title: Diagnostic value of color Doppler ultrasonography and MDCT angiography in complications of hemodialysis fistulas and grafts.
abstract: OBJECTIVE
  The purpose of the study was to compare the diagnostic value of color Doppler ultrasonography (CDUS) and multidetector computed tomography (MDCT) angiography against that of digital subtraction angiography (DSA) or surgery in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs).
  
  
  METHODS
  CDUS and MDCT angiography were performed with 41 patients (24 men, 17 women; mean age 55.8) with dysfunctional hemodialysis fistulas. The presence of stenosis, thrombosis, aneurysm, pseudoaneurysm and seroma were recorded. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy of CDUS and MDCT angiography were calculated both individually and in combination for the detection of vascular segments with significant stenosis, thrombosis, aneurysms, pseudoaneurysms, perivascular complications and stenosis subgroups.
  
  
  RESULTS
  Sixty-four segmental lesions were diagnosed by DSA or surgery. Sensitivity, specificity, PPV, NPV and accuracy of CDUS for all vascular tree lesions were 85.9%, 99.2%, 96.4%, 96.7% and 94.5%, respectively. For MDCT angiography the figures were 96.8%, 99.6%, 98.4%, 99.2% and 98.5%, respectively. When both tests were used in combination, sensitivity, specificity, PPV, NPV and accuracy for all vascular tree lesions rose to 100%.
  
  
  CONCLUSIONS
  Combined use of MDCT and CDUS for diagnosis of AVF dysfunctions is of equivalent value to surgery or DSA, a gold standard technique.
authors: Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey. drcansu@gmail.com
authors: Aysegul
authors: A
authors: Cansu
authors: Mehmet
authors: M
authors: Soyturk
authors: Mehmet Halil
authors: MH
authors: Ozturk
authors: Sibel
authors: S
authors: Kul
authors: Zerrin
authors: Z
authors: Pulathan
authors: Hasan
authors: H
authors: Dinc
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D061330:Multidetector Computed Tomography / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014652:Vascular Diseases / Q000175:diagnosis* / Q000209:etiology*
keywords: CDUS; Digital subtraction angiography; Hemodialysis fistula; MDCT angiography