Diagnostic Value Of Myocardial Ischemic Injury By Transluminal Attenuation Gradient Combined With Non-Invasive Fraction Flow Reserve In CT

Objective: 1 To investigate the significant differences of CT-FFR and TAG between myocardial ischemic injury group and non-myocardial ischemic injury group.2 To explore the diagnostic efficacy of TAG,CT-FFR and their combination in myocardial ischemic injury.Methods: CCTA and ICA examinations were performed in 73 patients with complete clinical data from January 2019 to July 2020,with a total of114 diseased vessels(49 in myocardial ischemic injury group and 65 in nonmyocardial ischemic injury group).According to the presence or absence of myocardial ischemic injury,there were 26 cases in myocardial ischemia group,20 males and 6 females,with an average age of(59.00 ±7.45)years,and 47 patients without myocardial ischemia,32 males and 15 females,with an average age of(62.51 ±7.07)years.The differences of clinical data and imaging features between the two groups were compared,including baseline data,number of diseased vessels,location of diseased vessels,CT-FFR value and TAG value.The joint probability of TAG and CT-FFR was calculated by Logistic regression,and the model of TAG,CT-FFR and their combination in the diagnosis of myocardial ischemic injury was established.Results: The number of single vessel involved in myocardial ischemic injury group was significantly lower than that in non-myocardial ischemic injury group,while the number of three vessels involved in myocardial ischemic injury group was significantly higher than that in the latter group(P<0.05),which had nothing to do with the location of the vessels.At the vascular level,the CT-FFR and TAG values of both single vessel and total vessel in the myocardial ischemic injury group were significantly lower than those in the non-myocardial ischemic injury group(P<0.01).In terms of diagnostic efficiency,the diagnostic specificity of CT-FFR was significantly better than that of TAG(87.7% vs 67.7%,P<0.017),and the diagnostic specificity of TAG combined with CT-FFR was higher than that of TAG(86.2% vs 67.7%,P<0.017).And the combination of the two is significantly better than TAG in the diagnosis of myocardial ischemic injury(0.889 vs0.788,P<0.017).Conclusion: 1 The CT-FFR and TAG values of both single vessel and total vessel in the myocardial ischemic injury group were significantly lower than those in the non-myocardial ischemic injury group.2 The diagnostic efficacy of CT-FFR in myocardial ischemic injury is still good.TAG combined with CT-FFR has higher AUC and specificity in myocardial ischemic injury,and has higher diagnostic efficacy than TAG alone,which is helpful for clinical diagnosis of myocardial ischemic injury.