Multislice computed tomographic angiography in evaluating dysfunction of the vascular access in hemodialysis patients.
OBJECTIVE
To introduce our preliminary experience in using multislice computed tomographic (CT) angiography (MSCTA) to assess stenoses of the hemodialysis vascular access and to guide revising operation or percutaneous transluminal angioplasty (PTA).


METHODS
Contrast-enhanced 16-slice spiral CT was used to examine 22 hemodialysis patients with various dysfunctions of their vascular access. The transverse source images were reformatted as maximum intensity projection, volume-rendering, and multiple/curved planar reconstruction images.


RESULTS
The whole spectrum of arteriovenous fistulas (AVF) with the feeding artery, anastomoses, and outflow tract up to the superior caval vein was clearly displayed in all patients. According to the results of MSCTA, AVF-revising surgery was done in 11 patients, and PTA under the guide of digital subtraction angiography (DSA) was done in 5 patients. The results of MSCTA coincide with the findings of surgery or DSA in these 16 patients.


CONCLUSIONS
In our opinion, MSCTA is a good noninvasive diagnostic technique to detect various hemodialysis vascular access abnormalities. It is more economical than DSA in the present medical settings and could replace DSA in the imaging of hemodialysis vascular access and provide important information for further AVF-revising surgery or PTA.
Ye
Chaoyang
C
Department of Nephrology, Changzheng Hospital, Second Military Medical University, Shanghai, China. yechaoyang63@126.com
Mao
Zhiguo
Z
Rong
Shu
S
Zhang
Yuqiang
Y
Mei
Changlin
C
Li
Huimin
H
Dong
Sheng
S
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*