Document Detail


Evaluation of failing hemodialysis fistulas with multidetector CT angiography: comparison of different 3D planes.
MedLine Citation:
PMID:  17961949     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate failing hemodialysis fistula complications using 16-detector MDCTA, and to assess the accuracies of different 3D planes. MATERIALS AND METHODS: Thirty patients (16 men, 14 women, aged 27-79 years) were referred for hemodialysis access dysfunction. Thirty-one MDCTA exams were done prior to fistulography. For MDCTA, contrast was administered (2mL/kg at 5mL/s) via a peripheral vein in the contralateral arm. Axial MIP, coronal MIP, and VRT images were constructed. Venous complications were evaluated on axial source images, on each 3D plane, and on all-planes together. Results were analyzed using McNemar test. RESULTS: Axial MIP, VRT and all-planes evaluations were most sensitive for fistula site detection (93%). Coronal MIP had the highest sensitivity, specificity and accuracy (35%, 96%, and 85%, respectively) for detecting venous stenosis. VRT and all-planes had the highest sensitivity and accuracy for detecting aneurysms (100%). All-planes and axial MIP were most sensitive for detecting venous occlusion (61% and 54%). Comparisons of detection frequencies for each venous pathology between the five categories of MDCTA revealed no significant differences (P>0.05). MDCTA additionally showed 3 partially thrombosed aneurysms, 4 anastomosis site stenosis and 12 arterial complications. CONCLUSION: MDCTA overall gives low sensitivity for detection of central vein stenosis and moderate sensitivity for occlusion. For most pathology, all-planes evaluation of MDCTA gives highest sensitivity and accuracy rates when compared to other planes. For venous stenosis and occlusion, MDCTA should be considered when ultrasonography and fistulography are inconclusive. MDCTA is helpful in identifying aneurysms, collaterals, partial venous thromboses and additional arterial, anastomosis site pathologies.
Authors:
E Karadeli; N C Tarhan; E M Kayahan Ulu; N U Tutar; O Basaran; M Coskun; E A Niron
Related Documents :
17638259 - Central venous catheter placement in hemodialysis: evaluation of electrocardiography us...
12616419 - Incidence of central vein stenosis and occlusion following upper extremity picc and por...
8173729 - Placement of a double lumen silastic catheter for hemodialysis access through the cepha...
21093199 - Lower extremity arteriovenous fistula with central venous stenosis iliocaval stenting t...
18197529 - Usefulness of groshong catheters for central venous access via the external jugular vein.
15050169 - Management of a small bowel transplant with complicated central venous access in a pati...
23814229 - Mycotic aneurysm: a rare and dreaded complication of infective endocarditis.
24576669 - Anomalous origin of the left subclavian artery from the pulmonary artery.
9251229 - Fatal occlusion of the left coronary main stem by a fragment from the femoral artery: a...
Publication Detail:
Type:  Journal Article     Date:  2007-10-24
Journal Detail:
Title:  European journal of radiology     Volume:  69     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-22     Completed Date:  2009-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  184-92     Citation Subset:  IM    
Affiliation:
Department of Radiology, Baskent University, Faculty of Medicine, Ankara, Turkey.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography / methods*
Arteriovenous Shunt, Surgical / adverse effects*
Graft Occlusion, Vascular / etiology*,  radiography*
Humans
Imaging, Three-Dimensional / methods*
Male
Middle Aged
Radiographic Image Interpretation, Computer-Assisted / methods*
Renal Dialysis / adverse effects*,  instrumentation
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Signal intensity of normal breast tissue at MR mammography on midfield: Applying a random coefficien...
Next Document:  Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancrea...