单纯含服硝酸甘油对全心导航冠状动脉MRA成像参数及图像质量影响的自身对照研究  

Own-control study of whole-heart three dimensional coronary MR angiography on imaging parameters and image quality using sublingual nitroglycerin

作　　者：金航[1,2] 曾蒙苏[1,2] 葛梅英[3] 恽虹[1,2] 杨姗[1,2] 陈锦[1,2] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032 [2]上海市影像医学研究所 [3]复旦大学附属上海市第五人民医院放射科,上海200240

出　　处：《放射学实践》2011年第11期1185-1188,共4页Radiologic Practice

基　　金：中山青年基金资助项目(393)

摘　　要：目的:探讨单纯舌下含服硝酸甘油对全心自由呼吸导航三维采样冠脉MRA的成像参数和图像质量的影响。方法:使用自由呼吸导航三维采样全心MR冠状动脉成像序列,对17例志愿者完成基础状态以及舌下含服硝酸甘油的MRA扫描,并进行自身对照研究,分析含服硝酸甘油对成像参数和图像质量的影响。结果:服用硝酸甘油前后受试者的心率分别为(68±7)和(79±5)次/分(t=16.292,P<0.05)、MRA扫描的触发延迟时间分别为(406.5±36.8)和(358.6±41.2)ms(t=5.607,P<0.05)、数据采集时间窗宽为(186.4±38.9)和(146.8±39.5)ms(t=14.335,P<0.05),扫描时间为(8.67±2.04)和(10.18±2.58)min(t=5.167,P<0.05),服用硝酸甘油对图像的SNR(分别为16.46±2.92和17.44±4.66)无明显影响(t=1.053,P>0.05)。图像评分结果显示41.2%(63/153)的冠脉节段在服用硝酸甘油后评分增加,9.8%(15/153)评分下降,49.0%(75/153)无明显变化,差异有显著性意义(Z=5.437,P<0.05),提示服用硝酸甘油引起的冠脉管径增加[平均增加(25.4±6.3)%]在总体上有助于提高图像质量。结论:单纯含服硝酸甘油在总体上有助于提高全心自由呼吸导航MR冠脉成像的图像质量,但伴随出现的心率增快、扫描时间延长等为其不利因素。Objective：The aim of this study was to evaluate the influence of sublingual nitroglycerin（NTG） on acquisition parameters and image quality of free-breathing whole-heart 3D coronary MR angiography.Methods：Free-breathing 3D whole-heart coronary MR angiography was performed in 17 healthy volunteers before and after sublingual nitroglycerin.The effects of sublingual nitroglycerin on scanning-related parameters and image quality were analyzed.Results：Heart rates increased significantly after sublingual nitroglycerin（before：68±7,after：79±5 beats per minute;t=16.292,P0.05）.The mean optimal acquisition window and trigger delay were（186.4±38.9） and（406.5±36.8）ms and（146.8±39.5） and（358.6±41.2）ms before and after sublingual nitroglycerin given（t=14.335,P0.05） and（t=5.607,P0.05）,respectively.The mean scanning time was 8.67±2.04 and 10.18±2.58 minutes for both groups（t=5.167,P0.05）.Similar results of SNR were found in the before and after-NTG images（16.46±2.92 vs 17.44±4.66;P0.05）.Image quality scores of 63（41.2%,63/153） segments were increased and 15 segments（9.8%,15/153） decreased after sublingual NTG,and the remaining 75 segments（49.0%,75/153） were unchanged,and the difference was significant（P0.05）,indicating that NTG administration generally yielded higher image quality in comparison with the baseline coronary MRA.Conclusion： Sublingual administration of nitroglycerin is capable of improving visualization of the coronary arteries in free-breathing 3D whole-heart coronary MR angiography generally,and is accompanied by several disadvantages including the increase of heart rate and the prolonged scanning time.

关 键 词：磁共振成像 磁共振血管成像 冠状动脉 硝酸甘油 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.3[医药卫生—诊断学]