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==Suspected fibrin sheath==
A fibrin sheath of central venous catheter (including PICC-lines and implanted ports) can be suspected when it is possible to infuse inject into it but not to aspirate.
===Choice of modality===
==Procedure==
Pre-contrast imaging
*For ports, it should include a '''lateral projection''' to confirm that the needle is in proper place before contrast infusioninjection.<ref name=Helsingborg/>
Contrast imaging
*After the procedure:
:*'''Flush''' with 20 - 30 ml normal saline.<ref name=Helsingborg/>
:*Optionally, quantify the '''amount''' of infused injected contrast.
==Evaluation==
A definite fibrin sheath is visualized as contrast flowing backwards around the catheter, looking like a thickening of the distal part, before exiting at a more proximal part of the catheter. Preferably note the distance between the catheter tip and the exiting point, and whether it is in a different vein (such as the brachiocephalic vein).
[[File:Central venous catheter with a fibrin sheath.jpg|thumb|center|The fibrin sheath is indirectly seen in these images before and after radiocontrast infusioninjection, as the radiocontrast collects around the catheter.]]
==Report==
Optionally, if tested or measured:
*Ability to aspirate.
*Infused Injected amount of contrast
{{Reporting}}
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