摘要
目的评价CT血流储备分数(CT-FFR)对冠心病患者主要心血管不良事件(MACE)的预测价值。方法选取2018年1月~2019年12月期间接受两次冠状动脉CT血管造影(CCTA)检查,且结果显示为一支或多支冠状动脉狭窄程度在30%~90%范围内的患者109例。收集并记录临床资料。使用CT-FFR软件对CCTA图像进行分析并得到病变的CT-FFR值,治疗前后的CT-FFR值和狭窄率分别记录为CT-FFR1、CT-FFR2、狭窄率1、狭窄率2。结合狭窄率、CT-FFR值和临床指标构建以下模型:功能学联合模型model 0(CT-FFR1+CT-FFR2),治疗前功能模型model 1(CT-FFR1+临床指标),治疗前解剖功能模型model 2(狭窄率1+CT-FFR1+临床指标)。分三组绘制受试者工作特征曲线(receiver operator characteristic curve,ROC):第一组CT-FFR1 vs狭窄率1,第二组CT-FFR1 vs CT-FFR2 vs model 0,第三组CT-FFR1 vs model 1 vs model 2,比较其对冠心病患者发生MACE的诊断效能。结果MACE组患者的CT-FFR值显著低于非MACE组(P<0.05)。CT-FFR1的AUC为0.747(95%CI:0.671~0.814),狭窄率1的AUC为0.633(95%CI:0.551~0.709),CT-FFR1的诊断效能高于狭窄率1(P=0.026);CT-FFR2的AUC为0.822(95%CI:0.752~0.879),model 0的AUC为0.829(95%CI:0.760~0.884),联合CT-FFR1和CT-FFR2诊断效能明显提高(P=0.011);model 1、model 2的AUC分别为0.863(95%CI:0.799~0.913)、0.866(95%CI:0.801~0.915),功能模型的诊断效能高于单独使用CT-FFR(P=0.014),解剖功能模型的诊断效能最高(P=0.014)。结论CT-FFR值对冠心病患者发生MACE事件具有良好的诊断效能,结合狭窄率和临床指标,可显著提升对患者MACE事件的诊断价值。
Objective To evaluate the predictive value of CT flow reserve fraction(CT-FFR)for major adverse cardiovascular events(MACE)in patients with coronary artery disease.Methods A total of 109 patients who underwent two coronary CT angiography(CCTA)between January 2018 and December 2019 and whose results showed one or more coronary stenoses in the range of 30%to 90%were retrospectively included.Clinical data were collected and recorded.The CT-FFR images were analyzed and the CT-FFR values of the lesions were obtained using CT-FFR software,and the CT-FFR values and stenosis rates before and after treatment were recorded as CT-FFR1,CT-FFR2,stenosis rate 1,and stenosis rate 2,respectively.The following models were constructed by combining the stenosis rates,CT-FFR values,and clinical indices the combined functional model model 0(CT-FFR1+CT-FFR2),pre-treatment functional model model 1(CT-FFR1+clinical indicators),and pre-treatment anatomical functional model model 2(stenosis rate1+CT-FFR1+clinical indicators).The receiver operator characteristic curve(ROC)was plotted in three groups group 1 CT-FFR1 vs.stenosis rate 1,group 2 CT-FFR1 vs.CT-FFR2 vs.model 0,group 3 CT-FFR1 vs.model1 vs.model2,to compare their diagnostic efficacy for the occurrence of MACE events in patients with coronary artery disease.Results Patients in the MACE group had significantly lower CT-FFR values than those in the no-MACE group(P<0.05).The AUC for CT-FFR1 was 0.747(95%CI 0.671~0.814)and the AUC for stenosis 1 was 0.633(95%CI 0.551~0.709),and the diagnostic efficacy of CT-FFR1 was higher than that of stenosis 1(P=0.026).The AUC of CT-FFR2 was 0.822(95%CI 0.752~0.879)and model 0 was 0.829(95%CI 0.760~0.884),and the diagnostic efficacy of combining CT-FFR1 and CT-FFR2 was significantly improved(P=0.011);the AUC of model 1 and model 2 AUC were 0.863(95%CI 0.799~0.913)and 0.866(95%CI 0.801~0.915),respectively,and the diagnostic efficacy of the functional model was higher than that of CT-FFR alone(P=0.014),with the highest diagnostic efficacy of the anat
作者
茆雯雯
胡春洪
胡粟
陈蒙
陶青
杨义文
MAO Wenwen;HU Chunhong;HU Su;CHEN Meng;TAO Qing;YANG Yiwen(Department of Radiology, The First Affiliated Hospital, Soochow University, Suzhou 215006, China)
出处
《医学影像学杂志》
2022年第7期1144-1149,共6页
Journal of Medical Imaging
基金
江苏省苏州市姑苏卫生人才计划项目(编号:GSWS2020003)。
