冠状动脉CT血管成像联合心肌血流储备分数对冠心病心肌缺血诊断价值的研究

Coronary CT Angiography Combined with Myocardium Fractional Flow Reserve in Diagnosis of Patients with Coronary Myocardial Ischemia

目的探究冠状动脉CT血管成像(CCTA)联合心肌血流储备分数(FFR)对冠心病心肌缺血的诊断价值。方法选取2016年4月—2017年4月成都医学院第一附属医院疑似为冠心病心肌缺血患者100例,分别行选择性冠状动脉造影术(CAG)、CCTA、FFR检测,将CAG作为"金标准",分析CCTA和FFR检测结果与CAG的诊断符合率。结果单独诊断冠心病心肌缺血时,CCTA特异性为77.8%、灵敏度为95.7%;FFR特异性为57.1%、灵敏度为89.6%;CCTA联合FFR诊断冠心病心肌缺血时敏感度和特异度均高于单独检测(P<0.05)。结论将CCTA诊断结果和FFR诊断结果进行"并联"及"串联"分析,可提高冠心病心肌缺血诊断的特异性和敏感性,展现出较高的临床应用价值。

Objective To investigate clinical value of coronary CT angiography( CCTA) combined with myocardium fractional flow reserve( FFR) in diagnosis of patients with coronary myocardial ischemia. Methods A total of 100 patients with suspected coronary myocardial ischemia during April 2016 and April 2017 underwent coronary arteriography( CAG),CCTA and FFR respectively. Diagnostic results of CCTA and FFR and their coincidence rate with by CAG diagnosis were analyzed when the CAG result was used as gold standard. Results In diagnosis of coronary myocardial ischemia alone,specificity and sensitivity of CCTA were 77. 8% and 95. 7% respectively; specificity and sensitivity of FFR were 57. 1% and 89. 6% respectively. The sensitivity and specificity of CCTA combined with FFR in diagnosis of patients with coronary myocardial ischemia were significantly higher than those by single one test( P < 0. 05). Conclusion Series and parallel analysis should be performed for diagnostic results of CCTA and FFR,and it can improve specificity and sensitivity in diagnosis of patients with coronary myocardial ischemia.