摘要
目的探索冠状动脉CT血管成像(cCTA)与CT血流储存分数(CT-FFR)预测冠脉钙化程度与心血管不良事件(MACE)的临床价值。方法采用回顾性研究设计,收集2020年4月至2022年4月期间于本院就诊的冠心病患者基本资料,患者均进行cCTA检查,并计算CT-FFR数值,根据cCTA检查的病变血管钙化积分分为轻度钙化组(冠脉整体钙化积分≤99分,n=38)、中重度钙化组(冠脉整体钙化积分>100分,n=70),比较两组cCTA参数值,并分析其参数与冠脉钙化的关系。亚组分析中,根据CT-FFR临界值(0.85)分为高CT-FFR(>0.85,n=48)、低CTFFR(≤0.85,n=60)为两组,均随访24个月,统计MACE发生情况,经Kaplan-Meier分析CT-FFR指数预测MACE的临床价值。结果两组CTA参数比较,两组的斑块总体积、脂质斑块体积、非钙化斑块体积负荷均无统计学差异性(P>0.05),但中重度钙化组斑块总体积负荷、钙化斑块体积及CT-FFR高于轻度钙化组(P<0.05);经pearson法分析,冠脉钙化程度与钙化斑块体积、CT-FFR呈正相关性(r=0.694、0.776,P<0.05)。经ROC曲线分析,CT-FFR预测患者发生MACE的AUC为0.721,临界值为0.85,敏感性、特异性分别是65.00%,特异度是80.0%;低CTFFR的MACE率为14.58%,高CT-FFR的MACE率为18.33%,经Kaplan-Meier分析显示,CT-FFR指数各自表达情况的MACE率、发生时间比较差异有统计学意义(P<0.05)。结论cCTA定量参数可有效评估冠脉钙化程度,二者存在—定相关性,且CT-FFR指数越高,患者后期发生MACE的风险越高。
Objective To explore the clinical value of coronary CT angiography(cCTA)and CT flow storage fraction(CT-FFR)in predicting the degree of coronary calcification and cardiovascular adverse events(MACE).Methods Retrospective study design,collect in April 2020 to April 2022 of coronary heart disease(CHD)patients in our hospital during the period of basic data,the patients were inspected cCTA,and computed tomography(CT)-FFR numerical calculation,according to cCTA check pathological vascular calcification score divided into mild calcification group(coronary calcium score 99 points or less whole,n=38)and moderate to severe calcification group(global coronary calcification score>100,n=70),the values of cCTA parameters of the two groups were compared,and the relationship between CCTA parameters and coronary calcification was analyzed.In subgroup analysis,according to the critical value of CT-FFR(0.85),the two groups were divided into high CT-FFR(>0.85,n=48)and low CT-FFR(≤0.85,n=60),and were followed up for 24 months to analyze the occurrence of MACE.CT-FFR index was analyzed by Kaplan-Meier to predict the clinical value of MACE.Results Compared with CTA parameters between the two groups,there were no statistical differences in the total plaque volume,lipid plaque volume and non-calcified plaque volume load between the two groups(P>0.05),but the total plaque volume load,calcified plaque volume and CT-FFR in moderate and severe calcification group were higher than those in mild calcification group(P<0.05).The degree of coronary calcification was positively correlated with the volume of calcified plaque and CT-FFR by pearson analysis(r=0.694,0.776,P<0.05).According to ROC curve analysis,the AUC of MACE predicted by CT-FFR was 0.721,the critical value was 0.85,the sensitivity and specificity were 65.00%,and the specificity was 80.0%.The MACE rate of low CT-FFR was 14.58%,and the MACE rate of high CT-FFR was 18.33%.Kaplan-Meier analysis showed that there were statistically significant differences in the MACE rate and occurrence time of CT-FFR index expression(P<0.05).Conclusion cCTA quantitative parameters can effectively evaluate the degree of coronary artery calcification,and there is a certain correlation between the two,and the higher the CT-FFR index,the higher the risk of later MACE.
作者
贺俊伟
张绍金
杨林
穆兰
HE Jun-wei;ZHANG Shao-jin;YANG Lin;MU LAN(Department of Radiology,Pi Du District People's Hospital,Chengdu 611730,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2025年第8期98-101,共4页
Chinese Journal of CT and MRI
