In response, blood flow through the venous vessel instantly increases. The arteriovenous fistula (AVF) first described by Brescia and Cimino in 1966, revolutionised vascular access, allowing repeated access to high volume blood flow by forming a surgical anastomosis between the radial artery and cephalic vein. Haemodialysis (HD) is the most common form of RRT however, the provision of optimal vascular access, essential for successful HD, has long remained a challenge. Patients with ESRD require some form of renal replacement therapy (RRT). Further, the ability to clearly delineate the post-surgery vessel edges with MEDIC MRI suggests that the technique may be useful for surveillance after AVF creation or for patient-specific modelling studies.Įnd-stage renal disease (ESRD) affects an estimated two million people worldwide and is increasing at a rate of around 3% per year. With the exception of ToF, the MRI data demonstrated excellent agreement with US for measurements of vessel geometry and flow velocity. At the same site the outer boundary of the vessel was consistently lost on ToF, but remained clearly delineated on the MEDIC images. Post-operatively, the intra-luminal signal intensity was hypo-intense at the anastomosis site using ToF and MEDIC. However, ToF underestimated the mean diameter of the cephalic vein relative to US ( p 0.05).
Resultsįor mean vessel diameters (radial and brachial arteries cephalic vein) MEDIC measurements were similar to US ( p > 0.05). Patients were also scanned after arteriovenous fistula (AVF) surgery. Subjects were scanned using US (reference standard), and MRI 2D time-of-flight (ToF), 2D phase contrast (PC), and 3D multi-echo data image combination (MEDIC). To compare non-contrast enhanced MRI with ultrasound (US) for measurement of arm blood vessel geometries and flow velocities in volunteers and patients with end-stage renal disease.
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