摘要
目的探讨并比较CT管腔内对比度衰减梯度(TAG)和改良校正的管腔内对比度衰减梯度(MTAG-CCO)对冠状动脉功能性狭窄的诊断价值。方法收集2016年2月~2017年8月来我院就诊并有意愿行CCTA及FFR检查的冠心病患者。将所有冠状动脉分为无功能性狭窄组(FFR>0.80)和功能性狭窄组(FFR≤0.80);记录每支冠状动脉的TAG、MTAG-CCO及FFR值,比较两组间TAG、MTAG-CCO,并计算TAG、TAG-CCO、CCTA及TAG+CCTA及MTAG-CCO+CCTA对功能性狭窄的灵敏度、特异度,阳性预测值和阴性预测值。结果纳入35例患者(37支冠状动脉)。无功能性狭窄组和功能性狭窄组(-15.39±2.250 vs-19.87±2.054)HU/10mm的TAG之间不存在显著性差异(P=0.1561),MTAG-CCO(-0.02521±0.001867 vs-0.03260±0.002369)/10mm之间存在显著性差异(P=0.0179)。单独CCTA的敏感度、特异度、阳性预测值和阴性预测值分别为50.0%,17.6%,41.7%和23.1%;TAG分别为55.0%,11.8%,42.3%和18.2%;MTAG-CCO分别为15.0%,41.2%,23.1%和29.2%;TAG+CCTA分别为90.0%,5.9%,52.9%和33.3%;MTAG-CCO+CCTA分别为50.0%,52.9%,55.6%和47.4%。结论MTAG-CCO较TAG有进一步区别冠状动脉功能性狭窄的可能性;MTAG-CCO+CCTA的敏感度、特异度均较高。
Objective The aim of this study was compared the transluminal attenuation gradient(TAG)and modified transluminal attenuation gradient-corrected coronary opacification(MTAG-CCO)in assessing coronary artery functional stenosis.Methods This prospective study recuited coronary artery stenosis patients who intented to do CCTA and FFR examination.All the vessels were divided into 2 groups:non-functional stenosis group(FFR>0.80)and functional stenosis group(FFR≤0.80).The TAG,MTAG-CCO and FFR values were recorded.All the TAG,MTAG-CCO were compared respectively.The sensitivity,specificity,positive predictive value and negative predictive value of TAG,MTAG-CCO,CCTA and MTAG-CCO+CCTA,and TAG+CCTA were evaluated.Results 35 patients(37 coronary arteries)were recuited.The TAG of non-functional stenosis group and functional stenosis group was(-15.39±2.250,-19.87±2.054)HU/10mm(P=0.1561),MTAG-CCO of the 2 group was(-0.02521±0.001867,-0.03260±0.002369)/mm(P=0.0179).The sensitivity,specificity,positive predictive value and negative predictive value of CCTA were 50.0%,17.6%,41.7%and 23.1%;TAG was 55.0%,11.8%,42.3%and 18.2%;MTAG-CCO were 15.0%,41.2%,23.1%and 29.2%;TAG+CCTA were 90.0%,5.9%,52.9%and 33.3%;MTAG-CCO+CCTA were 50.0%,52.9%,55.6%and 47.4%.Conclusion MTAG-CCO had the potential to further differentiate coronary artery functional stenosis compared with TAG;MTAG-CCO+CCTA had higher sensitivity and specificity.
作者
阚晓婧
葛英辉
刘霄静
张继良
谢瑞刚
潘玉坤
KAN Xiaojing;GE Yinghui;LIU Xiaojing;ZHANG Jiliang;XIE Ruigang;Pan Yukun(Department of Radiology,Henan Provincial People’s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,P.R.China)
出处
《医学影像学杂志》
2019年第12期2034-2037,共4页
Journal of Medical Imaging
基金
河南省医学科技攻关项目(编号:201702160)
河南省科技厅立项项目(编号:172102310520)
关键词
冠心病
体层摄影术
X线计算机
冠状动脉成像
密度梯度
Coronary heart disease
Tomography
X-ray computed
Coronary imaging
Transluminal attenuation gradient
