基于冠状动脉CT血管成像的冠状动脉生理学研究进展

Research progress of coronary physiology based on coronary CT angiography

冠状动脉CT血管成像(CCTA)是评价冠状动脉解剖学狭窄的重要手段,对冠状动脉粥样硬化性心脏病的诊断具有较高的阴性预测价值,但其不能准确地判断冠状动脉狭窄的生理学意义。近年来,国内外涌现出一系列基于CCTA的无创冠状动脉生理学评估手段,包括:基于CCTA的血流储备分数(CT-FFR)及其衍生指标、基于CCTA的瞬时无波形比值(iFRCT)等,有望实现冠状动脉功能学缺血程度与解剖学狭窄程度的一站式评估,对冠心病的早期筛查和精准诊疗具有重要意义。本文基于CCTA的冠状动脉生理学研究进展展开综述。

Coronary CT angiography(CCTA)is an important method to evaluate coronary artery stenosis and has a high negative predictive value for the diagnosis of coronary artery disease.However,the physiological significance of coronary artery stenosis cannot be accurately assessed by CCTA.In recent years,a series of non-invasive coronary physiological assessment methods based on CCTA have emerged,such as CCTA-based fractional flow reserve(CT-FFR)and its derived indexes,CCTA-based instantaneous wave-free ratio(iFRCT),which are expected to achieve one-stop evaluation of functional myocardial ischemia and anatomical stenosis of coronary artery.It is of great significance for early screening and accurate diagnosis and treatment of coronary heart disease.This paper reviews the research progress of coronary physiology based on CCTA.