MDCT angiography for evaluation of the complete vascular tree of hemodialysis fistulas

Sheung Fat Ko, Chung Cheng Huang, Shu Hang Ng, Tze Yu Lee, Ming Jang Hsieh, Fan Yen Lee, Min Chi Chen, Shyr Ming Sheen-Chen, Chi Hsiung Lee

Research output: Contribution to journalReview article

29 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to assess the clinical feasibility of MDCT angiography for evaluating hemodialysis arteriovenous fistulas (AVFs). MATERIALS AND METHODS. MDCT angiography of the complete vascular trees of 36 failing AVFs or AVF-related complications (20 native and 16 polytetrafluoroethylene graft AVFs) was reviewed. The numbers and degrees of stenoses at the anastomoses, graft loops, and draining and central veins and the presence of aneurysms or thrombosis were recorded. Wilcoxon's signed rank test was used to compare the findings of MDCT angiography with those of digital subtraction angiography (DSA) (n = 10), surgery (n = 22), or both (n = 4) performed within 2-6 days. Kappa statistics were used to correlate the clinical feasibility of MDCT angiography assessed by two reviewers. RESULTS. Among the 14 AVFs examined with both MDCT angiography and DSA, no significant difference was seen in the detection and grading (p = 0.317 to > 0.999) of stenoses at various segments of the entire vascular tree. Among the 36 AVFs examined, MDCT angiography also showed no significant difference from DSA or surgery in revealing vascular stenoses, aneurysms, and thromboses from the supplying artery to central veins (p = 0.317 to > 0.999). Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of MDCT angiography in lesion detection were 98.7%, 97.5%, 98.8%, 97.2%, and 98.3%, respectively. High image quality with superb interobserver correlation (κ = 0.809 to > 0.999) validated the clinical feasibility of MDCT angiography for assessing AVFs. CONCLUSION. MDCT angiography is clinically feasible for evaluating the complete vascular tree of failing AVFs and in showing uncommon complications, including brachial aneurysms and central vein lesions.

Original languageEnglish
Pages (from-to)1268-1274
Number of pages7
JournalAmerican Journal of Roentgenology
Volume185
Issue number5
DOIs
Publication statusPublished - Dec 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Ko, S. F., Huang, C. C., Ng, S. H., Lee, T. Y., Hsieh, M. J., Lee, F. Y., Chen, M. C., Sheen-Chen, S. M., & Lee, C. H. (2005). MDCT angiography for evaluation of the complete vascular tree of hemodialysis fistulas. American Journal of Roentgenology, 185(5), 1268-1274. https://doi.org/10.2214/AJR.04.1553