CT血流储备分数对冠状动脉狭窄危险分层及功能评价的临床初探

Clinical application of CT angiography-derived fractional flow reserve in evaluating the risk stratification of coronary artery stenosis and the myocardial function

目的 探讨CT血流储备分数(CT angiography derived fractional flow reserve, CT-FFR)对冠状动脉狭窄及粥样斑块定量参数的危险分层及其临床应用。方法 纳入徐州市中心医院接受冠状动脉CTA检查患者122例,其中非缺血组(CT-FFR>0.8)66例,缺血组(CT-FFR≤0.8)56例。对两组数据斑块特性进行比较。logistic回归分析斑块特征与缺血病变的关系。结果 CT-FFR>0.8血管218支,CT-FFR≤0.8血管174支,两组斑块总体积、钙化斑块体积、病变长度及狭窄度>50%比较差异有统计学意义(P<0.05)。回归分析得出斑块总体积、钙化斑块体积、病变长度及狭窄度>50%为局部心肌缺血的危险因素。结论 CT-FFR可以对冠状动脉管腔狭窄、斑块性质进行危险分层,能够从解剖学狭窄及功能学层面评估局部心肌血情况,优化诊疗措施。

Objective To discuss the clinical application of coronary CT angiography(CCTA)-derived fractional flow reserve(CT-FFR)in evaluating the risk stratification of the coronary artery stenosis and atherosclerotic plaque quantitative parameters.Methods A total of 122 patients,who received CCTA examination at the Xuzhou Municipal Central Hospital of China,were enrolled in this study.The patients were divided into non-ischemia group(CT-FFR>0.8,n=66)and ischemia group(CT-FFR≤0.8,n=56).The characteristics of atherosclerotic plaque were compared between the two groups.Logistic regression analysis was used to analyze the correlation between plaque characteristics and ischemic lesions.Results There were 218 vessels having a CT-FFR>0.8 and 174 vessels having a CT-FFR≤0.8.Statistically significant differences in the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio>50%existed between the two groups(all P<0.05).Logistic regression analysis indicated that the total plaque volume,calcified plaque volume,plaque length,and stenosis ratio>50%were the risk factors for myocardial ischemia.Conclusion CT-FFR can be used for the risk stratification of coronary stenosis and atherosclerotic plaque characteristics,which can evaluate the local myocardial blood supply condition from the anatomical stenosis and functional level so as to optimize the diagnosis and treatment measures.