Similarly, Heye et al [18] demonstrated an underestimation of stenoses on DSA when compared to MDCT angiography, where a stenosis was viewed in transverse and sagittal planes of planar reconstruction. CTV Extremity Area of Interest With IV Contrast CT venography (CTV) represents an alternative diagnostic study for many peripheral vascular interventions. However, it carries practical and logistical limitations in dialysis access imaging. There is no relevant literature to support the use of CTV with intravenous (IV) contrast in the evaluation of suspected dysfunction of a hemodialysis access. MRA Extremity Area of Interest Without and With IV Contrast Though not used in practice to visualize an AV access, MRA is a technique that has the potential to visualize the arterial and venous systems using IV contrast material. MRA represents a cross-sectional imaging modality that is noninvasive. It has been utilized for the assessment of vascular access failure, although it is relatively constrained by flow-related artifact, and limited field-of-view. In the meta-analysis by Li et al [11], they reported that MRA was an accurate diagnostic modality with sensitivity of 95.4%, specificity of 96.1%, and diagnostic odds ratio of 211.47, in evaluating hemodialysis AV access. The Li et al [11] meta-analysis of 500 patients with an autologous hemodialysis access, demonstrated that CTA and MRA supported accurate detection of stenoses and comparable diagnostic performance, suggesting that MDCT angiography and MRA may serve as diagnostic technical alternatives to DSA when assessing for stenoses in Dialysis Fistula Malfunction hemodialysis fistulas and grafts. Both CTA and MRA demonstrated high specificity, sensitivity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio with no significant difference in stenosis detection between CTA and MRA.
Dialysis Fistula Malfunction. Similarly, Heye et al [18] demonstrated an underestimation of stenoses on DSA when compared to MDCT angiography, where a stenosis was viewed in transverse and sagittal planes of planar reconstruction. CTV Extremity Area of Interest With IV Contrast CT venography (CTV) represents an alternative diagnostic study for many peripheral vascular interventions. However, it carries practical and logistical limitations in dialysis access imaging. There is no relevant literature to support the use of CTV with intravenous (IV) contrast in the evaluation of suspected dysfunction of a hemodialysis access. MRA Extremity Area of Interest Without and With IV Contrast Though not used in practice to visualize an AV access, MRA is a technique that has the potential to visualize the arterial and venous systems using IV contrast material. MRA represents a cross-sectional imaging modality that is noninvasive. It has been utilized for the assessment of vascular access failure, although it is relatively constrained by flow-related artifact, and limited field-of-view. In the meta-analysis by Li et al [11], they reported that MRA was an accurate diagnostic modality with sensitivity of 95.4%, specificity of 96.1%, and diagnostic odds ratio of 211.47, in evaluating hemodialysis AV access. The Li et al [11] meta-analysis of 500 patients with an autologous hemodialysis access, demonstrated that CTA and MRA supported accurate detection of stenoses and comparable diagnostic performance, suggesting that MDCT angiography and MRA may serve as diagnostic technical alternatives to DSA when assessing for stenoses in Dialysis Fistula Malfunction hemodialysis fistulas and grafts. Both CTA and MRA demonstrated high specificity, sensitivity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio with no significant difference in stenosis detection between CTA and MRA.