中国医学科学院学报2025，Vol.47Issue(4)：542-549,8.DOI:10.3881/j.issn.1000-503X.16412
影像组学结合CT血流储备分数诊断血流梗阻性冠心病效能评估
Coronary Computed Tomographic Angiography-Derived Radiomics Combing CT-Fractional Flow Reserve for Detecting Hemodynamically Significant Coronary Artery Disease
摘要
Abstract
Objective To develop a diagnostic model combining the CT angiography(CCTA)-derived myocardial radiomics signatures with the CT-derived fractional flow reserve(CT-FFR)based on coro-nary CCTA and investigate the diagnostic accuracy of the hybrid model for hemodynamically significant coronary artery disease(CAD).Methods The patients presenting stable angina pectoris,diagnosed with CAD,and clinically referred for CCTA examination and invasive coronary angiography were prospectively recrui-ted.Radiomics features of the left ventricular myocardium were extracted from the three main perfusion territories demarcated according to the coronary blood supply.The extracted features were first selected by the minimum re-dundancy maximum relevance feature ranking method.A least absolute shrinkage and selection operator Logistic regression algorithm with leave-one-out cross-validation was then employed to construct a radiomics model.The CT-FFR value was generated for each blood vessel.The area under the receiver operating characteristics curve(AUC_ROC),sensitivity,and specificity were adopted to evaluate the performance of each model against the reference standard invasive coronary angiography/FFR.Results A total of 70 patients[42 men and 28 women;(61±10)years old]were included in this study and complemented CCTA examination,with 175 vessels and the corresponding myocardial territories undergoing invasive coronary angiography/FFR.A total of 1 656 specific radiomics parameters were extracted,from which 14 features were selected to establish the radiomics model.The AUC_ROC,sensitivity,and specificity were 0.797(95％CI=0.732-0.861),77.1％,and 73.7％for the ra-diomics model,0.892(95％CI=0.841-0.943),81.4％,and 88.8％for the CT-FFR model,and 0.928(95％CI=0.890-0.965),83.3％,and 88.4％for the hybrid model,respectively.The hybrid model outper-formed the radiomics model and CT-FFR alone(P=0.040).Conclusions The radiomics signatures of the ves-sel-related myocardium from CCTA could provide incremental value to the diagnostic performance of CT-FFR and improve vessel-specific ischemia detection.The hybrid model combining CT-FFR with radiomics signatures is poten-tially feasible for improving the diagnostic accuracy for hemodynamically significant CAD.关键词
冠状动脉粥样硬化性疾病/计算机断层扫描血管造影/影像组学/CT血流储备分数/血流梗阻性冠心病Key words
coronary atherosclerotic disease/computed tomography angiography/radiomics/CT-derived fractional flow reserve/hemodynamically significant coronary artery disease分类
医药卫生引用本文复制引用
易妍,徐橙,吴炜,葛颖倩,徐珂婷,俞贤博,王怡宁..影像组学结合CT血流储备分数诊断血流梗阻性冠心病效能评估[J].中国医学科学院学报,2025,47(4):542-549,8.基金项目
北京市自然科学基金(Z210013)、国家自然科学基金(82402258、82325026)、中国医学科学院中央级公益性科研院所基本科研业务费专项(2024-RC320-03)、中国医学科学院医学与健康科技创新工程项目(2023-I2M-C&T-A-004)和中央高水平医院临床科研业务费(2022-PUMCH-A-097、2022-PUMCH-B-027) （Z210013）
