Contrast-Enhanced MR Angiography of Failing Hemodialysis Arteriovenous Fistulas and Grafts: A Preliminary Experience.
10.3348/jkrs.2004.51.6.609
- Author:
Young Sun LEE
1
;
Gong Yong JIN
;
Young Min HAN
;
Sang Yong LEE
;
Hak Hun PARK
;
Sung Kwang PARK
Author Information
1. Department of Diagnostic Radiology, Chonbuk National University Medical School, Korea. 0319-jin@hanmail.net
- Publication Type:Comparative Study ; Original Article
- Keywords:
Fistula, arteriovenous;
Magnetic resonance (MR), three-dimensional;
Magnetic resonance (MR), vascular studies;
Digital subtraction angiography
- MeSH:
Angiography*;
Angiography, Digital Subtraction;
Arteriovenous Fistula*;
Consensus;
Constriction, Pathologic;
Fistula;
Humans;
Magnetic Resonance Imaging;
Polytetrafluoroethylene;
Prospective Studies;
Renal Dialysis*;
Sensitivity and Specificity;
Transplants*
- From:Journal of the Korean Radiological Society
2004;51(6):609-614
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this report is to evaluate the vascular stenosis for failing hemodialysis arteriovenous fistulas and grafts using contrast-enhanced MR imaging (CE-MRI) and to compare the results with digital subtraction angiography (DSA). MATERIALS AND METHODS: Nine patients (27 segmental vessels) with symptoms and signs of AVF stenosis or occlusion who presented to our medical department were recruited into this prospective comparative study. All of the patients with Brescia-Cimino arteriovenous fistula (AVF) or synthetic polytetrafluoroethylene (PTFE, Goretex(R)) loop graft underwent MRA and DSA of the fistula. MRA was performed with a 1.5-T system using VIBE sequence: TR/TE=3.5/1.5 msec, flip angle 20-25degrees, matrix 115x256, FOV 350x350, interpolated slice thickness 2.0 mm, fat suppression, scan time 13-18 sec and total time of 5 min. DSA was used as the reference standard for assessing the accuracy of MRA, and MRA was analyzed for the presence of stenosis or occlusion, a grading of stenosis, and the presence of collateral vessels. Two radiologists prospectively analyzed the MRAs by working in consensus. RESULTS: Regarding the stenotic grade, CE-MRA corresponded with the DSA in six patients (66.7%) and it overestimated the stenoses in three patients (33.3%). For the stenotic site, MRA had a sensitivity of 86.4%, a specificity of 40%, a positive predictive value of 32.1%, and a negative predictive value of 66.7%. CONCLUSION:Multiphase CE-MRA of the AVF noninvasively provided information comparable to that provided by DSA for the vascular stenosis regarding failing hemodialysis arteriovenous fistula.
