Arteriovenous Fistula and Graft Evaluation in Hemodialysis Patients Using MDCT

• Main Authors: Min-chi Chen, 陳明至
• Other Authors: Su-jing Yang
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/89620598093285804416

碩士 === 中臺科技大學 === 放射科學研究所 === 99 === ABSTRACT Background: Patent arteriovenous fistula (AVF) is related to better prognosis and quality of life for patients on long-term dialysis. When AVF dysfunction is suspected, Multi-detector row CT (MDCT) is a good noninvasive tool for evaluating the entire AVF structure and determining reversible conditions for treatment. Purpose: The aim of this study was is to introduce the scanning and interpretation techniques and to illustrate the conditions related to early and late fistula failures. Materials and Methods: The MDCT scans from January 2005 to December 2009 for evaluating patients with suspected AVF dysfunction were reviewed. The scanning technique, interpretation algorithm and various findings of AVF dysfunction were summarized. Results: The scans were performed with MDCT upper limb arteriography protocol, using ''contrast-covering time'' concept as the contrast injection technique. Dedicated MDCT workstation is suggested for interpretation, which includes axial scrolling and interactive post-processing, such as volume-rendering technique. Causes of early fistula failure, like arterial stenosis, juxtaanastomotic stenosis, proximal vein stenosis, central vein stenosis, and accessory veins were demonstrated. Conditions related with late fistula failure, like neointimal hyperplasia, thrombosis, infection, and pseudoaneurysm were also reviewed. Conclusion: MDCT is a fast, noninvasive, and accurate technique for diagnosing AVF complications. Radiologists familiar with these techniques can help to improve the prognosis and quality of life for hemodialysis patients.