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Color Doppler ultrasound assessment of well-functioning mature arteriovenous fistula for hemodialysis access
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Abstracts / Journal of Clinical Imaging 30 (2006) 71 – 74
concepts, acquisition time could be reduced substantially without compromises in spatial resolution, enabling the implementation of more complex and flexible examination protocols. Whole-body MRI represents a new alternative to the stepwise multimodality concept for the detection of metastatic disease, multiple myeloma, and lymphoma of the bone with high diagnostic accuracy.
Color Doppler ultrasound assessment of well-functioning mature arteriovenous fistula for hemodialysis access Pietura R, Janczarek M, Zaluska W, Szymanska A, Janicka L, SkublewskaBednarek A, Szczerbo-Trojanowska M (Department of Interventional Radiology and Neuroradiology, University Medical School of Lublin, Jaczewskiego 8, Lublin 20-954, Poland). Eur J Radiol 2005;55:113 – 119. Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of hemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Color Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with color Doppler ultrasound. Materials and methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19Q79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with hemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure ( b 150 mmHg) at monthly evaluation; (3) Normal urea clearance Time/urea volume of distribution; and (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D. = 21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23% secondary, 11% third and fourth, 4% fifth, 5% sixth, and 8% patients had more than sixth. Results: There was no correlation between (1) patient’s age and fistula age; (2) patient’s age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; and (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient.
The mean flow volume was 1204.1 ml/min (S.D. = 554). It was significantly higher in the fistulas with aneurysms, calcifications, and tortuous vessels and lower in those with stenosis. There was no correlation between the flow volume or presence of stenosis and fistula age. Stenosis was detected in 64% fistulas. Fifty-seven percent of stenoses were located in the anastomotic region, 22% stenoses were in vein junction, 19% were at one or both ends of aneurysm, and 2% in the remaining region of the efferent vein. Perivascular color artefacts were present at the 94% fistulas with stenosis. Chronic venous occlusion with collateral veins was detected in 6% of fistulas. The aneurysms were observed in 54% fistulas. The mean diameter of aneurysms was 12.4 mm. Ninety-six percent of aneurysms were located at puncture sites. Ten patients had a small thrombus in an aneurysm and at puncture sites. Conclusions: We conclude that there was a high level of abnormalities present in well-functioning mature arteriovenous fistulas. However, these abnormalities were not sufficient to affect the functioning of the dialysis fistula.
The utility of endovaginal sonography in the evaluation of fecal incontinence Ramı´rez JM, Aguilella V, Martı´nez M, Gracia JA (Seccio´n de Coloproctologı´a, Servicio de Cirugia B, Hospital Clinico Universitario, C/ San Juan Bosco 15, E-Zaragoza, Spain). Rev Esp Enferm Dig 2005;97:317 – 322. Objective: The endoanal sonography in female patients with fecal incontinence is sometimes difficult and can lead to diagnostic errors. The aim of this study is to evaluate the value of endovaginal sonography in such cases. Materials and methods: Thirty female patients complaining of fecal incontinence are included in the study. Anal endosonography was performed in all of them in a single ambulatory session, pictures were taken from all along the anal, and results were analyzed afterward. Vaginal endosonography was then performed using the same equipment. Result from both techniques were compared. Results: Endoanal sonography was performed in all 30 patients. In 17 cases, no anomalies were found. In three patients, a simple internal anal sphincter defect was found. One case showed a lateral lesion in both sphincters. Six cases presented anterior external defect, and in the rest cases, a clear view of the anterior wall was impossible. Vaginal endosonography shows a clear image of the anal canal in 23 out of 30 patients. The results of anal endosonography changed in two cases. Conclusion: In the study of fecal incontinence, despite of its technical limitations, endovaginal ultrasound could be of help when the anterior wall of the anal canal is not property defined.
Abstracts / Journal of Clinical Imaging 30 (2006) 71 – 74
concepts, acquisition time could be reduced substantially without compromises in spatial resolution, enabling the implementation of more complex and flexible examination protocols. Whole-body MRI represents a new alternative to the stepwise multimodality concept for the detection of metastatic disease, multiple myeloma, and lymphoma of the bone with high diagnostic accuracy.
Color Doppler ultrasound assessment of well-functioning mature arteriovenous fistula for hemodialysis access Pietura R, Janczarek M, Zaluska W, Szymanska A, Janicka L, SkublewskaBednarek A, Szczerbo-Trojanowska M (Department of Interventional Radiology and Neuroradiology, University Medical School of Lublin, Jaczewskiego 8, Lublin 20-954, Poland). Eur J Radiol 2005;55:113 – 119. Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of hemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Color Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with color Doppler ultrasound. Materials and methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19Q79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with hemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure ( b 150 mmHg) at monthly evaluation; (3) Normal urea clearance Time/urea volume of distribution; and (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D. = 21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23% secondary, 11% third and fourth, 4% fifth, 5% sixth, and 8% patients had more than sixth. Results: There was no correlation between (1) patient’s age and fistula age; (2) patient’s age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; and (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient.
The mean flow volume was 1204.1 ml/min (S.D. = 554). It was significantly higher in the fistulas with aneurysms, calcifications, and tortuous vessels and lower in those with stenosis. There was no correlation between the flow volume or presence of stenosis and fistula age. Stenosis was detected in 64% fistulas. Fifty-seven percent of stenoses were located in the anastomotic region, 22% stenoses were in vein junction, 19% were at one or both ends of aneurysm, and 2% in the remaining region of the efferent vein. Perivascular color artefacts were present at the 94% fistulas with stenosis. Chronic venous occlusion with collateral veins was detected in 6% of fistulas. The aneurysms were observed in 54% fistulas. The mean diameter of aneurysms was 12.4 mm. Ninety-six percent of aneurysms were located at puncture sites. Ten patients had a small thrombus in an aneurysm and at puncture sites. Conclusions: We conclude that there was a high level of abnormalities present in well-functioning mature arteriovenous fistulas. However, these abnormalities were not sufficient to affect the functioning of the dialysis fistula.
The utility of endovaginal sonography in the evaluation of fecal incontinence Ramı´rez JM, Aguilella V, Martı´nez M, Gracia JA (Seccio´n de Coloproctologı´a, Servicio de Cirugia B, Hospital Clinico Universitario, C/ San Juan Bosco 15, E-Zaragoza, Spain). Rev Esp Enferm Dig 2005;97:317 – 322. Objective: The endoanal sonography in female patients with fecal incontinence is sometimes difficult and can lead to diagnostic errors. The aim of this study is to evaluate the value of endovaginal sonography in such cases. Materials and methods: Thirty female patients complaining of fecal incontinence are included in the study. Anal endosonography was performed in all of them in a single ambulatory session, pictures were taken from all along the anal, and results were analyzed afterward. Vaginal endosonography was then performed using the same equipment. Result from both techniques were compared. Results: Endoanal sonography was performed in all 30 patients. In 17 cases, no anomalies were found. In three patients, a simple internal anal sphincter defect was found. One case showed a lateral lesion in both sphincters. Six cases presented anterior external defect, and in the rest cases, a clear view of the anterior wall was impossible. Vaginal endosonography shows a clear image of the anal canal in 23 out of 30 patients. The results of anal endosonography changed in two cases. Conclusion: In the study of fecal incontinence, despite of its technical limitations, endovaginal ultrasound could be of help when the anterior wall of the anal canal is not property defined.