Diagnostic value of ultrasonic monitoring of brachial artery vascular parameters for autologous arteriovenous fistula complications

doi:10.3877/cma.j.issn.2095-655X.2021.04.003

Abstract

Abstract:

Objective

To explore the diagnostic value of brachial artery vascular ultrasound inspection for autologous arteriovenous fistula (AVF) complications.

Methods

Retrospective analysis of ultrasound imaging data was applied to 106 patients with chronic kidney disease undergoing AVF in the Ultrasonic Department of Drum Tower Hospital Affiliated to Medical School of Nanjing University from March 2016 to June 2020. Patients were divided into non-complication group (n=57) and common complication group (n=49) according to ultrasound examination results. The latter was further divided into cephalic venous thrombosis group (n=8), cephalic venous stenosis group (n=31) and cephalic venous aneurysm-like dilatation group (n=21), according to the type of complications, 10 patients had two or more complications. The diameter, peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI), time-averaged mean velocity (TAMV), pulsatility index (PI), and blood flow of brachial artery were measured by ultrasound. The parameters of brachial artery were compared between groups, and the diagnostic value for cephalic vein stenosis was analyzed by receiver operating characteristic(ROC)curve.

Results

The PSV[(149.42±41.95)cm/s], EDV[(71.75±23.62)cm/s], TAMV[(59.25±19.79)cm/s], blood flow [(898.26±357.09)ml/min] of brachial artery in non-complication group were higher than those of common complication group[(128.91±40.42)cm/s, (56.19±29.98)cm/s, (46.82±23.69)cm/s, 659.00(291.50, 934.50)ml/min], with significant differences (t=2.55, 2.98, 2.94, Z=-2.60, all P<0.05). PI[1.38(1.13, 1.61)] in non-complication group was lower than that of the common complication group [1.52(1.11, 2.40)], with significant difference (Z=2.13, P<0.05). The areas under the ROC curve of brachial artery diameter, PSV, EDV, RI, PI, TAMV and blood flow for the diagnosis of cephalic venous stenosis were 0.71, 0.73, 0.76, 0.70, 0.68, 0.75, 0.81. Specificities were 68.42%, 75.44%, 91.23%, 89.47%, 92.98%, 92.98%, 91.23%, while sensibilities were 67.74%, 64.52%, 54.84%, 48.39%, 51.61%, 54.84%, 61.29% (all P<0.01).

Conclusion

Ultrasound monitoring of brachial artery vascular parameters has certain diagnostic value for AVF complications, and the brachial artery flow has the greatest diagnostic value for cephalic venous stenosis.

Key words: Ultrasonography, Arteriovenous fistula, Brachial artery, Complication, Diagnosis

Han Zhang, Jiao Liu, Hengjin Wang, Ming Zhang, Min Wu, Wentao Kong. Diagnostic value of ultrasonic monitoring of brachial artery vascular parameters for autologous arteriovenous fistula complications[J]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(04): 226-231.

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Figures/Tables 7

References 24

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组别	例数	内径(cm，±s)	PSV(cm/s，±s)	EDV(cm/s，±s)	RIM(P₂₅，P₇₅)	TAMV(cm/s，±s)	PIM(P₂₅，P₇₅)	流量(ml/min)
无并发症组	57	0.56±0.09	149.42±41.95	71.75±23.62	0.53(0.48，0.58)	59.25±19.79	1.38(1.13，1.61)	898.26±357.09
常见并发症组	49	0.56±0.12	128.91±40.42	56.19±29.98	0.56(0.46，0.67)	46.82±23.69	1.52(1.11，2.40)	659.00(291.50，934.50)
统计量		t＝0.46	t＝2.55	t＝2.99	Z＝1.92	t＝2.94	Z＝2.13	Z＝-2.60
P值		0.649	0.012	0.004	0.055	0.004	0.034	0.009

组别	例数	内径(cm，±s)	PSV(cm/s，±s)	EDV(cm/s，±s)	RIM(P₂₅，P₇₅)	TAMV(cm/s，±s)	PIM(P₂₅，P₇₅)	流量(ml/min)
无并发症组	57	0.56±0.09	149.42±41.95	71.75±23.62	0.53(0.48，0.58)	59.25±19.79	1.38(1.13，1.61)	898.26±357.09
常见并发症组	49	0.56±0.12	128.91±40.42	56.19±29.98	0.56(0.46，0.67)	46.82±23.69	1.52(1.11，2.40)	659.00(291.50，934.50)
统计量		t＝0.46	t＝2.55	t＝2.99	Z＝1.92	t＝2.94	Z＝2.13	Z＝-2.60
P值		0.649	0.012	0.004	0.055	0.004	0.034	0.009

组别		例数	流量	统计量	P值
无并发症组		57	898.26±357.09
常见并发症组		49
	头静脉狭窄组	31	423.00(235.00，729.00)^ab	Z＝4.71	<0.001
	头静脉瘤样扩张组	21	895.00(711.00，1453.50)^ab	Z＝-0.89	>0.05
	头静脉血栓组	8	729.98±600.69^a	t＝0.77	>0.05

组别		例数	流量	统计量	P值
无并发症组		57	898.26±357.09
常见并发症组		49
	头静脉狭窄组	31	423.00(235.00，729.00)^ab	Z＝4.71	<0.001
	头静脉瘤样扩张组	21	895.00(711.00，1453.50)^ab	Z＝-0.89	>0.05
	头静脉血栓组	8	729.98±600.69^a	t＝0.77	>0.05

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