基于冠状动脉CT的血流储备分数在冠心病中的诊断价值分析

Analysis of the diagnostic value of fractional flow reserve based on coronary CT in coronary heart disease

目的:探讨基于冠状动脉CT血管造影(CTA)的血流储备分数(CT-FFR)在冠心病患者中的诊断价值。方法:回顾性收集67例行冠脉CTA及FFR检查的心绞痛住院患者,计算每例患者CT-FFR值。分析CT-FFR与FFR间的相关性和一致性。以FFR为金标准,同时计算CT-FFR对于冠心病的诊断效能。结果:CT-FFR值在评估功能性心肌缺血时的灵敏度为84.2%,特异度为89.6%,整体准确率达88.1%。受试者工作特征曲线下面积(AUC)为0.956(95%CI:0.909~1.000)。CT-FFR值与FFR值之间存在显著正相关性(r=0.6941,P<0.0001),且两者间的一致性较好。结论:基于冠脉CTA的CT-FFR值与作为金标准的FFR值具有较高一致性,其在冠心病患者中诊断功能性心肌缺血具有良好的应用价值。

Objective:To investigate the diagnostic value of blood flow reserve fraction(CT-FFR)based on coronary CT angiography(CTA)in patients with coronary heart disease.Methods:Sixty-seven hospitalized patients with angina pectoris who underwent coronary CTA and FFR were retrospectively collected and their CT-FFR value was calculated.The correlation and consistency between CT-FFR and FFR were analyzed.Meanwhile,the diagnostic efficacy of CT-FFR for coronary heart disease was also calculated by taking FFR as the gold standard.Results:The sensitivity,specificity and overall accuracy of CT-FFR in the evaluation of functional myocardial ischemia accounted for 84.2%,89.6%and 88.1%,respectively.The area under the working characteristic curve(AUC)was 0.956(95%CI:0.909-1.000).There was a significant positive correlation(r=0.6941,P<0.0001)and good consistency between CT-FFR and FFR.Conclusion:The CT-FFR value based on coronary CTA is consistent with the FFR value as the gold standard and has great application value in the diagnosis of functional myocardial ischemia in patients with coronary heart disease.