W T Jin1, G F Zhang2, H C Liu3, H Zhang1, B Li3, X Q Zhu3. 1. Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 2. Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Electronic address: 344092668@qq.com. 3. Department of Radiology, Shanghai Changzheng Hospital, Shanghai, China.
Abstract
AIM: To assess the diagnostic value of non-contrast-enhanced magnetic resonance angiography (NCE-MRA), using time-of-flight and black-blood MRA, in the evaluation of arteriovenous fistulas in haemodialysis patients in comparison to multidetector computed tomography angiography (MDCTA). MATERIAL AND METHODS: NCE-MRA and MDCTA were performed on the same day in 21 patients on maintenance haemodialysis with dysfunctional arteriovenous fistulas. The fistulas included three segments: arterial inflow, anastomosis, and venous outflow. Two experienced observers, who were blinded to the results of the NCE-MRA, recorded in consensus the significant stenoses (≥50%) seen on CTA. Two other experienced observers, unaware of the results of CTA, independently recorded significant stenoses (≥50%) in the NCE-MRA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were calculated, with MDCTA as the standard reference. RESULTS: Sixty-three vascular segments in the 21 patients were clearly displayed. For the two observers of NCE-MRA, the accuracy was 98% and 95.4%; sensitivity 96.4% and 96.4%; specificity 97.1% and 94.3%; positive predictive value 96.4% and 93.1%; and, negative predictive value 97.1% and 97.1%. Inter-/intra-observer agreement for detecting stenosis was excellent for NCE-MRA, with a weighted kappa of 0.968 (95% confidence interval [CI], 0.874-1) and 0.936 (95% CI, 0.848-1). CONCLUSION: Non-contrast-enhanced MRA, using time-of-flight and black-blood MRA, is a reproducible and reliable imaging technique for detecting ≥50% stenosis in dysfunctional haemodialysis arteriovenous fistulas.
AIM: To assess the diagnostic value of non-contrast-enhanced magnetic resonance angiography (NCE-MRA), using time-of-flight and black-blood MRA, in the evaluation of arteriovenous fistulas in haemodialysis patients in comparison to multidetector computed tomography angiography (MDCTA). MATERIAL AND METHODS: NCE-MRA and MDCTA were performed on the same day in 21 patients on maintenance haemodialysis with dysfunctional arteriovenous fistulas. The fistulas included three segments: arterial inflow, anastomosis, and venous outflow. Two experienced observers, who were blinded to the results of the NCE-MRA, recorded in consensus the significant stenoses (≥50%) seen on CTA. Two other experienced observers, unaware of the results of CTA, independently recorded significant stenoses (≥50%) in the NCE-MRA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were calculated, with MDCTA as the standard reference. RESULTS: Sixty-three vascular segments in the 21 patients were clearly displayed. For the two observers of NCE-MRA, the accuracy was 98% and 95.4%; sensitivity 96.4% and 96.4%; specificity 97.1% and 94.3%; positive predictive value 96.4% and 93.1%; and, negative predictive value 97.1% and 97.1%. Inter-/intra-observer agreement for detecting stenosis was excellent for NCE-MRA, with a weighted kappa of 0.968 (95% confidence interval [CI], 0.874-1) and 0.936 (95% CI, 0.848-1). CONCLUSION: Non-contrast-enhanced MRA, using time-of-flight and black-blood MRA, is a reproducible and reliable imaging technique for detecting ≥50% stenosis in dysfunctional haemodialysis arteriovenous fistulas.
Authors: Conor J MacDonald; Stephen Gandy; Eilidh C M Avison; Shona Matthew; Rose Ross; John G Houston Journal: MAGMA Date: 2018-08-21 Impact factor: 2.310
Authors: C J MacDonald; R Hellmuth; L Priba; E Murphy; S Gandy; S Matthew; R Ross; J G Houston Journal: Cardiovasc Eng Technol Date: 2020-07-01 Impact factor: 2.495