CT无创血流储备分数检测在冠状动脉功能性狭窄诊断中的应用

Application of CT noninvasive blood flow reserve score in diagnosis of coronary functional stenosis

目的探究CT无创血流储备分数(FFR-CT)在冠状动脉功能性狭窄评估中与金标准——基于冠脉造影的FFR性能的差异。方法收集2018年6月至2020年6月来河南省人民医院就诊的疑似冠心病患者58例,采用CT进行冠状动脉血管造影(CCTA)扫描并计算冠脉血流储备分数(FFR-CT),同时采用有创冠脉造影(CAG)检测FFR;以CAG测量的FFR为金标准,分析FFR-CT的诊断特异性和敏感度。结果 FFR-CT测量结果与FFR相比差异无统计学意义(P>0.05),二者呈显著正相关性(r>0,P<0.05)。以FFR≤0.8为金标准,FFR-CT的诊断特异性和敏感度分别为71.4%和90%;进行ROC曲线分析显示FFR-CT曲线下面积为0.922,最佳诊断界限值为≤0.825。结论基于CT的FFR测量与金标准基于CAG的有创FFR相比,在冠脉狭窄诊断上的性能较一致,具有临床推广价值。

Objective To explore the difference between CT non-invasive fractional flow reserve(FFR-CT) and the gold standard—FFR based on coronary angiography of diagnostic performance on coronary functional stenosis. Methods Totally 58 patients with suspected coronary heart disease were collected. Coronary angiography(CCTA) was used to scan and calculate the coronary blood FFR(FFR-CT), and invasive coronary angiography(CAG) was used to detect FFR. FFR measured by CAG was used as the gold standard to analyze the specificity and sensitivity of FFR-CT. Results There was no significant difference between FFR-CT and FFR(P>0.05), and the two showed a significant positive correlation(r>0, P<0.05). With FFR≤0.8 as the gold standard, the diagnostic specificity and sensitivity of FFR-CT were 71.4% and 90%, respectively. ROC curve analysis showed that the area under curve of FFR-CT was 0.922, and the optimal diagnostic threshold value was ≤0.825. Conclusion Compared with invasive FFR based on CAG, FFR-CT has consistent performance in the diagnosis of coronary stenosis and has clinical value.