基于CT血流储备分数和脂肪衰减指数的多成像参数预测阻塞性冠心病患者主要不良心脏事件的价值  

The value of multiple imaging parameters based on CT derived fractional flow reserve and fat attenuation index in predicting major adverse cardiac events in patients with obstructive coronary heart disease

作　　者：邢秋思 李相生 方圆 常晓霞 徐京瑶 XING Qiusi;LI Xiangsheng;FANG Yuan;CHANG Xiaoxia;XU Jingyao(Hebei North University,Zhangjiakou,Hebei Province 075000,China;Department of Medical Imaging,Air Force Medical Center,Air Force Medical University,Beijing 100142,China;Faculty of Information,Beijing University of Technology,Beijing 100124,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]空军军医大学空军特色医学中心医学影像科,北京100142 [3]北京工业大学信息学部,北京100124

出　　处：《实用放射学杂志》2024年第10期1625-1629,共5页Journal of Practical Radiology

摘　　要：目的探讨基于CT血流储备分数(CT-FFR)联合冠状动脉周围脂肪组织(PCAT)脂肪衰减指数(FAI)预测阻塞性冠心病(CHD)患者发生主要不良心脏事件(MACE)的价值。方法回顾性分析行冠状动脉CT血管成像(CCTA)检查的149例阻塞性CHD患者,按照患者是否发生MACE,分为MACE组和无MACE组。比较2组的临床资料、CCTA特征、CT-FFR、PCAT体积和FAI差异,采用多元logistic回归分析筛选MACE的独立预测因子。采用受试者工作特征(ROC)曲线的曲线下面积(AUC)评估单一独立预测因子及其联合预测MACE的效能。结果CT-FFR≤0.8、右冠状动脉(RCA)FAI(RCA-FAI)是阻塞性CHD患者发生MACE的独立危险因子(P<0.05)。CT-FFR≤0.8和RCA-FAI预测阻塞性CHD患者发生MACE的AUC分别为0.773和0.766,二者联合成像的AUC为0.865。结论与单一的成像参数相比,CT-FFR和RCA-FAI联合成像参数可以明显提高对阻塞性CHD患者MACE的预测效能。Objective To explore the value of CT derived fractional flow reserve(CT-FFR)combined with pericoronary adipose tissue(PCAT)fat attenuation index(FAI)in predicting major adverse cardiac events(MACE)in patients with obstructive coronary heart disease(CHD).Methods A total of 149 patients with obstructive CHD who underwent coronary computed tomography angiography(CCTA)examination were analyzed retrospectively.The patients were divided into MACE group and non-MACE group according to the occurrence of MACE.The clinical data,CCTA characteristics,CT-FFR,PCAT volume and FAI differences between the two groups were compared.Multiple logistic regression analysis was used to screen the independent predictors of MACE.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to evaluate the efficiency of a single independent predictor and its joint prediction of MACE.Results CT-FFR≤0.8 and right coronary artery(RCA)FAI(RCA-FAI)were independent risk factors for MACE in patients with obstructive CHD.The AUC of CT-FFR≤0.8 and RCA-FAI to predict MACE in patients with obstructive CHD were 0.773 and 0.766,respectively,while of their combination was 0.865.Conclusion Compared with single imaging parameters,the combined imaging parameters of CT-FFR and RCA-FAI can significantly improve the predictive efficiency of MACE in patients with obstructive CHD.

关 键 词：冠心病 主要不良心脏事件 基于CT血流储备分数 脂肪衰减指数 

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