广东医学2026，Vol.47Issue(1)：64-69,6.DOI:10.13820/j.cnki.gdyx.20251416
冠状动脉CT血管造影及FFR-CT对冠心病患者心肌缺血的诊断价值
Diagnostic value of coronary computed tomography angiography and CT-derived fractional flow reserve for my-ocardial ischemia in patients with coronary artery disease
摘要
Abstract
Objective To evaluate the diagnostic value of coronary computed tomography angiography(CCTA)and CT-derived fractional flow reserve(FFR-CT)for detecting myocardial ischemia in patients with coronary artery dis-ease(CAD).Methods A total of 140 patients with CAD admitted between May 2022 and May 2024 were retrospective-ly enrolled.All patients underwent coronary angiography(CAG),invasive FFR measurement,and CCTA,and FFR-CT values were calculated.Myocardial ischemia was defined as FFR ≤0.80,and patients were divided into ischemia and non-ischemia groups.CCTA plaque characteristics-including calcium score,total plaque volume,calcified plaque vol-ume,plaque burden,remodeling index,lesion length,and high-risk plaque features-along with FFR-CT values were compared between groups.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic per-formance of CCTA and FFR-CT for myocardial ischemia.Results Compared with the non-ischemia group,the ische-mia group showed significantly higher calcium scores,plaque burden,remodeling index,lesion length,and higher propor-tions of positive remodeling and napkin-ring sign(P＜0.05).FFR and FFR-CT values were significantly lower in the ischemia group(P＜0.05).No significant differences were observed in total plaque volume,calcified plaque volume ratio,low-attenuation plaque,or spotty calcification between groups(P＞0.05).ROC analysis demonstrated that,using inva-sive FFR as the reference standard,FFR-CT exhibited significantly higher sensitivity,specificity,positive predictive val-ue,negative predictive value,and area under the curve compared with CCTA(P＜0.05).Conclusion FFR-CT pro-vides superior diagnostic performance over CCTA alone for identifying myocardial ischemia in patients with coronary artery disease and may serve as a valuable noninvasive tool for clinical ischemia screening.关键词
冠状动脉CT血管造影/冠状动脉无创血流储备分数/冠心病/心肌缺血Key words
coronary computed tomography angiography/CT-derived fractional flow reserve/coronary artery disease/myocardial ischemia分类
医药卫生引用本文复制引用
王华锋,张晓瑞,高云云,王琦,相世峰,冯强..冠状动脉CT血管造影及FFR-CT对冠心病患者心肌缺血的诊断价值[J].广东医学,2026,47(1):64-69,6.基金项目
河北省卫生健康委科研计划项目(20242330) （20242330）
