The morphological evaluation of coronary arteries before and just after ergometer exercise stress test by intravenous coronary angiography using synchrotron radiation

我们评价了同步辐射静脉冠状动脉造影术(IVCAG)的临床应用价值，并将其应用于运动负荷试验前后冠状动脉的形态评价。2002年至2004年共对16例患者进行了IVCAG检查。6例患者在运动负荷试验后即刻进行IVCAG检查。本研究表明，IVCAG能充分显示左、右冠状动脉前降支，使我们能够诊断冠状动脉狭窄病变。然而，由于左心室对比图像与左冠状动脉回旋支重叠，IVCAG无法显示左回旋支远端。然而，即使在运动负荷试验后不久，IVCAG也可以安全地进行，并能显示所有6例患者的右冠状动脉。结果显示，运动后即刻冠状动脉内径变化不大。对于左冠状动脉，由于其冠状动脉管径细小，分支丰富，部分患者在运动后即刻测量困难。为了提高IVCAG的图像质量，2004年引进了平板这一优秀的数字成像设备。我们不能对患者使用平板，但在我们的同步辐射成像系统中测试了它的响应和分辨率。我们证实，通过将平板引入我们的图像处理中，IVCAG图像将得到改善。

We evaluated the clinical usefulness of the intravenous coronary angiography (IVCAG) using the synchrotron radiation, and also applied it to the morphological evaluation of the coronary arteries before and just after ergometer exercise stress test. The IVCAG was carried out in 16 patients since 2002 to 2004. In 6 patients, the IVCAG was done just after ergometer exercise stress test. The present study showed that the IVCAG could sufficiently visualize the right and the left anterior descending coronary arteries and enabled us to diagnose the coronary stenotic lesions. However, because the overlapping of contrast image of the left ventricle to the left circumflex coronary artery, the IVCAG could not visualize the distal portions of the left circumflex artery. Whereas, the IVCAG was safely carried out even just after the exercise stress test and could visualize the right coronary artery in all 6 patients. It was revealed that the coronary arterial diameter changed slightly just after the exercise. As for the left coronary arteries, since their coronary diameters are thin and are abounding with the branches, the measurements were difficult just after the exercise in some patients. In order to improve the IVCAG image quality, the flat panel, an excellent digital imaging device was introduced in 2004. We could not come to using the flat panel to the patient, but tested its response and resolution in our synchrotron radiation imaging system. We confirmed that the IVCAG image will be improved by introducing flat panel to our image processing.