CCTA的FAI对冠状动脉狭窄程度及斑块易损性的评估价值  

The evaluation value of FAI in CCTA for coronary artery stenosis severity and plaque vulnerability

作　　者：袁晨[1] 陈倩倩 马颖 陈忠[1] YUAN Chen;CHEN Qianqian;MA Ying;CHEN Zhong(Huainan Oriental Hospital Group General Hospital Imaging Department,Huainan 232038 China)

机构地区：[1]淮南东方医院集团总医院影像科,安徽淮南232038

出　　处：《中国辐射卫生》2024年第5期584-589,共6页Chinese Journal of Radiological Health

摘　　要：目的探讨冠状动脉CT血管造影(CCTA)脂肪衰减指数(FAI)对冠状动脉狭窄程度的临床价值及斑块易损性的诊断价值。方法回顾性纳入2021年1月—2023年11月的80例冠状动脉疾病(CAD)患者,均经冠状动脉CTA检查确诊为非钙化斑块(NCP)。根据管腔狭窄程度将患者分为轻度狭窄组39例、中度狭窄组24例、重度狭窄组17例,根据患者斑块是否为易损斑块,将患者分为易损斑块组(27例)与非易损斑块组(53例)。采用Spearman相关分析评估FAI与NCP患者狭窄程度的相关性,采用多因素logistic回归分析,探讨患者易损斑块的相关影响因素。结果重度狭窄组FAI(-76.95±7.91)HU低于轻度狭窄组(-66.73±7.69)HU、中度狭窄组(-71.58±8.65)HU,中度狭窄组低于轻度狭窄组,差异有统计学意义(t=4.534、2.190、4.534,P<0.05)。相关性分析结果显示,FAI与冠状动脉狭窄程度呈负相关(r=-0.726,P<0.05)。易损斑块组中高血压23(85.19%)、吸烟史8(29.63%)、FAI(-67.64±8.32)HU,非易损斑块组中高血压30(56.60)、吸烟史4(7.55)、FAI(-75.69±7.88)HU,2组比较差异有统计学意义(t=6.535、6.841、4.164,P<0.05)。多因素Logistic回归分析结果显示,FAI是患者斑块为易损斑块的危险因素(OR=1.439,P<0.05)。结论FAI可以有效地评估NCP的风险分层,对指导患者的临床管理有重要意义。Objective To investigate the clinical value of fat attenuation index(FAI)on coronary CT angiography(CCTA)in evaluating the degree of coronary artery stenosis and the diagnostic value of plaque vulnerability.Methods A total of 80 patients treated for coronary artery diseases from January 2021 to November 2023 were retrospectively included.All patients were diagnosed with non-calcified plaque(NCP)by CCTA examination.Patients were divided according to the severity of luminal stenosis(39 with mild stenosis,24 with moderate stenosis,and 17 with severe stenosis).According to plaque vulnerability,the patients were divided into a vulnerable plaque group(27 cases)and a non-vulnerable plaque group(53 cases).A Spearman correlation analysis was used to evaluate the correlation between FAI and stenosis severity in pa-tients with NCP,and a multivariate logistic regression analysis was used to explore the factors influencing vulnerable plaques.Results FAI was significantly lower in the severe stenosis group(−76.95±7.91 HU)than in the mild stenosis group(−66.73±7.69 HU)and the moderate stenosis group(−71.58±8.65 HU),and FAI was significantly lower in the mod-erate stenosis group than in the mild stenosis group(t=4.534,2.190,4.534,P<0.05).The correlation analysis showed that FAI was negatively correlated with the severity of coronary artery stenosis(r=−0.726,P<0.05).There were significant dif-ferences between vulnerable and non-vulnerable plaque groups in hypertension[23(85.19%)vs.30(56.60%)],smoking his-tory[8(29.63%)vs.4(7.55)],and FAI(−67.64±8.32 HU vs.−75.69±7.88 HU)(t=6.535,6.841,4.164,P<0.05).The multivariate logistic regression analysis showed that FAI was a risk factor for vulnerable plaque(odds ratio=1.439,P<0.05).Conclusion FAI can be used to effectively assess the risk stratification of NCP and is of great significance in guid-ing the clinical management of patients.

关 键 词：冠状动脉CT 血管造影 脂肪衰减指数 非钙化斑块 斑块易损性 风险分层 

分 类 号：R814.42[医药卫生—影像医学与核医学] R541.4[医药卫生—放射医学]