Nonnast-Daniel B, Martin R P, Lindert O, Mügge A, Schaeffer J, vd Lieth H, Söchtig E, Galanski M, Koch K M, Daniel W G
Department of Internal Medicine, Hannover Medical School, Germany.
Lancet. 1992 Jan 18;339(8786):143-5. doi: 10.1016/0140-6736(92)90209-l.
Satisfactory function of the arteriovenous fistula (AVF) is essential for adequate haemodialysis in patients with chronic renal failure. Existing methods to assess AVF function are imprecise (eg, clinical examination) or invasive (eg, angiography). We assessed the value of colour flow-doppler ultrasound (CFDU) in the investigation of clinically suspected AVF dysfunction. 51 patients with suspected impairment of AVF function were studied by CFDU, and 28 also underwent angiography. The findings were compared with the reference standard of the findings at reoperation. CFDU showed AVF stenoses in 18 patients, which were all confirmed at reoperation; the results of angiography in 13 of these 18 patients showed complete agreement with the findings of CFDU and surgery. CFDU showed partial or complete AVF thrombosis in 33 patients, confirmed in all patients at reoperation; 15 patients also underwent angiography, and thrombi were not found in 6 (in 4 because of technical failure). 7 patients had aneurysms on CFDU that were confirmed by surgery in all patients and by angiography in 2 of the 3 patients studied. CFDU enables reliable non-invasive assessment of AVF morphology and function and may become the procedure of choice for AVF assessment in patients with suspected AVF abnormalities.
动静脉内瘘（AVF）功能良好对于慢性肾衰竭患者进行充分的血液透析至关重要。现有的评估AVF功能的方法不准确（如临床检查）或具有侵入性（如血管造影）。我们评估了彩色多普勒超声（CFDU）在临床怀疑AVF功能障碍检查中的价值。对51例怀疑AVF功能受损的患者进行了CFDU检查，其中28例还接受了血管造影。将检查结果与再次手术时的检查结果这一参考标准进行比较。CFDU显示18例患者存在AVF狭窄，所有这些患者在再次手术时均得到证实；这18例患者中有13例的血管造影结果与CFDU及手术结果完全一致。CFDU显示33例患者存在部分或完全性AVF血栓形成，所有患者在再次手术时均得到证实；15例患者也接受了血管造影，其中6例未发现血栓（4例因技术失败）。7例患者在CFDU检查中发现有动脉瘤，所有患者经手术证实，3例接受血管造影检查的患者中有2例经血管造影证实。CFDU能够对AVF的形态和功能进行可靠的非侵入性评估，可能会成为怀疑有AVF异常的患者进行AVF评估的首选检查方法。
