OBJECTIVE. The purpose of this study was to assess the diagnostic value of
MR peritoneography in complications of continuous ambulatory peritoneal dia
lysis.
SUBJECTS AND METHODS, Twenty consecutive patients treated with continuous a
mbulatory peritoneal dialysis who were clinically suspected of dialysis-rel
ated complications were prospectively studied with MR peritoneography. For
MR peritoneography, 20 ml of gadodiamide was added to 2000-ml dialysate sol
ution (1.36% glucose) that was instilled into the peritoneal cavity. MR per
itoneography was performed with the peritoneal cavity filled (n = 12) and a
fter complete drainage of the contrast material-dialysate mixture (n = 20)
on a 1.5-T MR unit with a phased array coil. Imaging included axial T1-weig
hted fast low-angle shot (TR/TE, 174/4.2) with and without fat saturation a
nd axial and coronal T2-weighted fat-saturated turbo spin-echo (3000/138) s
equences. All studies were performed without IV contrast material. Images w
ere reviewed for evidence of peritoneal leaks, hernias, loculated fluid col
lections, and adhesions.
RESULTS. Abnormal findings were detected in 13 (65%) of 20 patients and inc
luded retroperitoneal leaks (n = 6), diaphragmatic leaks (n = 2), catheter
exit-site leaks (n = 2), inguinal hernias (n = 2), and peritoneal adhesions
(n = 1).
CONCLUSION. MR peritoneography is useful for the evaluation of complication
s related to continuous ambulatory peritoneal dialysis, and it offers excel
lent tissue contrast and multiplanar imaging for assessment of complication
s.