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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,χ~2=8.007,P=0.004)、左前降支(第8段,χ~2=8.571,P=0.003)、第1对角支(第9段,χ~2=6.667,P=0.010)、第2对角支(第10段,χ~2=38.400,P=0.000)、钝圆支(第12段,χ~2=12.000,P=0.001)、左旋支(第13段,χ~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 investigate the feasibility of using nitroglycerin to improve the imaging quality of multislice spiral CT (MSCT) coronary angiography. Methods Thirty patients with or without nitroglycerin were enrolled in this study. The 16-slice MSCT was used to compare the differences in the development of 13 segments of coronary arteries in two groups. Ten patients with nitroglycerin who underwent DSA-selective coronary angiography were compared. Results (1) In the two groups of 13 vascular segments of the coronary arteries, the right coronary artery (segments 1, 2 and 3), left main trunk (segment 5), left anterior descending artery (segments 6 and 7) (Paragraph 11) The same number of evaluable vessels (all 30 cases); posterior descending branch and left ventricular posterior branch (Paragraph 4, χ ~ 2 = 8.007, P = 0.004) The first diagonal branch (9th, χ ~ 2 = 6.667, P = 0.010), the second diagonal branch (10th, χ ~ 2 = 38.400, P = 0.003) 0.000). There was significant difference in the development of the left circumflex branch (section 13, χ ~ 2 = 10.335, P = 0.001) between the blunted branches (12th section, χ ~ 2 = 12.000, P = 0.001) (2) 10 cases of coronary angiography with nitroglycerin MSCT compared with selective coronary angiography, severe calcification and motion artifact affect the accuracy of stenosis, mild calcification or no calcification and no motion artifact, MSCT coronary artery Imaging was consistent with DSA coronary angiography. Conclusion The use of nitroglycerin improves the quality of MSCT coronary angiography.