Comparison of diagnostic accuracy with carbon dioxide versus iodinated contrast material in the imaging of hemodialysis access fistulas.

K. O. Ehrman, Tim Taber, G. M. Gaylord, P. B. Brown, J. P. Hage

Research output: Contribution to journalArticle

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Abstract

PURPOSE: Imaging of dialysis fistulas was performed with use of carbon dioxide and iodinated contrast material. Images were then compared to assess the quality and accuracy of CO2 as a contrast agent. PATIENTS AND METHODS: Thirty-two patients underwent digital subtraction imaging of the fistulas performed with both iodinated contrast material and CO2 to evaluate the venous anastomosis. The images were blinded and the degree of stenosis was graded in 10% increments by two physicians. Statistical analysis including sensitivity, specificity, and accuracy of CO2 images was performed. RESULTS: There was no significant difference in physician ratings of the degree of venous stenosis (P > .30). Estimation of the degree of stenosis was significantly higher with CO2 than with ionic contrast material (P = .0001). When iodinated contrast material is used as the gold standard, the sensitivity, specificity, and accuracy of CO2 were 94%, 58%, and 75%, respectively. CONCLUSIONS: CO2 has a role as a contrast agent in the imaging of dialysis access grafts when the use of iodinated contrast material is of concern. CO2 is safe for venous injections; however, it should not be used to evaluate the arterial anastomosis with the "reflux technique."

Original languageEnglish (US)
Pages (from-to)771-775
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume5
Issue number5
StatePublished - Sep 1994
Externally publishedYes

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Carbon Dioxide
Contrast Media
Fistula
Renal Dialysis
Pathologic Constriction
Dialysis
Physicians
Sensitivity and Specificity
Transplants
Injections

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Comparison of diagnostic accuracy with carbon dioxide versus iodinated contrast material in the imaging of hemodialysis access fistulas. / Ehrman, K. O.; Taber, Tim; Gaylord, G. M.; Brown, P. B.; Hage, J. P.

In: Journal of Vascular and Interventional Radiology, Vol. 5, No. 5, 09.1994, p. 771-775.

Research output: Contribution to journalArticle

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AB - PURPOSE: Imaging of dialysis fistulas was performed with use of carbon dioxide and iodinated contrast material. Images were then compared to assess the quality and accuracy of CO2 as a contrast agent. PATIENTS AND METHODS: Thirty-two patients underwent digital subtraction imaging of the fistulas performed with both iodinated contrast material and CO2 to evaluate the venous anastomosis. The images were blinded and the degree of stenosis was graded in 10% increments by two physicians. Statistical analysis including sensitivity, specificity, and accuracy of CO2 images was performed. RESULTS: There was no significant difference in physician ratings of the degree of venous stenosis (P > .30). Estimation of the degree of stenosis was significantly higher with CO2 than with ionic contrast material (P = .0001). When iodinated contrast material is used as the gold standard, the sensitivity, specificity, and accuracy of CO2 were 94%, 58%, and 75%, respectively. CONCLUSIONS: CO2 has a role as a contrast agent in the imaging of dialysis access grafts when the use of iodinated contrast material is of concern. CO2 is safe for venous injections; however, it should not be used to evaluate the arterial anastomosis with the "reflux technique."

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