Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China.
Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Eur J Radiol. 2023 Jul;164:110877. doi: 10.1016/j.ejrad.2023.110877. Epub 2023 May 11.
To investigate the improvement of image quality and visualization of fibula-free flap (FFF) perforators on computed tomography angiography (CTA) after administration of sublingual nitroglycerin (NTG) tablets.
A total of 60 patients with oral or maxillofacial lesions before CTA of the lower extremity were randomly divided into two groups (NTG group and non-NTG group). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), overall image quality and grading of vessels were evaluated and compared. The lumen diameters of the major arteries and the proximal and distal peroneal perforators were measured. The number of visible perforators in muscular clearance and muscular layer was also counted and compared between the two groups.
The CNR of posterior tibial artery and overall image quality of CTA images in the NTG group was significantly higher than that in the non-NTG group (p < 0.05), although the SNR and CNR of other arteries did not show significant differences (p > 0.05). The lumen diameters of the peroneal artery and its perforators, anterior tibial artery, and posterior tibial artery were significantly larger in the NTG group (p < 0.001), while no significant difference prevailed in the diameter of the popliteal artery between the two groups (p = 0.298). Compared with the non-NTG group, a significant increase in the number of visible perforators was noted in the NTG group (p < 0.001).
The administration of sublingual NTG in CTA of the lower extremity can improve the image quality and visualization of perforators, which aids to surgeons select the optimum FFF.
探讨舌下含服硝酸甘油（NTG）片对下肢 CT 血管造影（CTA）中腓骨皮瓣穿支血管成像质量和可视化程度的改善作用。
60 例拟行下肢 CTA 的口腔颌面部病变患者，随机分为 NTG 组和非 NTG 组。分别对两组的信噪比（SNR）和对比噪声比（CNR）、总体图像质量和血管分级进行评估和比较，测量主要动脉的管腔直径以及腓浅、腓深动脉的近、远端穿支的管腔直径，统计肌间隙和肌层内可见穿支的数量。
NTG 组胫后动脉的 CNR 及 CTA 图像总体质量显著高于非 NTG 组（p<0.05），而其他动脉的 SNR 和 CNR 差异无统计学意义（p>0.05）。NTG 组腓动脉及其穿支、胫前动脉和胫后动脉的管腔直径显著增大（p<0.001），而两组腘动脉的直径差异无统计学意义（p=0.298）。与非 NTG 组相比，NTG 组可见穿支的数量显著增加（p<0.001）。
下肢 CTA 中舌下含服 NTG 可提高穿支血管的成像质量和可视化程度，有助于术者选择最佳的腓骨皮瓣。
