利用动态计算机断层扫描心肌灌注成像诊断阻塞性冠状动脉疾病的心肌缺血:优化相对心肌血流比率。

Weifang Kong, Bingzhu Long, Fang Li, Lan Shang, Xinyue Chen, Aamer Chughtai
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引用次数: 0

摘要

目的:比较计算机断层扫描灌注(CTP)中不同相对心肌血流(MBF)比率对阻塞性冠状动脉疾病(CAD)患者心肌缺血的诊断效果:2020年10月至2024年3月期间,回顾性选取了接受CTP+冠状动脉计算机断层扫描血管造影术和有创冠状动脉造影术/分数血流储备的疑似或已知阻塞性冠状动脉疾病患者。患者和血管被分为缺血组和非缺血组。比较了三种相对 MBF 比率对阻塞性 CAD 患者的诊断效果:这项研究包括 48 名患者(144 条血管)。值得注意的是,48 位患者中有 34 位(70.83%)和 144 根血管中有 49 根(34.03%)被认为患有心肌缺血。Ratio-hi 的曲线下面积(0.944,95% 置信区间:0.893-0.976)高于 Ratio-av、Ratio-Q3 和 MBF-lowest 的曲线下面积,但没有发现统计学差异(P>0.005)。检测 Ratio-hi 的临界值为 0.667,其敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 91.8%、83.2%、75%、95.24% 和 86.81%:相对 MBF 比值,尤其是 Ratio-hi,在诊断阻塞性 CAD 患者的心肌缺血方面表现出色,且更稳健。
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Diagnosing myocardial ischemia of obstructive coronary artery disease using dynamic computed tomography myocardial perfusion imaging: optimization of relative myocardial blood flow ratio.

Purpose: To compare the diagnostic efficacy of different relative myocardial blood flow (MBF) ratios in computed tomography perfusion (CTP) for myocardial ischemia in patients with obstructive coronary artery disease (CAD).

Methods: Between October 2020 and March 2024, patients with suspected or known obstructive CAD who underwent CTP + coronary computed tomography angiography and invasive coronary angiography/fractional flow reserve were retrospectively selected. Patients and vessels were categorized into ischemia and non-ischemia groups. The diagnostic efficacies of the three relative MBF ratios were compared in patients with obstructive CAD.

Results: This study included 48 patients (144 vessels). Notably, 34 of the 48 patients (70.83%) and 49 of the 144 vessels (34.03%) were considered to have myocardial ischemia. The area under the curve of Ratio-hi (0.944, 95% confidence interval: 0.893-0.976) was higher than those of Ratio-av, Ratio-Q3, and MBF-lowest; However, no statistical differences were found (P>0.005). The cutoff value for detecting Ratio-hi was 0.667, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 91.8%, 83.2%, 75%, 95.24%, and 86.81%, respectively.

Conclusion: Relative MBF ratios, especially Ratio-hi, demonstrated excellent performance and exhibited greater robustness in diagnosing myocardial ischemia in patients with obstructive CAD.

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