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Upper-Extremity Venography: CO₂ versus Iodinated Contrast Material¹

¹ From the Department of Radiology, University Hospitals Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Received April 28, 2005; revision requested June 23; revision received September 7; accepted September 21; final version accepted November 23. Address correspondence to S.H. (e-mail: sam.heye{at}uz.kuleuven.ac.be).

View larger version (87K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: Anteroposterior venograms of the elbow region in a 27-year-old man with renal insufficiency and a failed hemodialysis AVF in the contralateral wrist and elbow. (a) CO2 venogram shows the cephalic (white arrows), basilic (arrowheads), and deep (black arrows) veins. (b) Conventional venogram depicts only the cephalic (arrows) and basilic (arrowheads) veins.

View larger version (90K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: Anteroposterior venograms of the elbow region in a 27-year-old man with renal insufficiency and a failed hemodialysis AVF in the contralateral wrist and elbow. (a) CO2 venogram shows the cephalic (white arrows), basilic (arrowheads), and deep (black arrows) veins. (b) Conventional venogram depicts only the cephalic (arrows) and basilic (arrowheads) veins.

View larger version (98K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: Anteroposterior venograms of the right upper arm in the 27-year-old man described for Figure 1. (a) CO2 and (b) conventional venograms show patent cephalic (arrows) and basilic (arrowheads) veins.

View larger version (115K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: Anteroposterior venograms of the right upper arm in the 27-year-old man described for Figure 1. (a) CO2 and (b) conventional venograms show patent cephalic (arrows) and basilic (arrowheads) veins.

View larger version (90K): [in this window] [in a new window] [Download PPT slide]   Figure 3a: Anteroposterior venograms of the forearm in the 27-year-old man described for Figure 1. (a) CO2 venogram depicts only the cephalic vein (arrows) with a proximal nonfilling segment (arrowheads). (b) Conventional venogram shows the segment in a is stenosed but patent (arrowheads); the basilic vein (arrows) also can be seen with use of iodinated contrast material.

View larger version (86K): [in this window] [in a new window] [Download PPT slide]   Figure 3b: Anteroposterior venograms of the forearm in the 27-year-old man described for Figure 1. (a) CO2 venogram depicts only the cephalic vein (arrows) with a proximal nonfilling segment (arrowheads). (b) Conventional venogram shows the segment in a is stenosed but patent (arrowheads); the basilic vein (arrows) also can be seen with use of iodinated contrast material.

View larger version (177K): [in this window] [in a new window] [Download PPT slide]   Figure 4a: Anteroposterior venograms of the right central veins in the 27-year-old man described for Figure 1. (a) CO2 venogram shows patency of the central veins but also stenosis (arrow) of the subclavian vein at the level of the central venous catheter. (b) Conventional venogram shows the innominate vein and superior vena cava are not assessable because of motion artifacts caused by respiration and too slow flow in the central veins.

View larger version (199K): [in this window] [in a new window] [Download PPT slide]   Figure 4b: Anteroposterior venograms of the right central veins in the 27-year-old man described for Figure 1. (a) CO2 venogram shows patency of the central veins but also stenosis (arrow) of the subclavian vein at the level of the central venous catheter. (b) Conventional venogram shows the innominate vein and superior vena cava are not assessable because of motion artifacts caused by respiration and too slow flow in the central veins.