摘要
目的:探讨不同流速对冠脉CT造影管腔内对比度衰减梯度(transluminal contrast attenuation gradient,TAG)的影响,以为临床判断血管狭窄提供可靠性依据。方法:回顾选取2019年5月—2021年6月在我院东芝320排CT进行冠脉CTA并复查的患者48例(体质指数BMI低于26 kg/m^(2)),第一次检查使用常规流速4.5 mL/s行冠状动脉造影检查,待患者第二次复查时采用同样的机型和造影剂,流速降为3.5 mL/s。分别测量两次CTA前降支(LAD)、回旋支(LCX)和右冠(RCA)冠脉的TAG值。比较两次检查间各分支冠脉TAG值差异。结果:48例患者中,无明显血管狭窄的44支,狭窄的血管100支。狭窄的血管中存在重度狭窄>75%的25支,中度狭窄50%~75%的血管30支,轻度狭窄<50%的45支。中重度狭窄血管中,两次检查的TAG值差异有统计学意义(P<0.05);无狭窄、轻度狭窄的血管中,两次检查的TAG值差异均无统计学意义(P>0.05)。结论:低流速冠脉CT造影会导致中重度狭窄的血管灌注不足,CT值差异更明显,血管的TAG负值变大,轻度狭窄影响不明显。
Objective To explore the effect of different flow velocities on the transcatheter contrast attenuation gradient(TAG)in coronary CT angiography,so as to provide reliable basis for clinical judgment of vascular stenosis.Methods 48 patients(body mass index lower than 26 kg/m^(2))who underwent coronary CTA in 320 CT scans of Toshiba from May 2019 to June 2021 in our hospital were selected retrospectively.The first examination was performed with conventional flow rate of 4.5 mL/s,and the second examination was performed with the same model and contrast agent,with the flow rate reduced to 3.5 mL/s.The TAG values of the anterior descending(LAD),circumflex(LCX)and right coronary(RCA)coronary arteries were measured twice.The differences in coronary TAG values of each branch between the two examinations were compared.Results Among the 48 patients,44 vessels had no obvious vascular stenosis and 100 vessels had stenosis.There were 25 vessels with severe stenosis>75%,30 vessels with moderate stenosis 50%~75%,and 45 vessels with mild stenosis<50%.In moderate to severe stenosis,the difference in TAG value between the two inspections was statistically significant(P<0.05);In the blood vessels without stenosis and mild stenosis,the difference in TAG value between the two inspections was not statistically significant(P>0.05).Conclusion Low-velocity coronary CT angiography can lead to insufficient perfusion of moderate to severe stenosis.The difference in CT value is more obvious,the negative value of TAG of the blood vessel becomes larger,and the effect of mild stenosis is not obvious.
作者
盛洋洋
SHENG Yangyang(Department of Radiology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,China)
出处
《影像研究与医学应用》
2022年第20期57-59,共3页
Journal of Imaging Research and Medical Applications
