Role of magnetic resonance venography in assessment of intra-thoracic central veins in hemodialysis patients

Aim: To determine diagnostic accuracy of magnetic resonance venography (MRV) in assessment of the patency and steno-occlusive disease of intrathoracic central veins in hemodialysis patients. Patients and methods: Between February 2013 and December 2014, 40 hemodialysis patients with suspected intrathoracic central venous stenosis were examined by MRV (phase contrast in 35 patients and contrast enhanced in 5 uncooperative patients). Digital subtraction venography (DSV) was done in the 40 patients and used as the standard reference. The results of MRV were compared with those of DSV. Kappa index with percent agreement between 2 methods was calculated. Results: The results showed excellent agreement as MRV detected 140 out of 141 patent, and all 36 stenotic and 62 out of 64 occluded segments of intra-thoracic central veins with k were 1.00, 1.00 and 0.97 and P value = <0.001, 0.001 and 0.023 respectively. MRV had 98.6% sensitivity, 100% specificity and 99.3% accuracy in diagnosis of patency and stenoocclusive disease of central veins. Conclusion MRV is a highly sensitive technique in the diagnosis of patency and steno-occlusive disease of intrathoracic central veins and may be used as an alternative to DSV for the abnormalities of central veins in hemodialysis patients.