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Diagnostic criteria for locating acquired arteriovenous fistulas with color Doppler sonography.
J Clin Ultrasound. 2002 Jul-Aug; 30(6):336-42.JC

Abstract

PURPOSE

The purpose of this prospective study was to evaluate and determine criteria for locating acquired arteriovenous fistulas using color Doppler sonography.

METHODS

We performed color Doppler sonography on 12 consecutive patients with acquired arteriovenous fistulas. We evaluated the morphologic and hemodynamic changes in the involved vessels to help locate the fistulas (10 in the extremities, 1 in the neck, and 1 in the abdomen).

RESULTS

In all cases, turbulent high-velocity flow spectrum and flow signals were present at the fistula sites, and arterialized waveforms from the draining veins were detected. In the 10 cases of acquired arteriovenous fistulas in the extremities, the resistance indices in the arteries proximal to the fistulas were all less than 1.00 (mean, 0.65), whereas the resistance indices in the arteries distal to the fistulas were all 1.00 or greater (mean, 1.17). In 70% of the cases, the diameter of the artery proximal to the fistula was at least 1.2 mm larger than that distal to the fistula. The fistula site was inferred by the point of maximal venous dilatation in 70% of the cases and by the focal perivascular color artifact in 82% of the cases. The fistula site was identified on gray-scale sonography and color flow imaging in 33% and 75% of the cases, respectively.

CONCLUSIONS

Fistula sites can be located effectively and quickly by a combination of major and minor diagnostic criteria. The major diagnostic criteria are (1) junction of low- and high-resistance flow in the supplying artery, (2) a high-velocity arterialized waveform in the draining vein, and (3) a turbulent, high-velocity flow spectrum at the junction of the artery and the vein. The minor diagnostic criteria are (1) direct communication between the involved artery and vein, (2) significant change in the diameter of the supplying artery, (3) a focal point of venous dilatation, and (4) a focal perivascular color artifact.

Authors+Show Affiliations

Li JC
Division of Ultrasound, Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Wang Fu Jing, Beijing 100730, China.
Cai S
No affiliation info available
Jiang YX
No affiliation info available
Dai Q
No affiliation info available
Zhang JX
No affiliation info available
Wang YQ
No affiliation info available

MeSH

AdolescentAdultArteriovenous FistulaBlood Flow VelocityBrachial ArteryCarotid Artery, CommonFemaleFemoral ArteryFemoral VeinHumansIliac ArteryIliac VeinJugular VeinsMaleMiddle AgedProspective StudiesUltrasonography, Doppler, ColorUltrasonography, Interventional

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12116095

Citation

Li, Jian-Chu, et al. "Diagnostic Criteria for Locating Acquired Arteriovenous Fistulas With Color Doppler Sonography." Journal of Clinical Ultrasound : JCU, vol. 30, no. 6, 2002, pp. 336-42.
Li JC, Cai S, Jiang YX, et al. Diagnostic criteria for locating acquired arteriovenous fistulas with color Doppler sonography. J Clin Ultrasound. 2002;30(6):336-42.
Li, J. C., Cai, S., Jiang, Y. X., Dai, Q., Zhang, J. X., & Wang, Y. Q. (2002). Diagnostic criteria for locating acquired arteriovenous fistulas with color Doppler sonography. Journal of Clinical Ultrasound : JCU, 30(6), 336-42.
Li JC, et al. Diagnostic Criteria for Locating Acquired Arteriovenous Fistulas With Color Doppler Sonography. J Clin Ultrasound. 2002 Jul-Aug;30(6):336-42. PubMed PMID: 12116095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic criteria for locating acquired arteriovenous fistulas with color Doppler sonography. AU - Li,Jian-Chu, AU - Cai,Sheng, AU - Jiang,Yu-Xin, AU - Dai,Qing, AU - Zhang,Jin-Xi, AU - Wang,Yan-Qing, PY - 2002/7/13/pubmed PY - 2002/8/17/medline PY - 2002/7/13/entrez SP - 336 EP - 42 JF - Journal of clinical ultrasound : JCU JO - J Clin Ultrasound VL - 30 IS - 6 N2 - PURPOSE: The purpose of this prospective study was to evaluate and determine criteria for locating acquired arteriovenous fistulas using color Doppler sonography. METHODS: We performed color Doppler sonography on 12 consecutive patients with acquired arteriovenous fistulas. We evaluated the morphologic and hemodynamic changes in the involved vessels to help locate the fistulas (10 in the extremities, 1 in the neck, and 1 in the abdomen). RESULTS: In all cases, turbulent high-velocity flow spectrum and flow signals were present at the fistula sites, and arterialized waveforms from the draining veins were detected. In the 10 cases of acquired arteriovenous fistulas in the extremities, the resistance indices in the arteries proximal to the fistulas were all less than 1.00 (mean, 0.65), whereas the resistance indices in the arteries distal to the fistulas were all 1.00 or greater (mean, 1.17). In 70% of the cases, the diameter of the artery proximal to the fistula was at least 1.2 mm larger than that distal to the fistula. The fistula site was inferred by the point of maximal venous dilatation in 70% of the cases and by the focal perivascular color artifact in 82% of the cases. The fistula site was identified on gray-scale sonography and color flow imaging in 33% and 75% of the cases, respectively. CONCLUSIONS: Fistula sites can be located effectively and quickly by a combination of major and minor diagnostic criteria. The major diagnostic criteria are (1) junction of low- and high-resistance flow in the supplying artery, (2) a high-velocity arterialized waveform in the draining vein, and (3) a turbulent, high-velocity flow spectrum at the junction of the artery and the vein. The minor diagnostic criteria are (1) direct communication between the involved artery and vein, (2) significant change in the diameter of the supplying artery, (3) a focal point of venous dilatation, and (4) a focal perivascular color artifact. SN - 0091-2751 UR - https://www.unboundmedicine.com/medline/citation/12116095/Diagnostic_criteria_for_locating_acquired_arteriovenous_fistulas_with_color_Doppler_sonography_ DB - PRIME DP - Unbound Medicine ER -