Objective To investigate the diagnostic capabilities of computed tomography venography (CTV) in diagnosing catheter-related thrombosis (CRT) in hemodialysis patients.

Methods A retrospective analysis was conducted on 60 hemodialysis patients with dysfunctional central venous catheters (CVC). The patients were divided into two groups: the direct group (CTV via CVC, n = 30) and indirect group (CTV via cubital vein, n = 30). The CT manifestations of CVC and CRTincluding CVC tip position, fibrin sheath (FS), mural thrombosis (MT), venous thrombosis (VT) and intraluminal clots (IC) were observed.The contrast-to-noise ratio (CNR), CRT visualization and general data were compared between two groups.The diagnostic accuracy of CRT between two groups was evaluated using the treatment outcomes and removed CVC specimens.

Results There was no statistical significance between two groups in the general information, position of CVC tip and CNR (P ＞ 0.05). Both VT and MT appeared as low-density shadows attaching to the walls of the vena cava and CVC, and there was no statistical significance in the detection rate between two groups (P ＞ 0.05). The IC appeared as low-density shadows or filling defects within CVC lumen, the FS appeared as a thin layer of low-density shadow around the CVC, and the differences in the detection rates between two groups were statistically significant (P ＜ 0.05). There was no statistical significance in the diagnostic accuracy of CRT between two groups (P ＞ 0.05).

Conclusions The direct CTV demonstrates superior diagnostic performance for IC and FS compared to indirect CTV, and no significant difference was observed in overall diagnostic accuracy.