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Background and objectives: To investigate the feasibility and safety of ultrasoundguided totally implantable venous access ports (TIVAPs) via the right brachiocephalic vein (BCV) in pediatric patients.Methods: A single-institute retrospective review was performed on 35 pediatric patients with predominantly hematological malignancies (88.6%) who underwent TIVAP implantation via ultrasound-guided right BCV approach from July 2018 to June 2021. The catheter tip was adjusted to be positioned at the cavoatrial junction under pulsed fluoroscopic guidance. Technical success rate, procedural information, and TIVAP-related complications were evaluated.Results: All the pediatric TIVAP devices were successfully implanted via right BCV access. Venous access was successful by first attempt in 32 children (91%), two cases (5.7%) required a second attempt, and one patient (2.9%) required a third attempt.The mean procedural time was 44.6 ± 6.4 minutes (range: 34-62 minutes). No intraoperative complications occurred. The average TIVAP indwelling time was 564 ± 208 days (range: 193-1014 days), with a cumulative 19,723 catheter-days. Overall, three patients (8.6%) experienced four postoperative complications (two cases of local hematoma and two catheter dysfunctions) at a rate of 0.2 per 1000 catheterdays. No other complications such as wound dehiscence, delayed incision healing, Abbreviations: BCV, brachiocephalic vein; CRBSI, catheter-related bloodstream infection; CRT, catheter-related thrombosis; CVC, central venous catheter; IJV, internal jugular vein; IQR, interquartile range; PICC, peripherally inserted central catheter; SCV, subclavian vein; TIVAP, totally implantable venous access port.

Chronic kidney disease (CKD) is chronic progressive renal parenchymal damage caused by multiple factors. Evaluation of the degree of renal interstitial fibrosis (IF) is of great importance in treatment and prognosis prediction. Herein, we use multi-parametric magnetic resonance imaging (mpMRI) to assess renal IF noninvasively with intention to identify the optimal MRI biomarkers for clinical application. Our results show that multi-parameter prediction model using cortical longitudinal relaxation time (cT1) and cortical true diffusion coefficient (cDt) can effectively assess the degree of renal IF and support clinical diagnosis, treatment strategy and risk stratification in CKD patients.