Kadowaki H, Ishikawa K, Ogai T, Katori R
J Cardiogr. 1986 Mar;16(1):11-7.
Several methods of digital subtraction angiography (DSA) were compared to determine which could better visualize regional myocardial perfusion using coronary angiography in seven patients with myocardial infarction, two with angina pectoris and five with normal coronary arteries. Satisfactory DSA was judged to be achieved if the shape of the heart on the mask film was identical to that on the live film and if both films were exactly superimposed. To obtain an identical mask film in the shape of each live film, both films were selected from the following three phases of the cardiac cycle; at the R wave of the electrocardiogram, 100 msec before the R wave, and 200 msec before the R wave. The last two were superior for obtaining mask and live films which were similar in shape, because the cardiac motion in these phases was relatively small. Using these mask and live films, DSA was performed either with the continuous image mode (CI mode) or the time interval difference mode (TID mode). The overall perfusion of contrast medium through the artery to the vein was adequately visualized using the CI mode. Passage of contrast medium through the artery, capillary and vein was visualized at each phase using TID mode. Subtracted images were displayed and photographed, and the density of the contrast medium was adequate to display contour lines as in a relief map. Using this DSA, it was found that regional perfusion of the contrast medium was not always uniform in normal subjects, depending on the typography of the coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
比较了几种数字减影血管造影(DSA)方法,以确定哪种方法能在7例心肌梗死患者、2例心绞痛患者和5例冠状动脉正常的患者中,通过冠状动脉造影更好地显示局部心肌灌注情况。如果蒙片上心脏的形状与实时片上的相同,且两张片子完全重叠,则判定DSA效果满意。为了获得与每张实时片形状相同的蒙片,从心动周期的以下三个阶段选择两张片子:心电图R波处、R波前100毫秒和R波前200毫秒。后两个阶段在获取形状相似的蒙片和实时片方面更具优势,因为这些阶段的心脏运动相对较小。使用这些蒙片和实时片,以连续图像模式(CI模式)或时间间隔差模式(TID模式)进行DSA。使用CI模式可充分显示造影剂从动脉到静脉的整体灌注情况。使用TID模式可在每个阶段显示造影剂通过动脉、毛细血管和静脉的情况。显示并拍摄减影图像,造影剂的密度足以像地形图一样显示轮廓线。使用这种DSA发现,正常受试者中造影剂的局部灌注并不总是均匀的,这取决于冠状动脉的形态。(摘要截短至250字)