Abstract: SA-PO1100
The Diagnostic Value of Multi-Detector CT Venography for Catheter-Related Central Venous Stenosis in Hemodialysis Patients
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Yang, Letian, West China Hospital of Sichuan University, Chengdu, China
- Zhao, Yuliang, Division of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- Cui, Tianlei, West China Hospital of Sichuan University, Chengdu, China
- Fu, Ping, West China Hospital of Sichuan University, Chengdu, China
Background
Central venous stenosis (CVS) is a common complication in hemodialysis patients, especially those who are dialyzed through a catheter. The objective of our study was to assess the diagnostic value of Multi-detector CT venography (MDCTV) for catheter related-CVS compared with conventional digital subtraction angiography (DSA) in hemodialysis patients.
Methods
Between October 1, 2012 and September 30, 2018, hemodialysis patients admitted to our center for suspected catheter related-CVS who received both MDCTV and DSA were retrospectively enrolled. We compared the sensitivity, specificity, Cohen's kappa coefficient (κ) of MDCTV compared to DSA.
Results
A total of 1533 vascular segments in 219 patients were analyzed. Among the 280 lesions identified by DSA, 156 were correctly identified by MDCTV. MDCTV had a high specificity (96.73%) but a low sensitivity (55.71%), with a moderate inter-test agreement (κ=0.5930). In stratified analyses of vascular segments, the specificities of MDCTV were 89.93% (superior vena cava), 98.95% (left innominate vein), 95.33% (right innominate vein), 99.53% (left subclavian vein), 97.61% (right subclavian vein), 97.13% (left internal jugular vein), and 95.86% (right internal jugular vein), while the sensitivities were 90.00%, 65.52%, 66.67%, 87.50%, 40.00%, 20.00% and 8.11%, respectively (Figure 1).
Conclusion
MDCTV was a reliable imaging technique with high specificity in being able to diagnose catheter related-CVS in hemodialysis. However, the low sensitivity in some vascular segments diminished its value as a screening test. MDCTV seemed to have better diagnostic value for centrally localized CVS in superior vena cava and innominate veins.
Figure 1. Specificity, sensitivity, cohen's κ coefficient by vascular segments. SVC: superior vena cava. LIV: left innominate veins. RIV: right innominate vein. LSCV: left subclavian vein. RSCV: right subclavian vein. LIJV: left internal jugular vein. RIJV: right internal jugular vein.
Funding
- Government Support - Non-U.S.