Coche E, Baile E M, Wiggs B, Kim K I, Mayo J R
Department of Radiology, Cliniques St Luc, Brussels, Belgium.
Acad Radiol. 1999 Jul;6(7):419-25. doi: 10.1016/s1076-6332(99)80192-5.
The authors performed this study to determine if there were differences in vascular caliber measured on angiograms obtained with the injection protocol used for spiral computed tomography (CT) versus that used for pulmonary angiography.
The authors studied seven juvenile anesthetized pigs by using a prospective repeated measures experimental design. All pigs received injections of nonionic contrast material via catheters in the brachial vein, superior vena cava, main pulmonary artery, and left pulmonary artery. Weight-adjusted injection rates and volumes ranged from 0.05 mL/kg/sec (3.5 mL/sec, spiral CT protocol) to 0.56 mL/kg/sec (40 mL/sec, pulmonary angiography protocol). Heart rate and pulmonary artery and systemic artery pressures were recorded. During each injection, identically positioned pulmonary angiograms were obtained at full inspiration. Vessel diameters were measured at identical locations after each injection by two observers. The relationship between vessel diameter and hemodynamic parameters and injection site and rate was assessed with analysis of variance.
At suspended full inspiration, no statistically significant difference (P > .05) in vessel diameter or hemodynamic parameters was found between the different injection sites or rates. There was no difference in vascular caliber between systole and diastole.
The improved detection of subsegmental pulmonary emboli at pulmonary angiography compared with contrast material-enhanced spiral CT is not due to differences in vascular distention.
作者开展本研究以确定，在使用螺旋计算机断层扫描（CT）的注射方案与肺血管造影的注射方案获得的血管造影图像上测量的血管管径是否存在差异。
作者采用前瞻性重复测量实验设计，对7只麻醉状态下的幼年猪进行了研究。所有猪均通过经肱静脉、上腔静脉、主肺动脉和左肺动脉的导管注射非离子型造影剂。根据体重调整的注射速率和注射量范围为0.05 mL/kg/秒（3.5 mL/秒，螺旋CT方案）至0.56 mL/kg/秒（40 mL/秒，肺血管造影方案）。记录心率、肺动脉压和体动脉压。在每次注射期间，于完全吸气时获取相同位置的肺血管造影图像。每次注射后，由两名观察者在相同位置测量血管直径。采用方差分析评估血管直径与血流动力学参数、注射部位和速率之间的关系。
在完全吸气暂停时，不同注射部位或速率之间在血管直径或血流动力学参数方面未发现统计学显著差异（P > 0.05）。收缩期与舒张期之间的血管管径无差异。
与造影剂增强螺旋CT相比，肺血管造影对亚段肺动脉栓塞的检测能力提高并非由于血管扩张程度的差异。
