Wert der Applikation von Nitroglycerin bei der 3D-MR-Koronarangiographie mit Echtzeit-Navigatortechnik

Multidetector computed tomography coronary angiography: sublingual nitroglycerine improves image quality significantly because of peripheral coronary vasodilatation

PURPOSE

In this study, we investigated the influence of sublingual nitroglycerine (NTG) on the peripheral diameter, intraluminal contrast agent density, and image quality of coronary arteries during computed tomography coronary angiography (CTCA).

MATERIALS AND METHODS

Thirty patients with sublingual NTG application were matched to 30 patients without NTG. The diameters of the left anterior descending coronary artery (LAD), the left circumflex coronary artery and the right coronary artery were measured at 1-, 4-, and 8-cm length of each vessel as well as the intraluminal contrast agent density along the LAD. Vessel diameters and contrast attenuation at 4 and 8 cm were referenced against the values at 1 cm and processed as percentage reduction. Image quality of the posterior descending artery was assessed subjectively by 2 independent observers.

RESULTS

The percentage of peripheral vessel diameter reduction and the peripheral attenuation of contrast agent density for all measured coronary arteries was significantly smaller in the group with NTG administration. The image quality of the posterior descending artery was significantly higher in the group with NTG.

CONCLUSIONS

Sublingual administration of NTG before CTCA results in improved diagnostic image quality because of a significant dilatation and improved intraluminal contrast agent density of the peripheral vessels.

Effects of sublingual nitroglycerin on coronary lumen diameter and number of visualized septal branches on 64-MDCT angiography

OBJECTIVE

This article describes the influence of sublingual nitroglycerin spray on the lumen diameter, number of side branches visualized, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of the coronary arteries with MDCT angiography.

SUBJECTS AND METHODS

Forty-two patients were prospectively included in this study: 21 were examined without sublingual nitroglycerin (group A), and 21 were examined after the administration of sublingual nitroglycerin (group B). CT angiography was performed using a 64-MDCT scanner. Two blinded observers quantitatively assessed lumen diameter and volume in the left anterior descending artery (LAD) and the right coronary artery (RCA). The number of septal branches was counted. The SNR and CNR in the LAD and RCA were calculated in both groups. The number of clinical side effects was evaluated.

RESULTS

The lumen diameters and the average volumes were significantly larger in group B than in group A. The number of septal branches visualized in group B was significantly higher than in group A. No statistically significant difference in SNR and CNR between the groups was shown. The number of side effects in the two groups was not significantly different.

CONCLUSION

Sublingual nitroglycerin spray significantly dilates the coronary arteries and allows more septal branches to be visualized at coronary CT angiography without diminishing image quality or increasing the number of side effects.