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目的以冠状动脉血流储备分数(FFR)为金标准,预测320排动态容积CT(320CT)结合ECT评价FFR<0.75的准确性。方法连续入选临床诊断不稳定性心绞痛(UA)且冠脉320CT提示前降支(LAD)单支病变的老年患者72例,行ECT静息和运动负荷试验检查,二者结合与冠状动脉造影联合FFR比较,评价其预测FFR<0.75的价值。结果 320CT示LAD狭窄超过50%联合ECT预测FFR<0.75的敏感度为98%,特异度为86%,阳性预测值为94%,阴性预测值为95%;以320CT示LAD狭窄超过75%联合ECT预测FFR<0.75的敏感度为96%,特异度为85%,阳性预测值为96%,阴性预测值为85%。结论当病变局限在LAD时,联合ECT和320排CT对预测LAD病变的功能学有较大价值,以320CT示狭窄超过50%为阳性标准时预测价值更高。
Objective To evaluate the accuracy of FFR <0.75 with 320-row dynamic volumetric CT (320CT) and ECT using the gold standard of coronary flow reserve (FFR). Methods Seventy-two elderly patients with clinical diagnosis of unstable angina pectoris (UA) and single coronary artery anterior descending coronary artery (320AD) were enrolled in this study. Resting ECT and exercise stress test were performed. The combination of the two combined with coronary angiography FFR to evaluate the value of its predicted FFR <0.75. Results 320CT showed a sensitivity of 98%, a specificity of 86%, a positive predictive value of 94%, and a negative predictive value of 95% for LAD stenosis of more than 50% with ECT and a prediction of FFR <0.75 with ECT; 320CT showed LAD stenosis of more than 75% ECT predicts an FFR <0.75 sensitivity of 96%, a specificity of 85%, a positive predictive value of 96%, and a negative predictive value of 85%. Conclusion When the lesion is limited to LAD, the combination of ECT and 320-slice CT is more valuable in predicting the function of LAD lesion, and the predictive value is higher when the stenosis of 320CT is more than 50%.