基于人工智能的CT-FFR与冠状动脉狭窄的相关性分析

Correlation analysis between CT-FFR and coronary stenosis based on artificial intelligence

摘要:

目的]应用基于人工智能的CT-血流储备分数(CT-FFR)探讨冠心病患者冠状动脉狭窄程度、钙化积分与冠状动脉血流动力学的相关性。[方法]回顾性收集206例青海大学附属医院2020年9月—2021年4月接受冠状动脉CT血管成像(CCTA)的疑似冠心病患者的临床及影像资料,通过人工智能软件分析患者的左前降支、左回旋支、右冠状动脉的CT-FFR值、钙化积分及狭窄程度,根据CT-FFR值将所有患者分为两组:有功能意义组(CT-FFR≤0.8)和无功能意义组(CT-FFR＞0.8),分析两组间冠状动脉狭窄程度、钙化积分与冠状动脉血流动力学的相关性。[结果]206例患者共有365支血管纳入研究,其中有功能意义组139支血管,无功能意义组226支血管。CT-FFR与狭窄程度(r＝－0.473,P＜0.001)、钙化积分(r＝－0.369,P＜0.001)呈中度负相关,钙化积分与狭窄程度呈极弱正相关(r＝0.141,P＝0.007)。与无功能意义组相比,有功能意义组患者男性占比高,发病年龄大,高血压、吸烟史比例均更高。[结论]冠状动脉狭窄程度和钙化积分是造成冠状动脉血流动力学异常的重要因素,CT-FFR有助于CCTA在冠状动脉病变中的功能学评估。

关键词:冠心病;CT-血流储备分数;冠状动脉CT血管成像;钙化积分;狭窄程度

Abstract:

Aim To investigate the correlation between coronary artery stenosis, calcification score and coronary hemodynamics in patients with coronary heart disease based on the CT-fractional flow reserve (CT-FFR) of artificial intelligence. Methods The clinical and coronary CT angiography (CCTA) datas of 206 patients with suspected coronary heart disease in the Affiliated Hospital of Qinghai University from September 2020 to April 2021 were included in this study retrospectively. The CT-FFR, coronary artery calcification score and stenosis degree of coronary artery were analyzed by artificial intelligence software, including left anterior descending artery, left circumflex branch and right coronary artery. The patients were divided into two groups according to the CT-FFR value. The vessels with CT-FFR≤0.8 were divided into functional meaning group, and the rest are non-functional meaning group. The correlations between coronary artery stenosis and calcification score and coronary hemodynamics were analyzed. Results 365 blood vessels from 206 patients were included in the study,and there were 139 blood vessels in the functional meaning group and 226 blood vessels in the non-functional meaning group. Degree of coronary stenosis (r＝－0.473, P＜0.001) and calcification score (r＝－0.369, P＜0.001) were negatively correlated with CT-FFR, and the calcification score was weakly correlated with the degree of stenosis (r＝0.141,P＝0.007). Compared with non-functional meaning group, the age of onset was older, and the proportion of male patients, hypertension, smoking history were significantly higher than those in the non-functional meaning group. Conclusion Degree of coronary stenosis and calcification score are important factors affecting coronary hemodynamics, CT-FFR is helpful for the functional evaluation of CCTA in coronary artery disease.

Key words:coronary heart disease; CT-fractional flow reserve; coronary CT angiography; calcification score;degree of stenosis