BACKGROUND.: New developments have made 16-slice multidetector computed tomography (MDCT) a promising technique for detecting significant coronary stenoses. At present, there is a paucity of data on the relation between fractional flow reserve (FFR) measurement and MDCT stenosis detection. OBJECTIVE.: The aim of this study was to investigate the relation between the anatomical severity of coronary artery disease detected by MDCT and functional severity measured by fractional flow reserve (FFR). METHODS.: We studied 53 patients (39 men and 14 women, age 62.5+/-8.1 years) with single-vessel disease scheduled for percutaneous coronary intervention (PCI). All patients underwent MDCT scanning one day prior to PCI and FFR was measured before PCI in the target vessel. RESULTS.: MDCT analysis could be performed in 52 of 53 patients (98.1%) and all patients had adequate FFR and quantitative coronary angiography (QCA) measurements. The mean stenosis diameters calculated by MDCT and QCA were 67.0+/-11.6% and 60.8+/-11.6% respectively. No significant relation was found between MDCT and QCA (r=0.22, p=0.12) The mean FFR in all patients was 0.67+/-0.18. A relation of r=-0.46 (p=0.0006) between QCA and FFR was found. In contrast, no relation between MDCT and FFR could be demonstrated (r=-0.09, p=0.50). Furthermore, a high incidence of false-positive and false-negative findings was present in both diagnostic modalities. CONCLUSION.: There is no clear relation between the anatomical and functional severity of coronary artery disease as defined by MDCT and FFR. Therefore, functional assessment of coronary artery disease remains mandatory for clinical decisionmaking. (Neth Heart J 2007;15:5-11.).

译文

背景: 新的发展使16层多探测器计算机断层扫描 (MDCT) 成为检测明显冠状动脉狭窄的有前途的技术。目前,关于血流储备分数 (FFR) 测量与MDCT狭窄检测之间关系的数据很少。目的: 本研究的目的是探讨MDCT检测的冠状动脉疾病的解剖严重程度与血流储备分数 (FFR) 测量的功能严重程度之间的关系。方法: 我们研究了53例 (39例男性和14例女性,年龄62.5 +/-8.1岁) 的单支疾病患者,这些患者计划进行经皮冠状动脉介入治疗 (PCI)。所有患者在PCI前一天接受了MDCT扫描,并在PCI前在目标血管中测量了FFR。结果: 53例患者中的52例 (98.1% 例) 可以进行MDCT分析,所有患者都有足够的FFR和定量冠状动脉造影 (QCA) 测量。通过MDCT和QCA计算的平均狭窄直径分别为67.0 +/-11.6% 和60.8 +/-11.6%。MDCT与QCA之间未发现显着关系 (r = 0.22,p = 0.12)。所有患者的平均FFR为0.67/-0.18。发现QCA和FFR之间的r =-0.46 (p = 0.0006) 关系。相反,MDCT和FFR之间没有关系 (r =-0.09,p = 0.50)。此外,在两种诊断方式中,假阳性和假阴性发现的发生率都很高。结论: MDCT和FFR定义的冠状动脉疾病的解剖和功能严重程度之间没有明确的关系。因此,冠状动脉疾病的功能评估对于临床决策仍然是强制性的。(Neth Heart J 2007;15:5-11。)。

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