优化算法FFR-CT与有创FFR的对照研究  

A comparative study of optimization algorithm FFR-CT and invasive FFR

作　　者：李长岭[1] 冷晓畅 冯立 胡涛[3] 张宇晨[4] 胡新央[1] 蒋峻[1] 孙勇[1] 姜文兵[5] 潘轶斌 向建平 王建安[1] Li Changling;Leng Xiaochang;Feng Li;Hu Tao;Zhang Yuchen;Hu Xinyang;Jiang Jun;Sun Yong;Xiang Jianping;Wang Jian'an;无(Department of Cardiology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;ArtetyFlow Technology Co.,Ltd.,Hangzhou 310052,China;Department of Cardiology,Xijing Hospital,the Fourth Military Medical University,Xi'an 710032,China;Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University 100029,China;Department of Cardiology,The Third Clinical Institute Affiliated to Wenzhou Medical University,Wenzhou 325099,China;Department of Cardiology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China)

机构地区：[1]浙江大学医学院第二附属医院心内科,杭州310009 [2]杭州脉流科技有限公司,杭州310052 [3]西安第四军医大学西京医院心内科,西安710032 [4]首都医科大学附属北京安贞医院心内科,北京100029 [5]温州医科大学附属第三临床学院心内科,温州325099 [6]浙江大学医学院附属金华医院心内科,金华321000

出　　处：《中华急诊医学杂志》2020年第12期1618-1621,共4页Chinese Journal of Emergency Medicine

基　　金：浙江省基础公益研究计划(LGF20H020012);浙江省教育厅科研项目(Y201330290);浙江省温州市重大项目(ZY2019006);浙江省金华市重大项目(2020A31003)。

摘　　要：目的基于冠状动脉CTA影像的无创血流储备分数(FFR-CT)与有创冠状动脉血流储备分数(FFR)的有效性对照研究。方法本研究共回顾性纳入47例(61支病变血管)患者,采用杭州脉流科技有限公司的AccuFFR®ct原型软件系统(AccuFFR®ct,version 1.0)计算每个狭窄处的FFR-CT值,并与有创FFR值进行比较,以FFR≤0.8为具有血流动力学意义的狭窄为参照,通过准确性、敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)以及计算在受试者操作特征(ROC)曲线下的面积(AUC)来评价FFR-CT的有效性。结果对每个患者的FFR-CT与有创FFR相比的准确率为91.5%,敏感性为88.2%,特异性为93.3%,PPV为88.2%,NPV为93.3%;对于每条血管相应的值分别为88.5%、88.2%、88.6%、75%和95.1%。FFR-CT和有创FFR之间存在显著的相关性(患者水平:r=0.71,P<0.0001,和血管水平:r=0.62,P<0.0001),并且AUC值分别为0.89和0.90。结论基于冠状动脉CTA影像计算的AccuFFR®ct系统可以作为评估冠状动脉狭窄引起功能性缺血的一种快速、准确的计算工具。Objective To compare non-invasive coronary blood fractional flow reserve based on coronary CTA(FFR-CT)imaging with invasive coronary blood fractional flow reserve(FFR).Methods Totally 47 patients(61 lesions)were retrospectively collected in this study,The FFR-CT value at each stenosis was calculated by AccuFFR®ct(version 1.0,ArteryFlow Technology Co.,Ltd.)and evaluated with accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and the area under the receiver operating characteristic(ROC)curve(AUC),with FFR≤0.8 as the reference for the diagnosis of hemodynamically significant coronary stenosis.Results The accuracy,sensitivity,specificity,PPV and NPV of AccuFFR®ct versus invasive FFR were 91.5%,88.2%,93.3%,88.2%,and 93.3%for the patient-level.The corresponding values for the vessel-level were 88.5%,88.2%,88.6%,75%and 95.1%,respectively.There was a significant correlation between FFR-CT and invasive FFR(patient-level r=0.71,P<0.0001,and vessel-level r=0.62,P<0.0001,respectively),with AUC values of 0.89 and 0.90,respectively.Conclusions AccuFFR®ct method based on coronary CTA imaging can be used as a fast and accurate tool to evaluate the functional significance due to coronary artery stenosis.

关 键 词：FFR FFR-CT 计算流体力学 冠状动脉CTA 狭窄 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]