HEMODIALYSIS ACCESS FISTULA CREATION - PREOPERATIVE ASSESSMENT WITH MR VENOGRAPHY AND COMPARISON WITH CONVENTIONAL VENOGRAPHY

PURPOSE: To prospectively evaluate magnetic resonance (MR) venography in the assessment of the adequacy of superficial veins for creation of hemodialysis access fistulas. MATERIALS AND METHODS: Twenty-eight upp er limbs in 24 patients were imaged with MR and conventional venograph y. MR venography was performed with sequential multisection two-dimens ional fast row-angle shot acquisitions in the axial plane from the wri st through the arm. two observers independently evaluated MR venograms without knowledge of conventional venographic results. MR and venogra phic data were compared with each other and with surgical data in 21 p atients. Diameters measured on MR and conventional venograms were perf ormed by using linear regression analysis. Qualitative comparisons wer e performed with the kappa coefficient. RESULTS: Conventional and MR v enographic diameter measurements were closely correlated overall (r = 0.91, P < .001) and on a vein-by-vein basis (r = 0.84-0.98, P < .001). MR and conventional venographic results were also well correlated in terms of demonstration of superficial veins (kappa = 0.83). MR venogra phy demonstrated more patent veins than venography did, but the differ ence was not significant. The correlation between MR venographic and s urgical findings (kappa = 0.78) was superior to that between conventio nal venographic and surgical findings (kappa = 0.56). CONCLUSION: MR v enography is an accurate, noninvasive technique that is as useful as c onventional venography for the planning of hemodialysis access fistula creation.