Failing arteriovenous hemodialysis fistulas - Assessment with magnetic resonance angiography

RATIONALE AND OBJECTIVES. The authors sought to evaluate prospectively magn etic resonance angiography (MRA) versus fistulography in the detection and characterization of complications associated with malfunctioning hemodialys is access fistulas (arteriovenous fistulas [AVF]). METHODS. Nineteen patients with clinical AVF dysfunction were studied by MR A and fistulography, Data front each study were collected prospectively and analyzed in a blinded manner. RESULTS. The main diagnosis was stenosis in eight patients, thrombosis in f ive patients (mural thrombosis with preserved flow in one), aneurysm withou t stenosis in tno patients, and normal AVF in four patients. A hazy flow vo id, assumed to be related to turbulence, was observed in normal arterial an astomoses, When Row void was considered as a criterion of stenosis or throm bosis, one false-positive and one false-negative MRA study were determined, yielding a sensitivity and specificity of 92% and 86%, respectively. CONCLUSIONS. Magnetic resonance angiography is a feasible and sensitive tec hnique with which to portray suspected malfunctioning hemodialysis access f istulas.