128排CT冠状动脉造影前硝酸甘油最佳含服时间的动态观察及其意义  

Dynamic observation on optimal time of coronary angiography performed using 128-MSCT after taking nitroglycerin and its significance

作　　者：王巍[1] 张锋磊[1] 周丽丽[1] 王红[2] 张晓平 史海莲 

机构地区：[1]吉林大学第一医院二部放射线科,吉林长春130031 [2]吉林省长春市二道区人民医院内科,吉林长春130031 [3]吉林省白山市靖宇县人民医院普外科,吉林靖宇135200

出　　处：《吉林大学学报（医学版）》2016年第2期375-379,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅青年科研基金资助课题(201201043)

摘　　要：目的：探讨128排CT冠状动脉造影（CCTA）过程中含服硝酸甘油后冠状动脉管径扩张至最大的时间,为提高冠状动脉CT造影成像质量提供依据。方法：选择43名接受CCTA检查的受检者,检查过程中分别对受检者于含服硝酸甘油后0min（将未含服硝酸甘油的扫描记为含药后0min）、3、5和10min进行钙化积分扫描（CACS）,利用CACS图像测量每一受检者同一血管同一位置不同时间的冠状动脉直径和扩张率,并分析统计其变化规律。结果：43名受检者含药3min后冠状动脉平均扩张率为8%,与0min时比较差异有统计学意义（P〈0.05）;但其中有5例冠状动脉未见扩张。含服硝酸甘油5和10min后所有受检者冠状动脉平均扩张率与0及3min时比较差异有统计学意义（P〈0.05）,最大扩张率为38%;其中13名受检者冠脉直径在含药5min时达到最大,平均扩张率为17%;2名受检者含药5和10min后冠脉扩张程度相同;28名受检者在含药10min后冠脉管径达最大,平均扩张率为19%。含服硝酸甘油5和10min时冠状动脉管径平均扩张率比较差异无统计学意义（P〉0.05）。结论：128排CT进行CCTA检查前,含服硝酸甘油对冠状动脉具有明显的扩张作用。进行CCTA检查时,含药5~10min时进行增强扫描可保证图像质量及诊断准确性。Objective： To investigate the optimal time of coronary computed tomography angiography （CCTA） after taking nitroglycerine, and to provide basis for improving the image quantity of CCTA. Methods; 43 patients underwent CCTA were scanned with coronary artery calcium score （CACS） after taking nitroglycerin 0, 3, 5 and 10 min. Then the diameters of the same coronary artery from the same anatomic location and the expanding rates were measured, and the change regular was analyzed with single factor analysis of variance of SPSS 17.0 software. Results： The average coronary artery expanding rate was 8% 3 rain after taking nitroglycerin, and the difference was significant compared with 0 min （P〈0.05） ; but there were 5 patients whose coronary artery didn＇ t expand. The coronary artery expanded obviously 5 and 10 min after taking nitroglycerin compared with 0 and 3 min （P〈 0.05）; the maximum expanding rates at 5 and 10 min were both 38%. There were 13 and 28 patients whose coronary artery reached the maximum expanding rates （17% and 19%） 5 and 10 min after taking nitroglycerin, respectively; the coronary artery of 2 patients expanded at a same level at 5 and 10 min. The average expanding rates of coronary artery had no significant differences between 5 and 10 min （P〉 0.05）. Conclusion.. Taking nitroglycerin can significantly expand the diameter of coronary arteries. It is necessary to perform CCTA during 5 10 min after taking nitroglycerine.

关 键 词：冠状动脉 多层螺族CT 硝酸甘油 造影 冠状动脉钙化积分 

分 类 号：R816.2[医药卫生—放射医学]