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基于穆雷定律的定量流量比率来评估左主分支狭窄:选择血管图谱投影问题

Nozomi Kotoku¹, Kai Ninomiya¹, Daixin Ding²

¹Department of Cardiology, University of Galway, University Road, Galway, H91 TK33, Ireland.

The international journal of cardiovascular imaging

|October 23, 2023

概括

来自单个血管图的定量流量比 (μQFR) 对于左主分叉是可行的. 在评估冠状动脉疾病时,最佳的光镜视图显著提高了μQFR准确性,而非最佳的视图.

科学领域:

心血管成像 - 心血管成像
干预心脏病学干预心脏病学

背景情况:

定量流量比 (μQFR) 使用单视图血管学评估分量流量储备 (FFR),但精度可能会受到投射角度的影响.
FFR_CT,源自冠状动脉计算机断层扫描 (CCTA),是一种经过验证的非侵入性FFR评估方法.

研究的目的:

为了评估μQFR在左主 (LM) 两叉的可行性.
为了评估最佳与次优的光镜视图对μQFR精度的影响,与FFR_CT相比.
为了确定μQFR与FFR_CT在LM分叉中的诊断一致性.

主要方法:

在300名患有远端LM,近端LAD (pLAD) 和近端LCX (pLCX) 三血管疾病的患者中比较FFR_CT和μQFR值.
使用CCTA 3D坐标定义了最佳LM分叉视角,并将其转换为2D光镜视图.
评估了μQFR可行性和使用最接近最佳CCTA视图的光镜角度的诊断性能.

主要成果:

在805个预测中成功计算了μQFR.
在最佳预测中,与FFR_CT相比,μQFR对pLAD和pLCX表现出高灵敏度和特异性.
曲线下的面积 (AUC) 对于预测FFR_CT ≤0.80的μQFR,在最佳与次优预测之间得到改善 (p=0.048对于pLAD,p=0.075对于pLCX).

结论:

在LM分叉中单视图μQFR计算是可行的,使用后期血管图分析.
光镜视角显著影响像μQFR.这样的单视图生理评估的诊断性能.

关键词:

两叉伤口的伤口.计算机断层扫描 (CT) 是一种计算机断层扫描.冠状动脉动脉扫描是一项冠状动脉动脉扫描.分量流量储备部分流量储备左侧主要冠状动脉疾病基于穆雷定律的定量流量比率.

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