邓欣,沈雳,王瑞,过伟峰,兰宏志,钱菊英,葛均波

• 1:复旦大学附属中山医院心内科上海市心血管病研究所
• 2:复旦大学附属中山医院放射科
• 3:美国加利福尼亚州斯坦福大学儿科学系

摘要(Abstract)：

目的探讨国产自主研发的基于冠状动脉CT的血流储备分数(CT-FFR)对心肌缺血的诊断价值。方法前瞻性入选2019年11月至2020年5月复旦大学附属中山医院完成冠状动脉CT血管造影检查的心绞痛住院患者。基于冠状动脉CT图像,利用CT-FFR软件来建模计算CT-FFR值。以冠状动脉造影术中导管测定的FFR值为诊断金标准,计算CT-FFR的诊断效能,包括敏感度、特异度、预测值、曲线下面积(AUC)等。采用Pearson相关分析和Bland-Altman图分析两者的相关性和一致性。并且针对临界病变人群和钙化病变人群进行亚组分析。结果入选患者77例。CT-FFR的诊断敏感度为91.4%,特异度为94.7%,阳性预测值为98.1%,阴性预测值为78.2%,准确性为92.2%。CT-FFR用于诊断心肌缺血的AUC为0.96 (95%CI 0.91～0.99,P=0.024),最佳诊断界值为0.795。Pearson相关分析显示CT-FFR和FFR的相关性良好(r=0.767, P<0.001),Bland-Altman图显示CT-FFR与FFR具有良好的一致性。在临界病变和钙化病变亚组分析中,CT-FFR也有着类似的诊断效能。结论 CT-FFR对心肌缺血疾病的诊断效能接近导管测定的FFR,是一种行之有效的无创检测心肌缺血的手段。

关键词(KeyWords)： 血流储备分数;CT血管造影;心肌缺血;冠状动脉造影

Abstract:

Keywords:

基金项目(Foundation): 上海市申康发展中心重大临床研究项目（SHDC2020CR3023B）

作者(Author): 邓欣,沈雳,王瑞,过伟峰,兰宏志,钱菊英,葛均波

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