| Stenosis detection in native hemodialysis fistulas with MDCT angiography. | |
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MedLine Citation:
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PMID: 19304717 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of our study was to assess the diagnostic value of 64-MDCT angiography in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs) in comparison with conventional digital subtraction angiography (DSA). SUBJECTS AND METHODS: Thirty-six patients (22 men; mean age +/- SD, 65 +/- 15 years) with hemodialysis fistula dysfunction underwent MDCT angiography before DSA. Linear weighted kappa was used to calculate interobserver agreement for stenosis for both MDCT angiography and DSA on a 5-point scale. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the detection of >/= 50% stenosis or occlusion on MDCT angiography was calculated using DSA as the standard of reference. Wilcoxon's signed rank test and Mann-Whitney U test were used to compare differences in image quality between MDCT angiography and DSA and between MDCT angiography with the patient's arm stretched overhead or alongside the body, respectively. RESULTS: Interobserver agreement for detecting stenosis was excellent for both DSA (kappa = 0.86; 95% CI, 0.81-0.91) and MDCT angiography (kappa = 0.82; 95% CI, 0.77-0.87). Accuracy, sensitivity, specificity, PPV, and NPV of MDCT angiography for detecting >/= 50% stenosis or occlusion was 92.0% (95% CI, 86.8-95.3%), 90.2% (77.8-96.3%), 92.8% (85.9-96.6%), 85.2% (72.3-92.9%), and 95.4% (89.0-98.3%), respectively. No significant difference in image quality was seen between MDCT angiography and DSA (p = 0.3008) or between MDCT angiography with the patient's arm stretched overhead or alongside the body (p = 0.2912). CONCLUSION: MDCT angiography is a reproducible and reliable imaging technique for detection of >/= 50% stenosis or occlusion in dysfunctional hemodialysis fistulas. |
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Authors:
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Sam Heye; Geert Maleux; Kathleen Claes; Dirk Kuypers; Raymond Oyen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 192 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-23 Completed Date: 2009-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 1079-84 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, UZ Leuven, University Hospitals Leuven, Herestraat 49, Leuven, 3000 Vlaams-Brabant 3000, Belgium. sam.heye@uzleuven.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography / methods* Angiography, Digital Subtraction Arteriovenous Shunt, Surgical* Contrast Media / administration & dosage Female Graft Occlusion, Vascular / radiography* Humans Iopamidol / administration & dosage, analogs & derivatives Male Middle Aged Predictive Value of Tests Radiographic Image Interpretation, Computer-Assisted Renal Dialysis* Sensitivity and Specificity Statistics, Nonparametric Tomography, X-Ray Computed* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 62883-00-5/Iopamidol; 78649-41-9/iomeprol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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