Document Detail


Multi-slice computed tomographic angiography for stenosis detection in forearm hemodialysis arteriovenous fistulas.
MedLine Citation:
PMID:  19085898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A method of diagnosing the extent and severity of arteriovenous fistula (AVF) stenoses is multislice computed tomographic angiography (MS-CTA). The aim of this prospective study was to assess the accuracy of MS-CTA for the detection and grading of stenoses in AVF in comparison to digital subtraction angiography (DSA), which was used as the gold standard of reference. METHODS: Fifteen hemodialysis (HD) patients with dysfunctioning forearm AVF were included. These AVFs were evaluated by both DSA and MS-CTA and were read in a prospective, blinded manner by two radiologists experienced in vascular imaging. RESULTS: ROC analysis revealed areas under the curve of 0.90+/-0.07 for observer I and 0.87+/-0.08 for observer II at a stenosis cut-off level of >or=50% diameter reduction. The combined results for MS-CTA showed sensitivity, specificity and positive and negative predictive values of 82%, 98%, 82% and 98% for stenoses>or=50% and 71%, 99%, 77% and 98% for stenoses>or=75%. Inter-observer agreement for the detection of stenoses>or=50% diameter reduction was 0.70 and 1.0, for MS-CTA and DSA, respectively. CONCLUSION: MS-CTA can provide good visualization of forearm HD access AVF and has moderate sensitivity, but high specificity for the detection of flow-limiting stenoses.
Authors:
P P G M Rooijens; G P Serafino; D Vroegindeweij; R Dammers; T I Yo; A A E A De Smet; J H M Tordoir
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The journal of vascular access     Volume:  9     ISSN:  1129-7298     ISO Abbreviation:  J Vasc Access     Publication Date:    2008 Oct-Dec
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  278-84     Citation Subset:  IM    
Affiliation:
Department of Surgery, Medical Center Rijnmond Zuid, Rotterdam, The Netherlands. prooijens@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography, Digital Subtraction*
Arteriovenous Shunt, Surgical / adverse effects*
Constriction, Pathologic
Female
Forearm / blood supply*
Humans
Male
Middle Aged
Observer Variation
Predictive Value of Tests
Prospective Studies
ROC Curve
Renal Dialysis*
Reproducibility of Results
Sensitivity and Specificity
Thrombosis / etiology,  radiography*
Time Factors
Tomography, X-Ray Computed*
Vascular Patency

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


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