冠状动脉CTA图像模拟无创血流储备分数对功能性心肌缺血的价值  

Diagnostic of noninvasive flow reserve fraction simulated by coronary CTA image in functional myocardial ischemia

作　　者：官晓晖[1] 李传[1] 黄涛[1] GUAN Xiaohui;LI Chuan;HUANG Tao(Department of Radiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530022, P.R.China)

机构地区：[1]广西壮族自治区人民医院放射科,广西南宁530022

出　　处：《医学影像学杂志》2021年第12期2035-2038,共4页Journal of Medical Imaging

摘　　要：目的探讨无创血流储备分数(FFRCT)在功能性心肌缺血中的诊断价值。方法选取我院进行冠状动脉CT血管造影(CTA)和FFRCT检查的患者110例进行研究,分析FFRCT对功能型心肌缺血的诊断作用。结果本组110例共有病变血管209支,FFRCT≤0.8的血管73支(34.93%),血管狭窄<50%的病变血管27支(12.92%)。冠状动脉CTA结果显示血管狭窄≥50%的病变血管169支(80.86%),FFRCT≤0.8的血管66支(31.58%),血管狭窄<50%的病变血管40支(19.14%)。FFRCT诊断患者水平方面的准确度、灵敏度、特异度、阳性预测值及阴性预测值分别为94.55%、96.15%、93.10%、92.59%及96.43%;FFRCT诊断血管水平方面的准确度、灵敏度、特异度、阳性预测值及阴性预测值为分别为91.87%、83.56%、96.32%、92.42%以及91.61%。在患者水平中FFRCT诊断功能性心肌缺血的ROC曲线下面积AUC=0.813;在血管方面FFRCT诊断功能性心肌缺血的ROC曲线AUC=0.788。结论冠状动脉CTA图像模拟的FFRCT对功能性心肌缺血的诊断准确率较高,具有重要临床价值。Objective To study the diagnostic value of non-invasive fractional flow reserve using computed tomographic angiography(FFRCT)in functional myocardial ischemia.Methods Patients(n=110)who underwent coronary CT angiography(CTA)and FFRCT in our hospital from June 2016 to June 2021 were selected for study,the diagnostic effect of FFRCT on functional myocardial ischemia was analyzed.Results There were 209 diseased vessels,73 vessels with FFRCT≤0.8(34.93%),and 27 vessels with vascular stenosis<50%(12.92%).Coronary CTA showed that 169 vessels(80.86%)had stenosis≥50%,66 vessels(31.58%)had FFRCT≤0.8,and 40 vessels(19.14%)had stenosis<50%.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ffrct were 94.55%,96.15%,93.10%,92.59%and 96.43%respectively;The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FFRCT in the diagnosis of vascular level were 91.87%,83.56%,96.32%,92.42%and 91.61%respectively.At the patient level,the area under the ROC curve of FFRCT in the diagnosis of functional myocardial ischemia AUC was 0.813;In terms of blood vessels,the ROC curve of FFRCT in the diagnosis of functional myocardial ischemia AUC was 0.788.Conclusion FFRCT simulated by coronary CTA image has high accuracy in the diagnosis of functional myocardial ischemia.It has important clinical value,which is worthy of clinical application and promotion.

关 键 词：冠状动脉 体层摄影术 X线计算机 无创血流储备分数 功能性心肌缺血 

分 类 号：R814.42[医药卫生—影像医学与核医学] R541[医药卫生—放射医学]