| Evaluation of failing hemodialysis fistulas with multidetector CT angiography: comparison of different 3D planes. | |
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MedLine Citation:
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PMID: 17961949 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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E Karadeli; N C Tarhan; E M Kayahan Ulu; N U Tutar; O Basaran; M Coskun; E A Niron |
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Publication Detail:
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Type: Journal Article Date: 2007-10-24 |
Journal Detail:
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Title: European journal of radiology Volume: 69 ISSN: 1872-7727 ISO Abbreviation: Eur J Radiol Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-22 Completed Date: 2009-05-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106411 Medline TA: Eur J Radiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 184-92 Citation Subset: IM |
Affiliation:
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Department of Radiology, Baskent University, Faculty of Medicine, Ankara, Turkey. |
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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