Ahmed Abdel Razek, Presenter: Nothing to Disclose

Ahmed Yousef Kandeel MD, PhD, Abstract Co-Author: Nothing to Disclose

Osama Rabeah, Abstract Co-Author: Nothing to Disclose

Amir Eltantawey, Abstract Co-Author: Nothing to Disclose

Ehab Saad, Abstract Co-Author: Nothing to Disclose

Hosam Elwakeal, Abstract Co-Author: Nothing to Disclose

To assess dysfunctional hemodialysis access fistula and graft of the upper extremity with high-resolution three dimensional contrast enhanced MR angiography.

Three-dimensional contrast enhanced MR angiography (CE-MRA) was performed for 33 patients (12 M, 11F mean age 34ys) with dysfunctional hemodialysis access fistula or graft of the upper extremity. This study was conducted on 1.5 tesla MR unit (Symphony -Siemens). The parameters used: TR=7msec, TE=3msec, Flip angle=40 degree, FOV=25-35 cm & matrix =256 X256. Bolus of gadolinium-DTPA was injected in the forearm (0.2mmol/kg at rate of 3ml/sec followed by 20ml saline flush at the same rate). Multiple series are taken after contrast administration. The first acquisition served as, a mask, which was subtracted from the other acquisitions

All CE-MRA examinations were technically adequate for analysis with high signal noise ratio. CE-MRA accurately diagnosed stenosis (n=16) along the venous or arterial side of the fistula and graft. Thrombosis with complete occlusion of the graft was seen in 4 patients. Venous hypertension was diagnosed in 4 patients. Steel phenomena with decreased perfusion of the hand (n=3) and pseudo-aneurysm were easily diagnosed with CE-MRA.

High resolution contrast enhanced MR angiography is a promising diagnostic imaging modality for diagnosis the causes of dysfunctional hemodialysis access fistula and graft and treatment planning.

Contrast enhanced MR angiography is essential for assessment of dysfunctional hemodialysis fistula access and graft and decision of treatment.

Abdel Razek, A, Kandeel, A, Rabeah, O, Eltantawey, A, Saad, E, Elwakeal, H, Assessment of Dysfunctional Hemodialysis Access Fistula and Graft of the Upper Extremity with High Resolution Contrast-enhanced MR Angiography.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5000619.html