CT血流储备分数、斑块参数及管腔内密度衰减梯度在评估冠状动脉功能性狭窄中的价值  

The value of CT fractional flow reserve,plaque parameters,transluminal attenuation gradient in vascular functional stenosis

作　　者：王利[1] 王超[1] 邱晓晖[1] 王亚丽 赵洪涛 WANG Li;WANG Chao;QIU Xiaohui;WANG Yali;ZHAO Hongtao(Department of Radiology,Bozhou People's Hospital,Bozhou,Anhui 236800,China)

机构地区：[1]亳州市人民医院影像中心,安徽亳州236800

出　　处：《安徽医药》2025年第2期289-293,共5页Anhui Medical and Pharmaceutical Journal

基　　金：亳州市人民医院科研项目库项目(by2023032)。

摘　　要：目的探讨CT血流储备分数(CT-FFR)、斑块参数及管腔内密度衰减梯度(TAG)在评估冠状动脉功能性狭窄中的价值。方法收集亳州市人民医院2022年1月至2023年9月行冠状动脉CT血管造影(CCTA)检查并发现冠状动脉斑块病人186例,共215支病变血管,测量、评估病变血管斑块性质、斑块长度、斑块总体积、血管狭窄程度、TAG以及CT-FFR值,并进行统计学分析。结果215支病变血管分为功能性狭窄组(CT-FFR≤0.80)114例和无功能性狭窄组(CT-FFR>0.80)101例,功能性狭窄组斑块长度(28.05 mm比9.30 mm)、斑块总体积(70.41 mm^(3)比12.51 mm^(3))均高于无功能性狭窄组,差异有统计学意义(均P<0.001);功能性狭窄组混合型斑块发生率高于无功能性狭窄组,钙化斑块发生率则反之,差异有统计学意义(P<0.001);两组轻、中、重度狭窄发生率均差异有统计学意义(均P<0.001)。CT-FFR与斑块长度、斑块总体积呈线性负相关(均P<0.001),CT-FFR与TAG间无线性关系。通过血管狭窄程度、斑块长度、斑块总体积、斑块性质、斑块长度+斑块总体积+血管狭窄程度联合指标诊断血管功能性狭窄曲线下面积(AUC)值分别为0.87、0.80、0.81、0.58、0.89(P<0.001,P<0.001,P<0.001,P=0.042,P<0.001)。结论血管狭窄严重程度的增加以及混合型斑块(相较于非钙化斑块、钙化斑块)更易导致血管功能性狭窄。斑块长度、斑块总体积与CT-FFR呈负相关,TAG与CT-FFR之间无明显相关。另外,斑块长度+斑块总体积+血管狭窄程度多指标联合对血管功能性狭窄的诊断效能优于单一指标。Objective To investigate the relationship between vascular functional stenosisandplaque parameters,transluminal attenuation gradient(TAG),CT fractional flow reserve(CT-FFR).Methods A total of 186 patients with coronary artery plaque detected by coronary CTA in Bozhou People's Hospital from January 2022 to September 2023 were collected,with a total of 215 diseased vessels.The plaque properties,plaque length,total plaque volume,degree of vascular stenosis,TAG and CT-FFR values of the diseased vessels were measured and evaluated,and statistical analysis was performed.Results A total of 215 diseased vessels were divided into functional stenosis group(CT-FFR≤0.80)114 cases and non-functional stenosis group(CT-FFR>0.80)101 cases.The plaque length(28.05 mm vs.9.30 mm)and total plaque volume(70.41 mm^(3) vs.12.51 mm^(3))in the functional stenosis group were higher than those in the nonfunctional stenosis group,and the differences were statistically significant(P<0.001).The incidence of mixed plaque in the functional stenosis group was higher than that in the non-functional stenosis group,and the incidence of calcified plaque was the opposite,the difference was statistically significant(P<0.001).There were significant differences in the incidence of mild,moderate and severe stenosis between the two groups(all P<0.001).There was a linear negative correlation between CT-FFR and plaque length and total plaque volume(all P<0.001).There was no linear relationship between CT-FFR and TAG.The areas under curve(AUC)values of vascular functional stenosis diagnosed by the degree of vascular stenosis,plaque length,total plaque volume,plaque properties and plaque length&total plaque volume&the degree of vascular stenosis combined index were 0.87,0.80,0.81,0.58 and 0.89,respectively(P<0.001,P<0.001,P<0.001,P=0.042,P<0.001).Conclusions The increase in the severity of vascular stenosis and mixed plaques(compared with non-calcified plaques and calcified plaques)are more likely to lead to vascular functional stenosis.Plaque length and to

关 键 词：冠状动脉狭窄 血流储备分数 斑块 管腔内密度衰减梯度 冠状血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]