title: Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.
abstract: Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged <60 years and 18 (43/9%) patients were aged >60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.
authors.forename: Masoud Pezeshki
authors.initials: MP
authors.lastname: Rad
authors.forename: Gholam Hosain
authors.initials: GH
authors.lastname: Kazemzadeh
authors.forename: Masood
authors.initials: M
authors.lastname: Ziaee
authors.affiliation: Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Ghodsieh
authors.initials: G
authors.lastname: Azarkar
mesh_terms: D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D034941:Upper Extremity / Q000098:blood supply*; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D014680:Veins / Q000000981:diagnostic imaging