Geoffroy O, Tassart M, Le Blanche A F, Khalil A, Duédal V, Rossert J, Bigot J M, Boudghène F P
Department of Radiology, Hôpital Tenon, Paris, France.
Kidney Int. 2001 Apr;59(4):1491-7. doi: 10.1046/j.1523-1755.2001.0590041491.x.
The purpose of this study was to evaluate the feasibility, safety, and potential role of gadoterate meglumine (Gd-DOTA) as a contrast agent for upper extremity venography before the creation of an arteriovenous fistula (AVF) for nondialyzed renal insufficiency patients.
Over a 16-month period, 50 venographies were performed on end-stage renal insufficiency patients, using Gd-DOTA as a contrast agent on a high-resolution digital subtraction angiography system. Three sequences were performed on forearm, arm, and chest at 3 mL/sec for a total of 35 mL of Gd-DOTA. Examinations were reviewed by two radiologists for diagnostic and opacification quality. Tolerance was evaluated on the evolution of serum creatinine levels and occurrence of pain during injection.
Good interobserver correlation was obtained in evaluating the feasibility of AVF creation by vein segment (0.64 < kappa < 0.88) and in relationship to opacification quality (0.62 to 0.87). No deterioration in renal function (creatinine level before and after) or pain was observed. Twenty-six patients underwent surgical creation of brachiobasilic (N = 8), brachiocephalic (N = 8), radiocephalic (N = 8), and cubitocephalic (N = 1) fistulas or insertion of a polytetrafluoroethylene (PTFE) graft (N = 1). Seventeen were awaiting AVF or were on peritoneal dialysis. Two died before surgery for reasons unconnected with the venography.
Venography with Gd-DOTA is an effective and safe technique in planning AVFs for renal insufficiency patients.
本研究的目的是评估钆喷酸葡胺（Gd - DOTA）作为对比剂在未透析的肾功能不全患者动静脉内瘘（AVF）建立前进行上肢静脉造影的可行性、安全性及潜在作用。
在16个月的时间里，对终末期肾功能不全患者进行了50次静脉造影，在高分辨率数字减影血管造影系统上使用Gd - DOTA作为对比剂。在前臂、上臂和胸部以3 mL/秒的速度进行三个序列扫描，共使用35 mL的Gd - DOTA。两名放射科医生对检查结果进行诊断和造影剂充盈质量评估。通过血清肌酐水平的变化和注射过程中疼痛的发生情况评估耐受性。
在评估按静脉节段建立AVF的可行性（0.64 < κ < 0.88）以及与造影剂充盈质量的关系（0.62至0.87）方面，观察者间具有良好的相关性。未观察到肾功能恶化（前后肌酐水平）或疼痛。26例患者接受了肱静脉 - 贵要静脉（N = 8）、头臂静脉（N = 8）、桡静脉 - 头静脉（N = 8）和肘静脉 - 头静脉（N = 1）内瘘的手术创建或聚四氟乙烯（PTFE）移植物的植入（N = 1）。17例患者在等待AVF或进行腹膜透析。2例患者在手术前因与静脉造影无关的原因死亡。
使用Gd - DOTA进行静脉造影是为肾功能不全患者规划AVF的一种有效且安全的技术。
