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Comparison of hemodialysis arteriovenous fistula blood flow rates measured by Doppler ultrasound and phase-contrast magnetic resonance imaging
- Source :
- Journal of vascular surgery. 68(6)
- Publication Year :
- 2017
-
Abstract
- OBJECTIVE: To compare blood flow rates measured by Doppler ultrasonography (DUS) and phase-contrast magnetic resonance imaging (PC-MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. METHODS: Blood flow rates in the proximal artery and draining vein of newly created upper-extremity AVFs were measured and compared using DUS and PC-MRI at 1 day, 6 weeks, and 6 months postoperatively. RESULTS: Blood flow rate in the proximal artery measured by DUS (1155 ± 907 mL/min, mean ± standard deviation) and by MRI (1170 ± 657 mL/min) were not statistically different (P = .812), based on 78 data pairs from 49 patients. Draining vein DUS-flow (1277 ± 995 mL/min) and MRI-flow (1130 ± 655 mL/min) were also not statistically different (P = .071), based on 64 data pairs. In both proximal artery and draining vein, the two methods substantially agreed with each other (Cohen’s kappa: proximal artery = 0.66, draining vein = 0.67) when flow rates were put into four clinically relevant categories (lower than 300, 300-599, 600-1499, and 1500 mL/min or higher). The Bland-Altman analyses of DUS- and MRI-flow identified six and four outliers for proximal artery and draining vein, respectively. Seven outliers had higher DUS- than MRI-flow, with all DUS scan sites having a large lumen and/or significant local curvature; the other three had lower DUS-flow, partly due to an underestimation of lumen diameter by DUS. CONCLUSIONS: DUS- and MRI-flow rates are generally comparable in both proximal artery and draining vein. When using DUS for flow measurements, careful attention to accurate lumen diameter measurements is needed and scan sites with marked curvature should be avoided. Our result may improve the accuracy of DUS-measured AVF blood flow rate.
- Subjects :
- Time Factors
Magnetic Resonance Imaging, Cine
030204 cardiovascular system & hematology
Article
030218 nuclear medicine & medical imaging
Upper Extremity
03 medical and health sciences
0302 clinical medicine
Arteriovenous Shunt, Surgical
Predictive Value of Tests
Renal Dialysis
medicine
Humans
Prospective Studies
Vein
Prospective cohort study
Ultrasonography, Doppler, Duplex
medicine.diagnostic_test
business.industry
Reproducibility of Results
Magnetic resonance imaging
Blood flow
medicine.anatomical_structure
Treatment Outcome
Regional Blood Flow
Predictive value of tests
Kidney Failure, Chronic
Surgery
Doppler ultrasound
Hemodialysis - arteriovenous fistula
Cardiology and Cardiovascular Medicine
Nuclear medicine
business
Blood Flow Velocity
Artery
Subjects
Details
- ISSN :
- 10976809
- Volume :
- 68
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of vascular surgery
- Accession number :
- edsair.doi.dedup.....974e3852c93b2ecd9e842e75190ceec2