USPIO-enhanced MR angiography of arteriovenous fistulas in patients with renal failure
Open accessAbstract
PURPOSE: To determine the feasibility of using ferumoxytol-enhanced magnetic resonance (MR) angiography to depict the vasculature of hemodialysis fistulas and improve image quality compared with nonenhanced time-of-flight (TOF) MR angiography. MATERIALS AND METHODS: The study was institutional review board approved and was in compliance with HIPAA regulations. All participants provided written informed consent. TOF and first-pass ferumoxytol-enhanced MR angiography were performed in 10 patients with upper extremity autogenous fistulas. Ferumoxytol was administered as a bolus solution containing 430 μmol of elemental iron. A qualitative comparison was performed on maximum intensity projection images. Lumen depiction was evaluated by using a five-point scale. The uniformity of intraluminal signal intensity was measured as the ratio between the mean signal intensity of the entirety of the imaged fistula and its standard deviation. The contrast-to-noise ratio (CNR) between intraluminal signal and adjacent tissue was evaluated as a function of image acquisition time. Lumen depiction scores, luminal signal heterogeneity, and CNR efficiency were compared between TOF and ferumoxytol-enhanced MR angiography by using a Wilcoxon-Mann-Whitney test. RESULTS: Flow artifacts were greatly reduced by the use of ferumoxytol-enhanced MR angiography. Ferumoxytol-enhanced MR angiography had significantly better performance than TOF MR angiography as measured with the following: lumen depiction scores in all segments (mean, 4.7±0.1 [standard error of the mean]; vs 3.0±0.3 for arterial inflow, 4.1±0.3 vs 1.9±0.3 for arterial outflow, 3.7±0.3 vs 1.8±0.2 for anastomosis, and 4.5±0.2 vs 2.1±0.2 for venous outflow; P<.001), intraluminal signal homogeneity (0.3±0.02 vs 0.4±0.06, P=.005), and CNR efficiency in the venous outflow (5.1±0.6 vs 2.5±0.4, P=.01). CONCLUSION: This study demonstrates the feasibility of using ferumoxytol-enhanced MR angiography in imaging hemodialysis fistulas with consistently superior image quality compared with nonenhanced TOF MR angiography.
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Ferumoxytol-enhanced MRA has superior image quality compared to non-enhanced TOF MRA for assessing arteriovenous fistula integrity in kidney failure patients.
“To assess the integrity of the fistula, ferumoxytol-enhanced MRA has been successfully employed and has shown superior image quality as compared to non-enhanced time-of-flight (TOF) MRA [188].”
From Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications (2019) · cites this paper as [188]
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- Authors
- Sigovan, M., Gasper, W., Alley, H. F., Owens, C. D., & Saloner, D.
- Affiliations
- University of California, San Francisco (US)
- San Francisco VA Medical Center (US)
- Venue
- Radiology
- Published
- 2012-11
- Volume
- 265
- Issue
- 2
- Pages
- 584-590
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- PMC
- PMC3480811
- OpenAlex
- W1976111275
- Cited by
- 55
- References
- 15
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 5 · 2015: 2 · 2014: 11 · 2013: 2 · 2012: 1
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Radiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01NS059944)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Physical Sciences › Materials Science › Materials Chemistry › Lanthanide and Transition Metal Complexes
- Keywords
- ferumoxytol, ultrasmall superparamagnetic iron oxide, magnetic resonance angiography, arteriovenous fistula, hemodialysis fistula, renal failure, time-of-flight MR angiography, contrast-to-noise ratio, flow artifacts, iron oxide contrast agents, image quality comparison, signal homogeneity, maximum intensity projection
- MeSH terms
- Anastomosis, Surgical, Arteriovenous Anastomosis, Contrast Media, Dextrans, Female, Humans, Image Enhancement, Male, Sensitivity and Specificity, Reproducibility of Results, Magnetic Resonance Angiography, Renal Insufficiency, Magnetite Nanoparticles
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