Kong Weifang, Long Bingzhu, Li Fang, Shang Lan, Chen Xinyue, Chughtai Aamer
Department of Radiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Int J Cardiovasc Imaging. 2024 Dec;40(12):2481-2490. doi: 10.1007/s10554-024-03254-0. Epub 2024 Oct 5.
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).
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.
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.
Relative MBF ratios, especially Ratio-hi, demonstrated excellent performance and exhibited greater robustness in diagnosing myocardial ischemia in patients with obstructive CAD.
比较不同相对心肌血流量（MBF）比值在计算机断层扫描灌注（CTP）中对阻塞性冠状动脉疾病（CAD）患者心肌缺血的诊断效能。
回顾性选取2020年10月至2024年3月期间接受CTP+冠状动脉计算机断层扫描血管造影以及有创冠状动脉血管造影/血流储备分数检查的疑似或已知阻塞性CAD患者。将患者和血管分为缺血组和非缺血组。比较三种相对MBF比值在阻塞性CAD患者中的诊断效能。
本研究纳入48例患者（144支血管）。值得注意的是，48例患者中有34例（70.83%），144支血管中有49支（34.03%）被认为存在心肌缺血。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；然而，未发现统计学差异（P>0.005）。检测Ratio-hi的截断值为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患者心肌缺血方面表现优异且具有更强的稳健性。
