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


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.
Department of Diagnostic and Interventional Radiology, University of Ulm, Ulm, Germany. oliver.klass@uniklinik-ulm.de
Oliver
O
Klass
Senguel
S
Mutlu
Kathrin
K
Hohl
Sebastian
S
Feuerlein
Martin
M
Jeltsch
Hans-Juergen
HJ
Brambs
Martin H K
MH
Hoffmann
D000286:Administration, Sublingual; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D011856:Radiographic Image Enhancement / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014664:Vasodilation; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D005996:Nitroglycerin