64层螺旋CT血管造影图像融合技术对血液透析动静脉内瘘功能不全的评价

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Abstract Objective: To evaluate the clinical value of 64-multislice spiral computed tomography angiography (64-MSCTA) with image fusion for failing arteriovenous fistula in hemodialysis patients. Methods: Thirty-two hemodialysis patients with failing autogenous arteriovenous fistula (AVF) and 4 patients with failing synthetic arteriovenous graft (AVG) underwent 64-MSCTA. After axial source images were obtained, maximum intensity projection (MIP), volume rendering (VR), curved planner reconstruction (CPR), multiple planar reconstruction (MPR) images were constructed. Using VR technique, computed tomography angiography (CTA) of inflow artery and outflow vein (the polytetrafluoroethylene loop graft also was included in patients with AVG) were reconstructed respectively, and then the images were fused together. Results: Among 32 hemodialysis patients with failing AVF, the anastomotic stenosis in 11 cases, the cases of mild (0%～49%), moderate(50%～74%), severe (75%～99%) and occlusion (100%) stenosis were 1, 1, 8 and 1, respectively. Outflow vein stenosis was found in 18 cases, the cases of mild, moderate, severe and occlusion were 2, 4, 8 and 4, respectively. Inflow artery stenosis was found in 5 cases, mild in 2 and severe in 3. Mural thrombus was displayed by MIP in 11 cases, vein tumor-like expansion in 13 cases, multiple calcified plaques in 2 cases. Among 4 hemodialysis patients with AVG, 2 cases stenosis was at the venous anastomosis, mild in 1 and severe in 1. One cases stenosis was at PTEE loop graft and was of mild segmental stenosis. One case stenosis at anastomosis and loop graft simultaneously. Conclusion: 64-MSCTA with image fusion can accurately evaluate arteriovenous fistulas and grafts, which is helpful for customize future intervention.

Key words： hemodialysis arteriovenous fistula arteriovenous grafts tomography, X-ray computed angi-ography fusion imaging technique

Received: 26 June 2014

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	Articles by authors
	WEI Peiying1
	JIA Xiufen1
	ZHENG Chenfei2
	ZHENG Yongfei1
	KONG Jianguo1
	ZHANG Hua1
	WU Enfu1.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2014/V44/I12/892

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