Older R A, Gizienski T A, Wilkowski M J, Angle J F, Cote D A
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Radiology. 1998 Apr;207(1):161-4. doi: 10.1148/radiology.207.1.9530312.
To evaluate color Doppler ultrasound (US) in detection of subclinical stenosis of hemodialysis access grafts and fistulas.
Doppler US was performed in 40 consecutive patients with no clinical or laboratory findings of hemodialysis access dysfunction. To assess the presence and percentage of stenosis, the maximum systolic blood velocity and velocity ratios were measured and the US images were assessed visually. Fistulography was recommended in patients who demonstrated stenosis greater than 50% at US.
At US, 32 of the 40 patients had evidence of stenosis greater than 50%. In 23 of the 32 patients, a follow-up fistulogram was obtained. Hemodynamically significant stenosis was confirmed in 19 of the 23 patients at fistulography. Percutaneous transluminal angioplasty was then performed in 18 of the 19 patients and was successful.
Color Doppler US is more sensitive than clinical or laboratory methods for detection of hemodialysis access stenosis. Screening with US appears to enable earlier detection and therapy.
评估彩色多普勒超声（US）在检测血液透析通路移植物和内瘘亚临床狭窄中的作用。
对40例无血液透析通路功能障碍临床或实验室检查结果的连续患者进行多普勒超声检查。为评估狭窄的存在及百分比，测量最大收缩期血流速度和速度比，并对超声图像进行视觉评估。对于超声显示狭窄大于50%的患者，建议进行瘘管造影。
超声检查时，40例患者中有32例有狭窄大于50%的证据。在32例患者中的23例进行了随访瘘管造影。瘘管造影证实23例患者中有19例存在血流动力学显著狭窄。然后对19例患者中的18例进行了经皮腔内血管成形术，手术成功。
彩色多普勒超声在检测血液透析通路狭窄方面比临床或实验室方法更敏感。超声筛查似乎能实现更早的检测和治疗。
