Long line positioning in neonates: does computed radiography improve visibility?

OBJECTIVES To assess the use of soft copy reporting of computed radiography (CR) images in determining intravenous long line tip position in neonates and compare visibility rates with hard copy printed images. METHOD A retrospective study of all long lines inserted on the neonatal unit over a period of one year was performed. Forty five lines were inserted in 30 neonates over this time. Assessment of the CR images was made by three independent observers by reviewing the films on the viewing console and as hard copy printed films. RESULTS Accurate identification of the line tip could be made in 66.7% of cases (kappa = 0.9) using hard copy images and 95.6% cases (kappa = 1.0) using soft copy reporting (significant difference: p = 0.002). The difference in percentage visibility using the two techniques was 28.9% (95% confidence interval 10.2% to 36.7%). CONCLUSION The use of soft copy review of CR image improves the visibility of the line tip position compared with hard copy films and reduces the need for repeat radiographs with/without intravenous contrast.