冠脉CTA-FFR评估冠脉狭窄及心肌缺血风险的价值  

Value of Coronary CTA-FFR in Assessing the Risk of Coronary Artery Stenosis and Myocardial Ischemia

作　　者：尹浡 厉菁[1] 张宇[1] 张华[1] YIN Bo;LI Jing;ZHANG Yu;ZHANG Hua(Department of Cardiology,the 7th People's Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第七人民医院心内科,河南郑州450000

出　　处：《中国CT和MRI杂志》2025年第2期121-123,共3页Chinese Journal of CT and MRI

摘　　要：目的分析冠脉CT血管成像-血流储备分数(CTA-FFR)评估冠脉狭窄及心肌缺血风险的临床价值。方法回顾性收集2021年5月至2024年3月期间60例就诊我院的冠脉狭窄患者的临床资料,患者均接受冠脉血管造影(CAG)、CTA、有创性FFR检测,并计算冠脉CTA-FFR值,分析冠脉CTA-FFR评估冠脉狭窄及心肌缺血风险的价值,同时通过Kappa检验分析冠脉CTA-FFR对冠脉狭窄及心肌缺血风险的评估结果与CAG、有创性FFR检测结果的一致性。结果以CAG诊断结果为“金标准”,CTA-FFR对冠状动脉狭窄程度评估的敏感度为89.58%,特异度为83.33%,阳性预测值为95.56%,阴性预测值为66.67%,准确度为88.33%,CTA-FFR检测结果与CAG检测结果的一致性较好(kappa值=0.81)。以有创性FFR检测结果为金标准,基于患者计数,CTA-FFR对冠状动脉后心肌缺血评估的敏感度为92.68%,特异度为89.47%,阳性预测值为95.00%,阴性预测值为85.00%,准确度为91.67%,CTA-FFR检测结果与有创性FFR检测结果的一致性较好(kappa值=0.85);基于血管计数,CTA-FFR对冠状动脉后心肌缺血评估的敏感度为94.54%,特异度为92.86%,阳性预测值为96.30%,阴性预测值为89.66%,准确度为93.98%,CTA-FFR检测结果与有创性FFR检测结果的一致性较好(kappa值=0.88)。结论CTA-FFR计数对于冠状动脉下肢及心肌缺血具有较好诊断价值,可在临床推广应用。Objective To analyze the clinical value of fractional flow reserve derived from coronary computed tomography angiography(CTA-FFR)in assessing the risk of coronary artery stenosis and myocardial ischemia.Methods The clinical data of 60 patients with coronary artery stenosis who were treated at the hospital between May 2021 and March 2024 were collected retrospectively.All patients included underwent coronary angiography(CAG),CTA and invasive FFR testing.The coronary CTA-FFR values were calculated.The value of coronary CTA-FFR in assessing the risk of coronary artery stenosis and myocardial ischemia was analyzed.The consistency between the evaluation results of coronary CTA-FFR for the risk of coronary artery stenosis and myocardial ischemia and the results of CAG and invasive FFR testing was analyzed through Kappa test.Results With the diagnostic result of CAG as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA-FFR for evaluating the degree of coronary artery stenosis were 89.58%,83.33%,95.56%,66.67%and 88.33%,respectively.The consistency between CTA-FFR testing results and CAG results was good(kappa value=0.81).With invasive FFR testing results as the gold standard and based on patients counting,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA-FFR for evaluating myocardial ischemia after coronary artery stenosis were 92.68%,89.47%,95.00%,85.00%and 91.67%,respectively.The consistency between CTA-FFR testing results and invasive FFR testing results was good(kappa value=0.85).Based on blood vessels counting,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA-FFR for evaluating coronary myocardial ischemia after coronary artery stenosis were 94.54%,92.86%,96.30%,89.66%and 93.98%,respectively.The consistency between CTA-FFR testing results and invasive FFR testing results was good(kappa value=0.88).Conclusion CTA-FFR has good diagnostic value for corona

关 键 词：冠状动脉CT血管成像 血流储备分数 冠状动脉狭窄 心肌缺血 诊断价值 

分 类 号：R543.31[医药卫生—心血管疾病]