Objective To evaluate the efficacy of high-resolution MRI using the MRCP (HR-MRCP) and T2WI (HR-T2WI).sequences for displaying the tip position and complications of transjugular chronic dialysis catheter insertion in the superior vena cava. Methods 41 consecutive patients with suspicion of catheter dysfunction and complications underwent HR-MRCP and HR-T2WI after injecting 5 ml of saline into the catheter lumen. Chest X-ray (CXR) was obtained within 1-2 days and the catheter was withdrawn within 3-10 days..The tip point on CXR was used as the gold standard for evaluating the HR-MRI. Results 38 patients underwent HR-MRI successfully normal outcomes (13) and abnormal findings (25) including fibrin sheaths (22), thrombosis (9) and intraluminal clots (4). There was no significant difference between HR-MRCP and CXR (P=0.132) in the distance from the top to the tip of the catheter. Normal catheter appearance included the “double eyes” sign on HR-T2WI and “double tracks”sign on HR-MRCP. Fibrin sheaths were displayed as “thin ring” sign (<3 mm); thrombosis appeared as patchy hyperintensity or“thick ring” (>5 mm) on HR-T2WI; unilateral intraluminal clot (2) appeared as “single eye” on HR-T2WI and “single track” on HR-MRCP; bilateral intraluminal clot (2) showed absence of the “double eye” sign on HR-T2WI and “double track” sign. After surgical withdrawal of the catheters, 12/22 fibrin sheaths, 4/9 thrombosis, and 4/4 intraluminal clots were confirmed. Conclusion HR-MRCP and HR-T2WI are promising methods for visualizing chronic dialysis catheter tip location and complications.%目的：评估高分辨率MRCP（HR－MRCP）和高分辨率T2WI（HR－T2WI）显示经颈内静脉置入长期透析导管（CDC）的尖端位置和相关并发症的能力。方法41例怀疑CDC功能不良和相关性并发症的终末期肾病（ESRD）患者接受了HR－MRCP和HR－T2WI扫描。在扫描之前，每位ESRD患者的CDC管腔内注入5 ml生理盐水。扫描完成后由两名副主任医师对CDC的尖端位置和相关性并发症进行评估。所有患者在MRI检查后1～2 d内行胸部X线检查。对于HR－MRI诊断为CDC相关性并发症的患者，CDC在3～10 d内拔出。结果38例成功执行了HR－MRI扫描，其中的13名ESRD患者CDC的HR－MRI结果正常， HR－T2WI表现为“双眼征”和HR－MRCP为“双轨征”。25名患者CDC的HR－MRI结果为异常，包括纤维蛋白鞘22例、附壁血栓6例、静脉血栓3例及血凝块4例。对于纤维蛋白鞘（22例），HR－T2WI表现为“薄环征”（小于3 mm）———环绕CDC周围薄层高信号；对于附壁血栓（6例），HR－T2WI表现为片状高信号且基底于静脉壁；对于静脉血栓（3例），HR－T2WI表现为“厚环征”（大于5 mm）且占满整个血管管腔；对于血凝块（4例），当CDC一侧管腔内出现血凝块时，HR－T2WI表现为“单眼征”及HR－MRCP为“单轨征”（2例），当CDC双侧管腔内出现血凝块时，HR－T2WI的“眼征”和HR－MRCP的“轨道征”均缺失（2例）。对于MRI诊断为CDC异常的ESRD患者，拔除CDC后发现纤维蛋白鞘12例、静脉血栓4例和血凝块4例。对于显示导管尖端的位置，HR－MRCP和胸片之间无显著性差异（P＝0．132）。结论 HR－MRCP联合HR－T2WI能准确显示CDC尖端的位置及其相关并发症，是一种很有前景的无创检查方法，有助于ESRD患者的治疗方案调整。
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