两种基于冠状动脉造影图像预测心肌血流储备分数方法的对比研究Comparison between two methods in predicting myocardial fractional flow reserve using coronary angiography images
双东思,汪敏,郭卉,苏晞,宋丹,夏成雨
摘要(Abstract):
目的比较柏肃叶等式和FAST评分预测心肌血流储备分数(fractional flow reserve,FFR)的差异。方法入选2009年1月1日至2014年12月1日武汉亚洲心脏病医院行冠状动脉造影及FFR测定的冠心病患者80例,同时计算病变长度(lesion length,LL)/[最小管腔直径(minimal lumen diameter,MLD)]4和FAST评分。通过ROC曲线下面积大小,比较两种评估方法预测FFR的准确度。结果柏肃叶等式和FAST评分的ROC曲线下面积分别为(0.674±0.065)和(0.505±0.065),柏肃叶等式的ROC曲线下面积差异具有统计学意义(P<0.05),而FAST评分显示差异无统计学意义(P>0.05)。结论 FAST评分不能预测FFR<0.8,柏肃叶等式的评分能用于预测FFR<0.8,但准确性不高。
关键词(KeyWords): 柏肃叶等式;FAST评分;心肌血流储备分数;ROC曲线
基金项目(Foundation): 武汉市科委课题项目(WX14C79)
作者(Author): 双东思,汪敏,郭卉,苏晞,宋丹,夏成雨
参考文献(References):
- [1]Pijls NH,van Schaardenburgh P,Manoharan G,et al.Percutaneous coronary intervention of functionally nonsignificant stenosis:5-year follow-up of the DEFER Study.J Am Coll Cardiol,2007,49:2105-2111.
- [2]Fearon WF,Tonino PA,De Bruyne B,Et al.Rationale and design of the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation(FAME)study.Am Heart J,2007,154:632-636.
- [3]Hanley JA,Mc Neil BJ.The meaning and use of the area under a Receiver oerating chamcteristic(ROC)cuwe.Radiology,1982,143:29-36.
- [4]Pijls NH,De Bruyne B,Peels K,et al.Measurement of Fractional Flow Reserve to assess the functional severity of coronary-artery stenoses.N Engl J Med,1996,334:1703-1708.
- [5]Molloi S,Zhou Y,Kassab GS.Regional volumetric coronary blood flow measurement by digital angiography:in vivo validation.Acad Radiol,2004,11:757-766
- [6]Molloi S,Kassab GS,Zhou Y.Quantification of coronary artery lumen volume by digital angiography:in vivo validation.Circulation,2001,104:2351-2357.
- [7]Molloi S,Ersahin A,Tang J,et al.Quantification of volumetric coronary blood flow with dual-energy digital subtraction angiography.Circulation,1996,93:1919-1927.
- [8]Molloi S,Chalyan D,Le H,at al.Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images.Int J Cardiovasc Imaging,2012,28:1-11.
- [9]Zhang Z,Takarada S,Molloi S.Quantification of absolute coronary flow reserve and relative fractional flow reserve in a swine animal model using angiographic image data.Am J Physiol Heart Circ Physiol,2012,303:H401-H410.
- [10]Jaffe R,Halon DA,Roguin A,et al.A Poiseuille-based coronary angiographic index for prediction of fractional flow reserve.Int J Cardiol,2013,167:862-865.
- [11]Hoole SP,Seddon MD,Poulter RS,et al.Development and validation of the fractional flow reserve(FFR)angiographic scoring(FAST)to improve the angiographic gradingand selection of intermediate lesions that require FFR assessment.Coron Artery Dis,2012,23:45-50.