic examination should be performed if the patient is suspected of having ectopia in right heart system by chest X-ray examination.

Key words: echocardiography,  , catheterization, central venous, children