光学流比值评估支架置入结果和残留病变的生理意义。
Optical flow ratio for assessing stenting result and physiological significance of residual disease.
机构信息
Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
出版信息
EuroIntervention. 2021 Dec 17;17(12):e989-e998. doi: 10.4244/EIJ-D-21-00185.
BACKGROUND
Optical flow ratio (OFR) is a novel method for fast computation of fractional flow reserve (FFR) from optical coherence tomography (OCT) images.
AIMS
We aimed to evaluate the accuracy of OFR in predicting post-percutaneous coronary intervention (PCI) FFR and the impact of stent expansion on within-stent OFR pressure drop (in-stent OFR).
METHODS
Post-PCI OFR was computed in patients with both OCT and FFR interrogation immediately after PCI. Calculation of post-PCI OFR (called simulated residual OFR) from pre-PCI OCT pullbacks after elimination of the stenotic segment by virtual stenting was performed in a subgroup of patients who had pre-PCI OCT images. Stent underexpansion was quantified by the minimum expansion index (MEI) of the stented segment.
RESULTS
A total of 125 paired comparisons between post-PCI OFR and FFR were obtained in 119 patients, among which simulated residual OFR was obtained in 64 vessels. Mean post-PCI FFR was 0.92±0.05. Post-PCI OFR showed good correlation (r=0.74, p<0.001) and agreement (mean difference=-0.01±0.03, p=0.051) with FFR. The accuracy in predicting post-PCI FFR ≤0.90 was 84% for post-PCI OFR. Simulated residual OFR significantly correlated with post-PCI FFR (r=0.42, p<0.001). MEI showed a moderate correlation (r=-0.49, p<0.001) with in-stent OFR.
CONCLUSIONS
Post-PCI OFR showed good diagnostic concordance with post-PCI FFR. Simulated residual OFR significantly correlated with post-PCI FFR. Stent underexpansion significantly correlated with in-stent pressure drop.
背景
光流比（OFR）是一种从光学相干断层扫描（OCT）图像快速计算血流储备分数（FFR）的新方法。
目的
我们旨在评估 OFR 在预测经皮冠状动脉介入治疗（PCI）后 FFR 的准确性，以及支架扩张对支架内 OFR 压降（支架内 OFR）的影响。
方法
在 PCI 后，对同时进行 OCT 和 FFR 检查的患者进行 post-PCI OFR 计算。在一组有 PCI 前 OCT 图像的患者中，通过虚拟支架排除狭窄段后，从 PCI 前 OCT 拉回中计算 post-PCI OFR（称为模拟残余 OFR）。支架扩张不足通过支架段最小扩张指数（MEI）进行量化。
结果
在 119 名患者中，共获得了 125 对 post-PCI OFR 与 FFR 的比较，其中 64 个血管获得了模拟残余 OFR。平均 post-PCI FFR 为 0.92±0.05。post-PCI OFR 与 FFR 相关性良好（r=0.74，p<0.001）和一致性（平均差值=-0.01±0.03，p=0.051）。post-PCI OFR 预测 post-PCI FFR≤0.90 的准确性为 84%。模拟残余 OFR 与 post-PCI FFR 显著相关（r=0.42，p<0.001）。MEI 与支架内 OFR 呈中度相关（r=-0.49，p<0.001）。
结论
post-PCI OFR 与 post-PCI FFR 具有良好的诊断一致性。模拟残余 OFR 与 post-PCI FFR 显著相关。支架扩张不足与支架内压降显著相关。
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