校正的管腔内对比度衰减梯度对冠状动脉功能性狭窄诊断价值的初步研究

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Abstract Objective: To compare the difference of transluminal contrast attenuation gradient(TAG), TAG with corrected contrast opacification(TAG-CCO) using fractional flow reserve(FFR) as the gold standard, to evaluate the application value of TAG combined with coronary CTA(CCTA) and TAG-CCO combined with CCTA in the diagnosis of functional stenosis of coronary artery. Methods: We measured TAG and TAG-CCO of 26 major epicardial coronary arteries from 18 patients who underwent CCTA and followed by invasive coronary angiography and FFR. Diagnostic performance of TAG and TAG-CCO was assessed using FFR≤0.80 as the reference standard. Results: TAG and TAG-CCO were not statistically significant between functional stenosis group and non functional stenosis group(P=0.893 vs P=0.683). The sensitivity, specificity, positive, negative predictive values and accuracy of TAG and TAG-CCO for FFR≤0.80 were 77.8% vs 77.8%, 41.2% vs 29.4%, 41.2% vs 36.8%, 77.8% vs 71.4% and 53.9% vs 46.2%, respectively. The area under the ROC curve of CCTA, TAG combined with CCTA and TAG-CCO combined with CCTA were 0.657, 0.693 and 0.670, and there was no significant difference among the three(P>0.05). Conclusion: The value of TAG or TAG-CCO in evaluating hemodynamically significant stenosis by CCTA seems to be limited. TAG or TAG-CCO combined with CCTA can not improve the diagnosis of ischemia-causing coronary stenosis.

Key words： Coronary stenosis Tomography, X-ray computed

Received: 01 March 2016

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	WANG Yu-ke
	HOU Yang
	MA Yue

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WANG Yu-ke,HOU Yang,MA Yue. Diagnostic value of corrected transluminal contrast attenuation gradient in coronary computed tomography angiography for the evaluation of physiologically significant coronary artery stenosis[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(10): 713-717.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2016/V27/I10/713

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