Lu G, Su Y, Jiang Y, Yang L, Wang Y, Shi G, Zhang F, Duan X, Hu H
Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong, China.
Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 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.
Clin Radiol. 2023 Nov;78(11):e791-e797. doi: 10.1016/j.crad.2023.07.004. Epub 2023 Jul 26.
To investigate the improvement of image quality and visualisation of the anterolateral thigh (ALT) flap perforators on computed tomography angiography (CTA) after administration of sublingual glyceryl trinitrate (GTN).
Sixty patients with oral lesions received thigh CTA examinations were divided randomly into two groups after administration of sublingual GTN (GTN group) or without administration of sublingual GTN (non-GTN group). Two radiologists calculated the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and assessed the image quality of each vessel. Besides, the grade of thigh artery, the lumen diameter of deep femoral artery, lateral circumflex femoral artery (LCFA), the descending branch of LCFA and its proximal and distal perforators, and the number and type of visible perforators were evaluated quantitatively.
The SNR and CNR were not significantly different between the two groups (p>0.05). The image quality of CTA in the GTN group was significantly better than that in the non-GTN group (p<0.01). The lumen diameters of the deep femoral artery, LCFA, the descending branch of LCFA and its perforators were significantly larger in the GTN group than those in the non-GTN group (p<0.01). Compared with the non-GTN group, the number of visible perforators and the number of visible septocutaneous perforators were significantly more in the GTN group, and the qualitative grade of visible perforators was significantly higher (p<0.001).
The administration of sublingual GTN in preoperative thigh CTA can improve the image quality and visualisation of perforator vessels, thus could help surgeons to select the optimum ALT flaps.
探讨舌下含服硝酸甘油（GTN）后计算机断层血管造影（CTA）对股前外侧（ALT）皮瓣穿支血管图像质量及可视化的改善情况。
60例接受大腿CTA检查的口腔病变患者在舌下含服GTN后随机分为两组（GTN组）或未舌下含服GTN（非GTN组）。两名放射科医生计算信噪比（SNR）、对比噪声比（CNR），并评估各血管的图像质量。此外，对大腿动脉分级、股深动脉、旋股外侧动脉（LCFA）、LCFA降支及其近端和远端穿支的管腔直径，以及可见穿支的数量和类型进行定量评估。
两组间SNR和CNR差异无统计学意义（p>0.05）。GTN组CTA的图像质量明显优于非GTN组（p<0.01）。GTN组股深动脉、LCFA、LCFA降支及其穿支的管腔直径明显大于非GTN组（p<0.01）。与非GTN组相比，GTN组可见穿支数量和可见肌皮穿支数量明显更多，可见穿支的定性分级明显更高（p<0.001）。
术前大腿CTA中舌下含服GTN可提高穿支血管的图像质量及可视化程度，从而有助于外科医生选择最佳的ALT皮瓣。
