DUAL ENERGY DUAL SOURCE CT VENOGRAPHY (DECTV) FOR CENTRAL VEIN STENOSIS/OCCLUSION

MD NOH, DR MOHAMAD SYAFEEQ FAEEZ (2020) DUAL ENERGY DUAL SOURCE CT VENOGRAPHY (DECTV) FOR CENTRAL VEIN STENOSIS/OCCLUSION. Masters thesis, Universiti Putra Malaysia.

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Abstract

Objective: To propose a new protocol with the application of dual energy dual source CT venography (DECTV) in the diagnosis of central vein stenosis/occlusion in patients with end stage renal disease (ESRD), in comparison to the current gold standard, digital subtraction venography (DSV). Materials and methods: 11 end stage renal disease (ESRD) patients (21 readings/limbs) scheduled for digital subtraction venography (DSV) in our center were consecutively enrolled to undergo the proposed CT protocol. All patients had both studies done during the same visit. The degree of stenosis, image quality/artefacts, and confidence level of making a diagnosis when compared to DSV (taken as the gold standard) were assessed. The specificity, sensitivity, positive predictive value, and negative predictive value were also determined. Statistical analysis was done utilizing Cohen’s kappa coefficient, as well as Chi square. Results: The inter-observer agreement analysed via Cohen’s kappa coefficient demonstrated excellent agreement, with kappa of 0.93 for dual energy dual source CT venography (DECTV), and kappa of 1.00 for digital subtraction venography (DSV). Meanwhile, the sensitivity of DECTV when compared to DSV was 71.4%, while the specificity was found to be 100%, for the 21 readings included in the analysis (p<0.05). The positive predictive value of DECTV, in comparison to DSV was 100%, while the negative predictive value was found to be 87.5% (p<0.05). Lastly, DECTV managed to demonstrate additional causes of central vein stenosis/occlusion, which was not seen on DSV. Conclusion: Our proposed protocol demonstrates that dual energy dual source CT venography (DECTV) is a viable alternative to digital subtraction venography (DSV), in the diagnosis of central venous occlusion/stenosis, with excellent interreader agreement, as well as good sensitivity, specificity, positive and negative predictive values. Additionally, other causes not demonstrable on DSV as the cause of stenosis/occlusion may also be detected on DECTV. The utilization of our CT protocol allows prompt diagnosis in centres where expertise and adequate facilities for endovascular interventional work are not readily available. Keywords: Digital subtraction venography (DSV), Dual energy dual source computed tomography (DECT), Dual energy dual source computed tomography venography (DECTV), Central vein stenosis/occlusion (CVS/CVO), Vascular, Endovascular, Interventional radiology, End stage renal disease (ESRD), Chronic kidney disease (CKD)

Item Type:	Thesis (Masters)
Subjects:	Medicine > Medicine (General) Medicine > Other systems of medicine
Depositing User:	ENCIK SAIFUL FADZLY JAMALUDIN
Date Deposited:	21 Oct 2026 15:14
Last Modified:	21 Oct 2026 15:14
URI:	https://repositori.mohe.gov.my/id/eprint/488

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