冠状动脉周围脂肪组织与冠状动脉血流动力学相关性研究  

Correlation study between pericoronary adipose tissue and hemodynamic significance of coronary arteries

作　　者：黄晶 乔瑾 罗倩 黄明刚[2] HUANG Jing;QIAO Jin;LUO Qian;HUANG Ming-gang(Xi’an Medical University,Shaanxi 710000,China)

机构地区：[1]西安医学院,陕西西安710000 [2]陕西省人民医院CT室,陕西西安710068

出　　处：《影像诊断与介入放射学》2022年第2期121-126,共6页Diagnostic Imaging & Interventional Radiology

基　　金：陕西省重点研发计划基金资助项目(2020ZDLSF04-02)。

摘　　要：目的探讨冠状动脉周围脂肪组织(PCAT)与冠状动脉血流动力学的相关性。方法回顾性分析在1个月内同时接受冠状动脉CT血管成像(CCTA)和冠状动脉血管造影术(CAG)患者的临床及影像资料,选取至少有一支冠状动脉狭窄50%以上的75例患者(共计120条血管)作为研究对象,基于血管水平测量血管周围脂肪衰减指数(FAI),无创血流储备分数(FFR_(CT)),斑块参数包括斑块长度和直径狭窄程度(DS),以及总斑块(TP)、钙化斑块(CP)、非钙化斑块(NCP)体积及相应负荷;设定FFR_(CT)不超过0.8为阳性组,FFR_(CT)大于0.8为阴性组。结果FFR_(CT)阳性组的FAI、斑块长度、DS、TP和NCP的体积及负荷高于FFR_(CT)阴性组(P<0.05);而两组的CP体积及负荷无统计学差异(P>0.05)。通过绘制ROC曲线并分析可知,FAI、斑块长度、DS、TP负荷、NCP负荷、TP体积、NCP体积的AUC分别为0.733、0.647、0.735、0.643、0.638、0.662、0.679。其中,FAI和DS的AUC最大,二者联合时AUC为0.827。结论FAI与冠状动脉血流动力学意义具有相关性,联合FAI与DS可以有效提高对病变特异性缺血的诊断效能。Objective To investigate the correlation between pericoronary adipose tissue and hemodynamic significance of coronary arteries. Methods The clinical and imaging data of patients who underwent coronary CT angiography and coronary angiography within one month of each other were analyzed retrospectively. 75 patients with at least 50% coronary artery stenosis in 120 vessels were included in the study. Perivascular fat attenuation index(FAI), non-invasive flow reserve fraction(FFR_(CT)), plaque parameters including plaque length, diameter stenosis, total plaque(TP), calcified plaque(CP), non-calcified plaque(NCP) volume and corresponding burden were measured based on vascular level. FFR_(CT)≤0.8 was categorized as the positive group and FFR_(CT)>0.8 as the negative group. Results The FAI, plaque length, diameter stenosis, TP and NCP volume and burden in FFR_(CT)-positive group were significantly higher than those in FFR_(CT)-negative group(P <0.05). There was no significant difference in CP volume and burden between the two groups(P>0.05).The areas under the receiver operating characteristic curve(AUC) of FAI(0.733) and diameter stenosis(0.735) were the highest with combined AUC of 0.827 compared to AUC of 0.647 for plaque length, 0.643 for TP burden, 0.638 for NCP burden, 0.662 for TP volume,and 0.679 for NCP. Conclusion FAI correlates with the hemodynamic significance of coronary arteries. Combining FAI and diameter stenosis improves the diagnostic efficiency of lesion-specific ischemia.

关 键 词：冠状动脉周围脂肪组织 血管周围脂肪衰减指数 无创血流储备分数 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]