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Magnetic resonance angiographic assessment of upper extremity vessels prior to vascular access surgery: feasibility and accuracy

  • Vascular-Interventional
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Abstract

A contrast-enhanced magnetic resonance angiography (CE-MRA) protocol for selective imaging of the entire upper extremity arterial and venous tree in a single exam has been developed. Twenty-five end-stage renal disease (ESRD) patients underwent CE-MRA and duplex ultrasonography (DUS) of the upper extremity prior to hemodialysis vascular access creation. Accuracy of CE-MRA arterial and venous diameter measurements were compared with DUS and intraoperative (IO) diameter measurements, the standard of reference. Upper extremity vasculature depiction was feasible with CE-MRA. CE-MRA forearm and upper arm arterial diameters were 2.94 ± 0.67 mm and 4.05 ± 0.84 mm, respectively. DUS arterial diameters were 2.80 ± 0.48 mm and 4.38 ± 1.24 mm; IO diameters were 3.00 ± 0.35 mm and 3.55 ± 0.51 mm. Forearm arterial diameters were accurately determined with both techniques. Both techniques overestimated upper arm arterial diameters significantly. Venous diameters were accurately determined with CE-MRA but not with DUS (forearm: CE-MRA: 2.64 ± 0.61 mm; DUS: 2.50 ± 0.44 mm, and IO: 3.40 ± 0.22 mm; upper arm: CE-MRA: 4.09 ± 0.71 mm; DUS: 3.02 ± 1.65 mm, and IO: 4.30 ± 0.78 mm). CE-MRA enables selective imaging of upper extremity vasculature in patients requiring hemodialysis access. Forearm arterial diameters can be assessed accurately by CE-MRA. Both CE-MRA and DUS slightly overestimate upper arm arterial diameters. In comparison to DUS, CE-MRA enables a more accurate determination of upper extremity venous diameters.

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Authors and Affiliations

  1. Department of Vascular Surgery, Maastricht University Hospital, Peter Debijelaan 25, 6202 AZ, Maastricht, The Netherlands

    Nils R. Planken & Jan H. Tordoir

  2. Department of Radiology, Maastricht University Hospital, Maastricht, The Netherlands

    Nils R. Planken, Michiel W. de Haan & Tim Leiner

  3. Department of Nephrology, Maastricht University Hospital, Maastricht, The Netherlands

    Frank M. van der Sande & Jeroen P. Kooman

  4. Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands

    Lucien E. Duijm & Harrie C. van den Bosch

  5. Cardiovascular Research Institute Maastricht, Maastricht University Medical School, Maastricht, The Netherlands

    Nils R. Planken, Jan H. Tordoir, Frank M. van der Sande, Jeroen P. Kooman, Michiel W. de Haan & Tim Leiner

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  1. Nils R. Planken
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Correspondence to Nils R. Planken.

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Planken, N.R., Tordoir, J.H., Duijm, L.E. et al. Magnetic resonance angiographic assessment of upper extremity vessels prior to vascular access surgery: feasibility and accuracy. Eur Radiol 18, 158–167 (2008). https://doi.org/10.1007/s00330-007-0714-y

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  • DOI: https://doi.org/10.1007/s00330-007-0714-y

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