PEIR Digital Library

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RADIOLOGY: VASCULAR: Case# 33650: ARTERIOVENOUS GRAFT INFECTION. 40 year old female with chronic renal failure and sepsis one week status post arteriovenous graft placement. Sagittal and transaxial images of the AV graft and extremity reveal that the graft is patent with normal duplex doppler signal characteristics. There is a thick hypoechoic band immediately superior to and along the cephalad extent of the graft. Tiny anechoic collections are also present. Frequently, ultrasound is utilized to evaluate the patency of arteriovenous grafts. Additionally, US can be very helpful in determining if a focal and drainable graft abscess is present, in the clinical setting of sepsis, pain, and persistent swelling. Abscesses generally are anechoic to very hypoechoic and are generally well circumscribed. Adjacent edema may be present and manifested by ill defined hypoechoic regions within the tissue, usually confined by the fascial planes. This patient demonstrated a thick band and edema and fluid infiltration with tiny anechoic regions, likely representing microabscesses. No focal and drainable abscesses were identified.

Peter Anderson
radiology, Vascular