服用硝酸甘油对多层螺旋CT冠状动脉成像的影响  

The influence of taking nitroglycerin on multislice CT coronary angiography

作　　者：朱巧洪[1] 曾庆思[1] 孙翀鹏[1] 林翰菲[1] 岑人丽[1] 张超亮[1] 刘莉[1] 

机构地区：[1]广州医学院第一附属医院放射科,510120

出　　处：《中华放射学杂志》2007年第8期809-812,共4页Chinese Journal of Radiology

摘　　要：　目的：探讨通过服用硝酸甘油提高多层螺旋CT（MSCT）冠状动脉成像显影质量的可行性。方法：选服用与不服用硝酸甘油患者各30例，用16层MSCT扫描，对比2组患者冠状动脉13个节段显影的差异。并将服用硝酸甘油患者中10例进行了DSA选择性冠状动脉成像的图像进行对比。结果：（1）2组在冠状动脉13个血管节段中，右冠状动脉（第1、2、3段）、左主干（第5段）、左前降支（第6、7段）、左旋支（第11段）可评价血管例数相同（均为30例）；后降支和左室后支（第4段，X^2=8．007，P=0．004）、左前降支（第8段，X^2=8．571，P=0．003）、第1对角支（第9段，X^2=6．667，P=0．010）、第2对角支（第10段，X^2=38．400，P=0．000）、钝圆支（第12段，X^2=12．000，P=0．001）、左旋支（第13段，X^2=10．335，P=0．001）的显影差异有统计学意义。（2）服用硝酸甘油MSCT冠状动脉成像10例与选择性冠状动脉成像初步对比，严重的钙化和运动伪影影响狭窄的准确性，轻度钙化或无钙化和无运动伪影时，MSCT冠状动脉成像与DSA冠状动脉成像结果吻合。结论：使用硝酸甘油可提高MSCT冠状动脉成像的显影质量。Objective To study the feasibility of using nitroglycerin to improve the image quality of muhislice computed tomography （MSCT） coronary angiography. Methods Sixty patients underwent 16-MSCT scan. Half of the patients received nitroglycerin, the other half served as the control group and did not receive nitroglycerin. Image quality comparison was made in the 13 segments. 10 cases with nitroglycerin also performed DSA examination. Results （ 1 ） In the right coronary artery （ RCA, segments 1-3 ）, left main branch （LM, segment 5 ） ,left anterior descending branch （LAD, segments 6-7） and left circumflex branch （LCX, segment 11 ） of the 13 segments, the assessable segments were the same between the two groups （30 cases）. The visibility of small branches including the posterior descending branch and posterior branch of left ventricle （ segment 4, X^2 = 8. 007, P = 0. 004 ）, left anterior descending branch （ LAD, segment 8,X^2 =8.571, P=0.003）, 1st diagonal branch （D1, segment 9,X^2 =6.667, P =0.010）, 2nd diagonal branch （ D2, segment 10, X^2 = 38.400, P = 0. 000 ）, obtuse marginal branch （ OM, segment 12, X^2 = 12. 000, P =0. 001 ） ,and left circumflex branch （ LCX, segment 13, X^2 = 10. 335, P = 0. 001 ） was significantly higher in the nitroglycerin group than in the control group. （2） The accuracy of MSCT diagnosis was influenced by severe calcification or movement artifact. But in cases of mild or no calcification, MSCT angiography correlated very well with DSA coronary artery angiography for the diagnosis of coronary stenosis. Conclusion Nitroglycerin can improve the image quality of MSCT coronary angiography.

关 键 词：心血管造影术 体层摄影术 X线计算机 硝酸甘油 

分 类 号：R816.2[医药卫生—放射医学]