摘要
目的分析冠状动脉CT血管造影(CCTA)及冠状动脉无创血流储备分数(FFR-CT)对冠心病患者心肌缺血的诊断价值。方法选取2022年5月至2024年5月该院收治的140例冠心病患者为研究对象,入院后均行冠状动脉造影(CAG)、FFR检查、CCTA,并计算FFR-CT,以FFR值≤0.8作为心肌缺血诊断标准并分为心肌缺血组、无心肌缺血组,比较心肌缺血组与无心肌缺血组的CCTA斑块特征参数指标(钙化积分、斑块总体积、钙化斑块体积、斑块负荷、重建指数、病变长度等)及FFR-CT值差异性,绘制受试者工作特征(ROC)曲线评估CCTA及FFR-CT对冠心病心肌缺血的诊断价值。结果心肌缺血组(FFR≤0.8)的CCTA钙化积分、斑块负荷、重建指数、病变长度及正性重构、餐巾环征比例高于无心肌缺血组(P<0.05),心肌缺血组FFR值、FFR-CT值低于无心肌缺血组(P<0.05),两组斑块总体积、钙化斑块体积比、低密度斑块、点状钙化比例差异无统计学意义(P>0.05);ROC曲线分析显示,以FFR为金标准,CCTA诊断冠心病患者心肌缺血的敏感度、特异度、阳性预测值、阴性预测值、曲线下面积均低于FFR-CT诊断(P<0.05)。结论FFR-CT诊断冠心病患者心肌缺血的效能较CCTA好,利于临床上对冠心病患者进行心肌缺血筛查。
Objective To evaluate the diagnostic value of coronary computed tomography angiography(CCTA)and CT-derived fractional flow reserve(FFR-CT)for detecting myocardial ischemia in patients with coronary artery dis-ease(CAD).Methods A total of 140 patients with CAD admitted between May 2022 and May 2024 were retrospective-ly enrolled.All patients underwent coronary angiography(CAG),invasive FFR measurement,and CCTA,and FFR-CT values were calculated.Myocardial ischemia was defined as FFR≤0.80,and patients were divided into ischemia and non-ischemia groups.CCTA plaque characteristics—including calcium score,total plaque volume,calcified plaque vol-ume,plaque burden,remodeling index,lesion length,and high-risk plaque features—along with FFR-CT values were compared between groups.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic per-formance of CCTA and FFR-CT for myocardial ischemia.Results Compared with the non-ischemia group,the ische-mia group showed significantly higher calcium scores,plaque burden,remodeling index,lesion length,and higher propor-tions of positive remodeling and napkin-ring sign(P<0.05).FFR and FFR-CT values were significantly lower in the ischemia group(P<0.05).No significant differences were observed in total plaque volume,calcified plaque volume ratio,low-attenuation plaque,or spotty calcification between groups(P>0.05).ROC analysis demonstrated that,using inva-sive FFR as the reference standard,FFR-CT exhibited significantly higher sensitivity,specificity,positive predictive val-ue,negative predictive value,and area under the curve compared with CCTA(P<0.05).Conclusion FFR-CT pro-vides superior diagnostic performance over CCTA alone for identifying myocardial ischemia in patients with coronary artery disease and may serve as a valuable noninvasive tool for clinical ischemia screening.
作者
王华锋
张晓瑞
高云云
王琦
相世峰
冯强
WANG Hua-feng;ZHANG Xiao-rui;GAO Yun-yun;WANG Qi;XIANG Shi-feng;FENG Qiang(Department of Computed Tomography,Handan Central Hospital,Handan 056002,Hebei,China;不详)
出处
《广东医学》
2026年第1期64-69,共6页
Guangdong Medical Journal
基金
河北省卫生健康委科研计划项目(20242330)。
关键词
冠状动脉CT血管造影
冠状动脉无创血流储备分数
冠心病
心肌缺血
coronary computed tomography angiography
CT-derived fractional flow reserve
coronary artery disease
myocardial ischemia
