多支冠状动脉病变患者心脏 T2*BOLD 与定量血流比值（QFR）在狭窄性冠状动脉诊断中的相关性。
The association between cardiac T2*BOLD and quantitative flow ratio (QFR) in the diagnosis of stenotic coronary arteries in patients with multi-vessel coronary artery disease.
机构信息
Department of Cardiovascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China.
Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, People's Republic of China.
出版信息
Radiol Med. 2024 Aug;129(8):1184-1196. doi: 10.1007/s11547-024-01847-2. Epub 2024 Jul 13.
BACKGROUND
T2*BOLD is based on myocardial deoxyhemoglobin content to reflect the state of myocardial oxygenation. Quantitative flow ratio is a tool for assessing coronary blood flow based on invasive coronary angiography.
PURPOSE
This study aimed to evaluate the correlation between T2*BOLD and QFR in the diagnosis of stenotic coronary arteries in patients with multi-vessel coronary artery disease.
METHODS
Fifty patients with MVCAD with at least 1 significant coronary artery stenosis (diameter stenosis > 50%) and 21 healthy control subjects underwent coronary angiography combined with QFR measurements and cardiovascular magnetic resonance (CMR). QFR ≤ 0.80 was considered to indicate the presence of hemodynamic obstruction.
RESULTS
Totally 60 (54%) obstructive vessels had hemodynamic change. Between stenotic coronary arteries (QFR ≤ 0.8) and normal vessels, T2BOLD showed AUCs of 0.97, 0.69, and 0.91 for left anterior descending (LAD), left circumflex (LCX) and right coronary (RCA) arteries and PI displayed AUCs of 0.89, 0.77 and 0.90 (all p > 0.05, except for LAD). The AUCs of T2BOLD between stenotic coronary arteries (QFR > 0.8) and normal vessels were 0.86, 0.72, and 0.85 for LAD, LCX and RCA; while, PI showed AUCs of 0.93, 0.86, and 0.88, respectively (p > 0.05). Moreover, T2*BOLD displayed AUCs of 0.96, 0.74, and 0.91 for coronary arteries as before between coronary arteries with stenosis (QFR ≤ 0.8 and > 0.8), but the mean PI of LAD, LCX and RCA showed no significant differences between them.
CONCLUSION
T2* BOLD and QFR have good correlation in diagnosing stenotic coronary arteries with hemodynamic changes in patients with stable multi-vessel CAD. T2* BOLD is superior to semi-quantitative perfusion imaging in analyzing myocardial ischemia without stress.
背景
T2*BOLD 基于心肌去氧血红蛋白含量来反映心肌氧合状态。定量血流比是一种基于有创冠状动脉造影评估冠状动脉血流的工具。
目的
本研究旨在评估 T2*BOLD 与 QFR 在诊断多支血管性冠状动脉疾病患者狭窄性冠状动脉中的相关性。
方法
50 例多支血管性 CAD 患者（至少有 1 处主要冠状动脉狭窄（直径狭窄 > 50%））和 21 例健康对照者接受冠状动脉造影联合 QFR 测量和心血管磁共振（CMR）检查。QFR ≤ 0.80 被认为存在血流动力学阻塞。
结果
总共 60 个（54%）阻塞性血管存在血流动力学改变。在狭窄的冠状动脉（QFR ≤ 0.8）和正常血管之间，T2BOLD 对左前降支（LAD）、左旋支（LCX）和右冠状动脉（RCA）的 AUC 分别为 0.97、0.69 和 0.91，PI 的 AUC 分别为 0.89、0.77 和 0.90（所有 p 值均>0.05，除 LAD 外）。在狭窄的冠状动脉（QFR > 0.8）和正常血管之间，T2BOLD 的 AUC 对 LAD、LCX 和 RCA 分别为 0.86、0.72 和 0.85，而 PI 的 AUC 分别为 0.93、0.86 和 0.88（p 值均>0.05）。此外，T2*BOLD 对狭窄性冠状动脉（QFR ≤ 0.8 和 > 0.8）之间的冠状动脉的 AUC 为 0.96、0.74 和 0.91，但 LAD、LCX 和 RCA 的平均 PI 之间无显著差异。
结论
T2BOLD 和 QFR 在诊断稳定型多支血管 CAD 患者有血流动力学改变的狭窄性冠状动脉方面具有良好的相关性。T2BOLD 在分析无应激状态下的心肌缺血方面优于半定量灌注成像。
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