Diagnostic value of coronary computed tomography angiography and CT-derived fractional flow reserve for my-ocardial ischemia in patients with coronary artery disease
WANG Hua-feng
ZHANG Xiao-rui
GAO Yun-yun
WANG Qi
XIANG Shi-feng
FENG Qiang
Abstract：Objective To evaluate the diagnostic value of coronary computed tomography angiography(CCTA)and CT-derived fractional flow reserve(FFR-CT)for detecting myocardial ischemia in patients with coronary artery dis-ease(CAD).Methods A total of 140 patients with CAD admitted between May 2022 and May 2024 were retrospective-ly enrolled.All patients underwent coronary angiography(CAG),invasive FFR measurement,and CCTA,and FFR-CT values were calculated.Myocardial ischemia was defined as FFR ≤0.80,and patients were divided into ischemia and non-ischemia groups.CCTA plaque characteristics-including calcium score,total plaque volume,calcified plaque vol-ume,plaque burden,remodeling index,lesion length,and high-risk plaque features-along with FFR-CT values were compared between groups.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic per-formance of CCTA and FFR-CT for myocardial ischemia.Results Compared with the non-ischemia group,the ische-mia group showed significantly higher calcium scores,plaque burden,remodeling index,lesion length,and higher propor-tions of positive remodeling and napkin-ring sign(P＜0.05).FFR and FFR-CT values were significantly lower in the ischemia group(P＜0.05).No significant differences were observed in total plaque volume,calcified plaque volume ratio,low-attenuation plaque,or spotty calcification between groups(P＞0.05).ROC analysis demonstrated that,using inva-sive FFR as the reference standard,FFR-CT exhibited significantly higher sensitivity,specificity,positive predictive val-ue,negative predictive value,and area under the curve compared with CCTA(P＜0.05).Conclusion FFR-CT pro-vides superior diagnostic performance over CCTA alone for identifying myocardial ischemia in patients with coronary artery disease and may serve as a valuable noninvasive tool for clinical ischemia screening.
Keywords：coronary computed tomography angiographyCT-derived fractional flow reservecoronary artery diseasemyocardial ischemia
Publication Date：2026-01-15
Online Publishing Date：2026-03-04(First online date of this platform, not the publication date of the document)
Pages：6( 64-69 )