Noninvasive Diagnosis of Ischemia-Causing Coronary Stenosis Using CT Angiography: Diagnostic Value of Transluminal Attenuation Gradient and Fractional Flow Reserve Computed From Coronary CT Angiography Compared to Invasively Measured Fractional Flow Reserve

摘要: Objectives The aim of this study was to compare the diagnostic performance coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) and transluminal attenuation gradient (TAG) for diagnosis lesion-specific ischemia. Background Although CCTA is commonly used detect artery disease (CAD), it cannot reliably assess functional significance CAD. Novel technologies based on were developed integrate anatomical assessment CAD; however, these methods has never been compared. Methods Fifty-three consecutive patients who underwent with FFR measurement included. Independent core laboratories determined CAD severity by CCTA, TAG, FFRCT. TAG defined as linear regression coefficient between intraluminal radiological length from ostium; FFRCT data using computational fluid dynamics technology. Results Among 82 vessels, 32 lesions (39%) had ischemia invasive (FFR ≤0.80). Sensitivity, specificity, positive negative predictive values, likelihood ratio (≤ −0.654 HU/mm) detection 38%, 88%, 67%, 69%, 3.13, 0.71, respectively; those 81%, 94%, 90%, 89%, 13.54, 0.20, respectively. Receiver-operating characteristic curve analysis showed a significantly larger area under (AUC) (0.94) compared that (0.63, p Conclusions Noninvasive provides better stenosis TAG.