Complications of continuous ambulatory peritoneal dialysis: Findings on MRperitoneography

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.