RESUMO
BACKGROUND: Regular monitoring of autogenous arteriovenous fistulas (AVFs) for hemodialysis patients has importance. Hence, 4D flow MRI may be an alternative for assessing the hemodynamics of AVFs. PURPOSE: To compare the hemodynamics of AVFs using Doppler ultrasound (DUS) and 4D-MRI in renal dialysis patients. STUDY TYPE: Case-control study from October 2017 to April 2018. POPULATION: Fifty patients (age [range] = 59.52 [39-71] years) with AVFs were included. FIELD STRENGTH/SEQUENCE: Black-blood MRI and 4D flow MRI at 3.0T and AVF ultrasonography were also performed. ASSESSMENT: The hemodynamics acquired from 4D flow MRI and ultrasonography by two radiologists were compared. The AVF anatomy was described through an examination of the black-blood MRI. STATISTICAL TESTS: The consistency of AVF anatomy and hemodynamics and the consistency of the hemodynamics of AVFs from 4D flow MRI and ultrasound were analyzed by paired t-tests. The morphological parameters of AVFs acquired from black-blood MRI were used for a Pearson correlation analysis with the hemodynamic parameters obtained from 4D flow MRI data. RESULTS: The consistency of the morphological and hemodynamic parameters measured from MRI by the two radiologists was good (all P < 0.01). The velocities and flow volumes from the 4D flow MRI and vascular ultrasound of AVFs were in moderate agreement (all P < 0.05, r = 0.292-0.569), except for the peak flow velocity at the anastomosis (P = 0.366, r = -0.078). The flow volume and WSS near the anastomotic site were closely related to the morphology of the AVFs (all P < 0.05). The hemodynamics of the complications group were significantly different from those of patients without any complications (normal patients group) (all P < 0.01). DATA CONCLUSION: Compared with ultrasonography, 4D flow MRI is a promising technique to noninvasively estimate the AVF hemodynamics of renal dialysis patients. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1272-1280.