冠状动脉无创血流储备分数诊断冠心病效能的研究进展

Advances in the Efficacy of Noninvasive Coronary Flow Reserve Fraction for the Diagnosis of Coronary Artery Disease

冠状动脉CT扫描在检测阻塞性冠心病方面具有较高的敏感性和阴性预测价值,但其特异性和阳性预测价值欠佳。在冠状动脉CT扫描评估的疑似阻塞性冠心病者中,有三分之二的患者在接受有创冠状动脉造影检查时都没有梗阻性疾病。近十年,血流储备分数是评估解剖和生理性冠状动脉狭窄的金标准,具有高度的敏感性和特异性。然而,由于这种技术的侵入性和昂贵性,从冠状动脉CT血管造影所得血流储备分数(FFRCT)已成为评价阻塞性疾病强有力的替代方案。本文就FFRCT的工作原理及软件研发、与多种检查技术的诊断效能比较、与斑块特征的相关性、临床价值、局限性及发展方向进行综述。

Coronary CT angiography has high sensitivity and negative predictive value in detecting coronary artery disease,but its specificity and positive predictive value are low.Two thirds of patients with suspected obstructive disease assessed by CCTA did not have obstructive disease at the time of invasive coronary angiography examination.For nearly a decade,fraction flow reserve is the gold standard for evaluating anatomic and physiological coronary artery stenosis,with high sensitivity and specificity.However,due to the invasive and expensive nature of this technique,fracyional flow reserve based on CT imaging(FFRCT)has emerged as a powerful alternative for the evaluation of obstructive disease,increasing the physician's clinical decision confidence.In this paper,the working principle and software development of FFRCT,the diagnostic effectiveness of FFRCT compared with various examination techniques,the correlation with plaque characteristics,clinical value,limitations and development direction are reviewed.