Nørgaard B L, Jensen J M, Leipsic J
Department of Cardiology B, Aarhus University Hospital Skejby, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark,
Eur Radiol. 2015 Aug;25(8):2282-90. doi: 10.1007/s00330-015-3619-1. Epub 2015 Feb 14.
Fractional flow reserve (FFR) measured during invasive coronary angiography is the gold standard for lesion-specific decisions on coronary revascularization in patients with stable coronary artery disease (CAD). Current guidelines recommend non-invasive functional or anatomic testing as a gatekeeper to the catheterization laboratory. However, the "holy grail" in non-invasive testing of CAD is to establish a single test that quantifies both coronary lesion severity and the associated ischemia. Most evidence to date of such a test is based on the addition of computational analysis of FFR to the anatomic information obtained from standard-acquired coronary CTA data sets at rest (FFRCT). This review summarizes the clinical evidence for the use of FFRCT in stable CAD in context to the diagnostic performance of other non-invasive testing modalities. Key Points • The process of selecting appropriate patients for invasive coronary angiography is inadequate • Invasive fractional flow reserve is the standard for assessing coronary lesion-specific ischemia • Fractional flow reserve may be derived from standard coronary CT angiography (FFR CT ) • FFR CT provides high diagnostic performance in stable coronary artery disease.
在有创冠状动脉造影期间测量的血流储备分数（FFR）是稳定型冠状动脉疾病（CAD）患者冠状动脉血运重建病变特异性决策的金标准。当前指南推荐将无创功能或解剖学检查作为导管室的守门人。然而，CAD无创检查的“圣杯”是建立一种能同时量化冠状动脉病变严重程度和相关缺血情况的单一检查。迄今为止，此类检查的大多数证据是基于将FFR的计算分析添加到从静息状态下标准采集的冠状动脉CTA数据集获得的解剖学信息（FFRCT）中。本综述总结了在稳定型CAD中使用FFRCT的临床证据，并与其他无创检查方式的诊断性能进行了对比。要点 • 选择合适患者进行有创冠状动脉造影的过程并不完善 • 有创血流储备分数是评估冠状动脉病变特异性缺血的标准 • 血流储备分数可从标准冠状动脉CT血管造影（FFR CT）得出 • FFR CT在稳定型冠状动脉疾病中具有较高的诊断性能
