Kathrein H, König P, Weimann S, Judmaier G, Dittrich P
Univ. Klinik für Innere Medizin Innsbruck.
Ultraschall Med. 1989 Feb;10(1):33-40. doi: 10.1055/s-2007-1005958.
In 61 patients with end-stage renal disease the results of 89 consecutive Duplex examinations of the arteriovenous fistulas used for haemodialysis were evaluated. The examinations were performed because of various problems concerning the vascular access or before the first puncture. Using 7.5 and 10.0 MHz probes (pulsed Doppler 3.0 and 4.5 MHz) the morphology and the function of the fistulas were evaluated. In 35 cases the results were normal, in a further 27 cases minor anomalies were seen without influencing the function. Complete thrombosis was observed in 7, partial thrombosis and severe stenosis in 4 cases each. Large aneurysms were documented in 6 examinations and in the remaining 6 the fistulas had not matured sufficiently within 4 weeks. The ultrasound results correlated well with consecutive angiography or surgery. The mean flow in normal fistulas was 514 +/- 223 ml/min. It was higher in PTFE shunts (614 +/- 242 ml/min) than in Cimino-Brescia fistulas (464 +/- 199 ml/min). Complications were observed more often in the PTFE group (63.9% vs. 58.5%). We think that Duplex sonography offers an accurate, non-invasive way to evaluate the morphology and the function of arteriovenous fistulas of patients on haemodialysis. This should therefore be performed as the first imaging method whenever problems concerning the fistula occur.
对61例终末期肾病患者进行了89次连续性双功超声检查，以评估用于血液透析的动静脉内瘘情况。检查是由于血管通路存在各种问题或在首次穿刺前进行的。使用7.5和10.0MHz探头（脉冲多普勒3.0和4.5MHz）评估内瘘的形态和功能。35例结果正常，另外27例可见轻微异常但不影响功能。观察到7例完全血栓形成，4例部分血栓形成和重度狭窄。6次检查记录到较大动脉瘤，其余6例内瘘在4周内未充分成熟。超声结果与连续性血管造影或手术结果相关性良好。正常内瘘的平均血流量为514±223ml/min。聚四氟乙烯分流管（614±242ml/min）的血流量高于西米诺-布雷西亚内瘘（464±199ml/min）。聚四氟乙烯组并发症发生率更高（63.9%对58.5%）。我们认为双功超声检查为评估血液透析患者动静脉内瘘的形态和功能提供了一种准确、无创的方法。因此，每当内瘘出现问题时，应将其作为首选的影像学检查方法。
