舌下含服硝酸甘油对螺旋CT冠状动脉造影中检测冠脉内径狭窄程度准确性影响的评价

目的评价64层螺旋CT(64-MSCT)冠状动脉造影中舌下含服硝酸甘油对检测冠脉内径狭窄程度准确性的影响。方法 2010年6月至2013年6月疑为冠心病的患者共72例行64-MSCT冠状动脉造影,分为给硝酸甘油及不给硝酸甘油两组,每组各36例,分别对两组患者右冠状动脉(RCA),左前降支(LAD),回旋支(LCA),左主干(LMA)近端内径进行测量,同时计算两组图像冠状动脉的13个节段显影的差异。结果硝酸甘油组的RCA、LM、LAD、LCX各支冠脉近端平均内径比非硝酸甘油组大,差异具有统计学意义(P0.05)。两组冠状动脉13个节段中,右冠状动脉、左主干、左前降支、左旋支可评价血管例数相同,后降支和左室后支、左前降支远段、第l对角支、钝圆支显示例数硝酸甘油组较多,但两者差异无统计学意义(P0.05);第2对角支及左旋支远段两组显示的例数有显著性差异(P0.05)。结论硝酸甘油对冠状动脉近端内径有显著的扩张作用,显示的节段数增多,可以提高64层螺旋CT冠状动脉造影成像质量,在一定程度上能提高冠状动脉内径狭窄程度的诊断的准确性。

To evaluate the degree of coronary artery diameter stenosis detection accuracy after holding nitroglycerin under the tongue with MSCT coronary angiography

Objective To evaluate the degree of coronary artery diameter stenosis detection accuracy after holding nitroglycerin under the tongue with 64- slice spiral CT coronary angiography. Methods 64- slice CT angiography was performed in 72 patients with 64- slice spiral CT coronary angiography. Patients were divided into two groups： with or without nitroglycerin（ group A and group B）. Each group included 36 patients,The maximal lumen diameters and densities were measured for the left main coronary artery,the left anterior descending,the left circumflex,and the right coronary artery,respectively in all 72 datasets. Number of clinical side effects in both groups was evaluated. Results The lumen diameters were significantly larger in group A than in group B. In the RCA,LM,LAD and LCX of the 1 3 segments. The segments were the same between the two groups. The number of segments in the posterior descending artery and posterior branch of left ventricle,LAD,1st diagonal branch and obtuse marginal branch was larger in group A than in group B,but no statistic significant difference existed. The visibility of segments including 2nd diagonal branch and LCX was significantly higher in group A than in group B. The number of side effects in the two groups was not significantly different. Conclusion Sublingual nitroglycerin significantly dilates the coronary arteries and allows more segments to be visualized at coronary CT angiography. This method can improve the diagnostic accuracy of coronary artery diameter stenosis in a certain extent.