Abstract
Background: Appropriate indications for radiologic evaluation of central venous ports are not fully understood.
We aimed to quantitatively assess the utility of clinical history and imaging in the evaluation of malfunctioning central
venous ports.
Methods: Clinical history, plain radiographs, and line injections intended to evaluate central venous port malfunction
in 153 consecutive cases over a nearly 4-year period were retrospectively reviewed by 2 radiologists. Radiographs and
line injections were separately categorized as normal or abnormal, and a consensus was reached on the final imaging
diagnosis. The likelihood of a port-related abnormality necessitating immediate intervention was determined for all
represented combinations of clinical history, radiographic findings, and line injection results.
Results: A radiologic diagnosis was made in 96.1% of cases; 19.7% of these diagnoses were classified as critical,
requiring prompt intervention. Very low risk histories had a 0.0% incidence of critical port abnormalities in our cohort,
regardless of imaging findings. Low risk histories had a 10.5% incidence of a critical abnormality and were best
evaluated either by line injection, either directly or following an abnormal chest radiograph. Intermediate and high risk
histories were associated with a 30.5% and 61.1% incidence of critical port abnormalities, respectively, and were best
evaluated by line injection without preceding chest radiograph.
Conclusions: There are several scenarios in which imaging does not meaningfully affect management of malfunctioning
central venous ports. Recognizing these inefficiencies may allow for more appropriate and cost-effective use of
radiographs and line injections to evaluate the cause of port malfunction.
Keywords: central venous catheterization, indwelling catheters, interventional radiography, diagnostic imaging