CAJ | 학술논문

目的定量评估64层CT在冠状动脉成像中含服和不含服硝酸甘油对冠状动脉显示的差异.方法分别在相对时段中对含服硝酸甘油(A组)和不含服硝酸甘油(B组)的各100例患者进行64层CT冠状动脉检查,2组受检者均采用回顾性后门控智能mA扫描技术.分别选取左、右冠状动脉的最佳期相进行MPR、MIP、CPR、VR重组.对2组图像分别进行冠状动脉10个测量点管径的测量,并对右冠状动脉、前降支、回旋支3支冠状动脉显示的分支数目进行统计,然后对2组图像管径测量值和分支数目采用完全随机的两样本均数t检验进行统计学比较.结果右冠状动脉近、中、远段管径A组比B组分别增加0.29、0.17、0.11mm,扩张率分别为8.0%、5.0%、4.0%;前降支分别增加0.40、0.23、0.10 mm,扩张率分别为11.0%、8.0%、4.7%;回旋支分别增加0.42、0.35、0.12 mm,扩张率分别为13.5%、12.5%、5.5%;左主干增加0.31 mm,扩张率7.8%.A组较B组分支数目增加率,右冠状动脉、前降支、回旋支分别为83%、80%、113%.A、B 2组冠状动脉10个血管节段中,右冠状动脉近段、左主干、前降支近、中段、回旋支近、中段差异有统计学意义(t值分别为3.86、3.74、5.35、3.58、5.29、4.64,P值均＜0.01);右冠状动脉中、远段、前降支远段、回旋支远段差异亦有统计学意义(t值分别为2.13、2.58、2.35、2.14,P值均＜0.05).结论服用硝酸甘油能有效扩张冠状动脉并能有效增加冠状动脉分支的显示,从而提高64层CT冠状动脉成像质量.
목적 정량평고64층CT재관상동맥성상중함복화불함복초산감유대관상동맥현시적차이.방법 분별재상대시단중대함복초산감유(A조)화불함복초산감유(B조)적각100례환자진행64층CT관상동맥검사,2조수검자균채용회고성후문공지능mA소묘기술.분별선취좌、우관상동맥적최가기상진행MPR、MIP、CPR、VR중조.대2조도상분별진행관상동맥10개측량점관경적측량,병대우관상동맥、전강지、회선지3지관상동맥현시적분지수목진행통계,연후대2조도상관경측량치화분지수목채용완전수궤적량양본균수t검험진행통계학비교.결과 우관상동맥근、중、원단관경A조비B조분별증가0.29、0.17、0.11mm,확장솔분별위8.0%、5.0%、4.0%;전강지분별증가0.40、0.23、0.10 mm,확장솔분별위11.0%、8.0%、4.7%;회선지분별증가0.42、0.35、0.12 mm,확장솔분별위13.5%、12.5%、5.5%;좌주간증가0.31 mm,확장솔7.8%.A조교B조분지수목증가솔,우관상동맥、전강지、회선지분별위83%、80%、113%.A、B 2조관상동맥10개혈관절단중,우관상동맥근단、좌주간、전강지근、중단、회선지근、중단차이유통계학의의(t치분별위3.86、3.74、5.35、3.58、5.29、4.64,P치균＜0.01);우관상동맥중、원단、전강지원단、회선지원단차이역유통계학의의(t치분별위2.13、2.58、2.35、2.14,P치균＜0.05).결론 복용초산감유능유효확장관상동맥병능유효증가관상동맥분지적현시,종이제고64층CT관상동맥성상질량.
Objective To quantitatively evaluate the influence of taking nitroglycerin on the lumen diameter of coronary arteries and segments visualized on 64-MSCT angiography.Methods Two hundred patients were recruited in this study:half of the patients (group A) received nitroglycerin,the other half (group B) served as the control group and did not receive nitroglycerin.CT anglography was performed using 64-MSCT scanner with ECG modulated mA turned on.MPR,MIP,CPR and VR images in best phase were used to display coronary arteries.Lumen diameters of each coronaries were measured from 10 different slices and number of segments visualized were documented.All the data was analyzed using t test.Results For right coronary artery (RCA),in proximal,middle and distant segments,the lumen diameters in group A increased 0.29,0.17,0.11 mm (8.0% ,5.0% ,4.0%) than group B,respectively. For left anterior descending branch (LAD),the lumen diameters increased 0.40,0.23,0.10 mm(11.0% ,8.0% ,4.7%)respectively.For left circumflex (LCX),the lumen diameters increased 0.42,0.35,0.12 mm(13.5%,12.5% ,5.5%) respectively.For left main artery (LMA),the lumen diameters increased 0.31 mm and the increased percentage was 7.8%.The visualized segments were significantly more in group A than in group B.The percentage of increased number was 83% for RCA,80% for LAD,and 113% for LCX,respectively.In proximal,middle segments of LAD and LCX,together with RCA and LMA,the diameters were statistically different between group A and group B (t=5.35,3.58,5.29,4.64,3.86 and 3.74,P＜0.01).In distant segments of LAD,LCX and RCA,together with middle segments of RCA,there were differences in diameters between group A and group B (t=2.35,2.14,2.58,2.13,P＜ 0.05).Conclusion Using nitroglycerin can significantly improve the image quality by expanding the diameter of coronary arteries and increasing the number of visualized segments in 64-MSCT coronary angiography.