基于冠状动脉CT造影的血流储备分数在冠状动脉疾病中的诊断价值  

Diagnostic value of flow reserve fraction based on coronary angiography in diagnosis and treatment of coronary artery disease

作　　者：鞠斌 孙敏[1] 罗彩华[1] 苏秦[1] 陈旖 JU Bin;SUN Min;LUO Caihua;SU Qin;CHEN Yi(Department of Imaging,Jingjiang people's Hospital,Taizhou 214500,China)

机构地区：[1]江苏省靖江市人民医院影像科,江苏泰州214500

出　　处：《医学影像学杂志》2023年第12期2191-2195,共5页Journal of Medical Imaging

摘　　要：目的探讨基于冠状动脉CT造影的血流储备分数(CT-FFR)在冠状动脉疾病(CHD)诊治中的临床指导意义。方法选取在我院接受冠状动脉CTA(CCTA)检查的患者87例,筛选符合条件血管,评估狭窄程度,并将图像导入数坤AI软件分析CT-FFR值。CT-FFR<0.75或冠状动脉CTA中度以上狭窄(狭窄程度≥50.0%)推荐血运重建手术;CT-FFR≥0.75或冠状动脉中度以下狭窄(狭窄程度<50.0%)推荐药物维持,随访患者实际接受的临床决策,比较冠状动脉CTA方法和CT-FFR方法对冠状动脉疾病的临床指导价值。结果入选136支血管,接受血运重建手术(支架植入或搭桥手术)共27例/48支,药物维持治疗60例/88支。CT-FFR方法灵敏度75.0%,特异度92.1%;冠状动脉CTA方法灵敏度79.2%,特异度60.2%,两者灵敏度差异无统计学意义(P>0.05),特异度差异有统计学意义(P<0.001)。结论基于冠状动脉CT造影血流储备分数对心肌缺血有单独预测价值,可以指导临床决策。Objective To explore the clinical significance of flow reserve fraction based on coronary artery CT angiography(CT-FFR)in the diagnosis and treatment of coronary artery disease(CHD).Methods A retrospective study was conducted on 87 patients who underwent coronary artery CTA(CCTA)examination in our hospital.The eligible vessels were screened,the de⁃gree of stenosis was evaluated,and the images were imported into the digital AI software to analyze the CT-FFR value.Revascu⁃larization was recommended for patients with CT-FFR<0.75or coronary CTA stenosis(≥50.0%),drug maintenance was recom⁃mended for CT-FFR≥0.75 or less than moderate coronary stenosis(stenosis<50.0%).The patients accepted clinical decisions were followed up,and the clinical guiding value of coronary artery CTA and CT-FFR for coronary artery disease was compared.Results 136 vessels were selected for revascularization(stent implantation or bypass surgery)in 27 cases/48 vessels and drug maintenance therapy in 60 cases/88 vessels.The sensitivity of CT-FFR method was 75.0%,and the specificity was 92.1%.The sensitivity of coronary CTA method was 79.2%,and the specificity was 60.2%.There was no significant difference in sensi⁃tivity between the two methods(P<0.001).Conclusion CT-FFR has independent predictive value for myocardial ischemia and can guide clinical decision-making.

关 键 词：血流储备分数 体层摄影术 X线计算机 冠状动脉疾病 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]