Tordoir J H, de Bruin H G, Hoeneveld H, Eikelboom B C, Kitslaar P J
Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
J Vasc Surg. 1989 Aug;10(2):122-8. doi: 10.1067/mva.1989.0100122.
The results of duplex ultrasound scanning for the diagnosis of stenoses in Brescia-Cimino arteriovenous fistulas and graft arteriovenous fistulas created for hemodialysis access are reported. Quantitative Doppler spectrum analysis of 64 arteriovenous fistulas was correlated with the outcome of digital subtraction angiography. The best Doppler parameter for the detection of a stenosis was the peak systolic frequency. In graft arteriovenous fistulas the use of this parameter resulted in a diagnostic accuracy of 86%, a sensitivity of 92%, and a specificity of 84% in the detection of stenoses. In Brescia-Cimino arteriovenous fistulas the diagnosis of anastomotic stenoses was possible with a diagnostic accuracy of 81%, a sensitivity of 79%, and a specificity of 84%. Measurement of peak systolic frequency ratios or end-diastolic frequencies had no additional diagnostic value for the detection of stenoses. The diagnosis of efferent vein stenoses was very accurate with duplex investigation (accuracy 96%, sensitivity 95%, and a specificity of 97%. We conclude that duplex scanning is a promising noninvasive method for the diagnosis of stenoses in arteriovenous fistulas created for hemodialysis access.
本文报告了双功超声扫描用于诊断为血液透析通路而建立的 Brescia-Cimino 动静脉内瘘和移植动静脉内瘘狭窄的结果。对 64 例动静脉内瘘进行定量多普勒频谱分析，并与数字减影血管造影结果进行关联。检测狭窄的最佳多普勒参数是收缩期峰值频率。在移植动静脉内瘘中，使用该参数检测狭窄时，诊断准确率为 86%，灵敏度为 92%，特异性为 84%。在 Brescia-Cimino 动静脉内瘘中，吻合口狭窄的诊断准确率为 81%，灵敏度为 79%，特异性为 84%。测量收缩期峰值频率比或舒张末期频率对检测狭窄没有额外的诊断价值。双功超声检查对流出静脉狭窄的诊断非常准确（准确率 96%，灵敏度 95%，特异性 97%）。我们得出结论，双功扫描是一种很有前景的非侵入性方法，可用于诊断为血液透析通路而建立的动静脉内瘘狭窄。
