回顾性探讨冠状动脉造影的质量控制

目的:探讨冠状动脉造影的质量控制,就其对比剂的选择及注射、摄影体位的选择、曝光参数设定及其它操作因素的分析提出质量控制措施。方法:常规Seldinger导管法,选择好造影技术参数,常规呼吸训练及心电监护,分别进行左右冠状动脉造影、多体位摄影,并对其图像质量进行综合分析评价。结果:检查155例病例(PTCA19例,CAG136例),获取930个曝光采集序列(Sequences),洗印1220幅图像,其中图像质量优秀的776个序列,占83.4%;图像质量良好的121个序列,占13%;图像质量差的33个序列,占3.6%。结论:不同病例、不同部位的图像采集应用不同的摄影体位;使用非离子型对比剂有利于提高检查图像质量;绝大多数病例造影要利用密度补偿;手推对比剂要注意总量、压力、流率控制及血管充盈情况;术中监护与呼吸训练必不可少。

Quality Control Of coronary Artery Angiography

Objective:To discuss the quality control (QC) of coronary artery angiography (CAG).Kinds of contrast medium,injection rate,position of the patient,exposure parameters and other operating factors were studied and analyzed.Recommendation of QC measure was put forward accordingly.Methods:By means of routine Seldinger approach,after selecting technical parameters of angiography,breath-hold training,then under electrocardiogram monitoring,the left and right coronary artery angiography were undertaken respectively with multiple redording positions.Quality of acquired images was analyzed and evaluated.Results:In this studied population,155 cases (19 cases with percutaneous transcatheter coronary angioplasty (PTCA),136 cases with CAG,930 exposure sequences were acquired and 1220 images were printed.Of all these studies,776 sequences (83.4%) were graded as excellent quality,121 sequences (13%) were graded as fair,33 sequences (3.6%) were graded as poor.Conclusion:The image acquisition and positioning of the patient should be adopted according to different status of patients.Non-ionic contrast medium could improve the image quality.Density Compensation technology was necessary for most of the angiography procedure.The volume of contrast medium,pressure of injection,flow rate,and the filling status of blood vessels should be noticed in the whole course of the manoeuvre.Monitoring and breath-hold training of patients were also essential during the angiography procedure.