Evaluation of the Advantages of Myocardial Blood Flow Index in the Diagnosis of Chronic Obstructive Coronary Artery Disease Versus Coronary Computed Tomography Angiography: A Feasibility Study

AuthorQing-Feng Xiongen
AuthorGuang-Yao Wuen
AuthorXiao-Rong Fuen
AuthorDi Zhouen
AuthorSheng-Peng Guoen
OrcidQing-Feng Xiong [0000-0002-6641-1991]en
Issued Date2022-07-31en
AbstractBackground: There is a hidden relationship between the degree of coronary artery stenosis and downstream myocardial remodeling. The mutual influence in myocardial ischemia and myocardial remodeling provides an index for quantifying the myocardial blood flow based on the principles of physics. Objectives: This study aimed to evaluate the advantages of myocardial blood flow index (MBFI) in the diagnosis of chronic obstructive coronary artery disease (CAD). Patients and Methods: The data of 68 patients (39 males; mean age: 57.0 ± 10.20 years) with suspected CAD were analyzed retrospectively, including the imaging findings of coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) within one week. The MBFI was also calculated for the patients. After determining the optimal cut-off value based on ICA (stenosis ≥ 70%) as the gold standard test, the diagnostic performance of MBFI and CCTA was compared. The diagnostic accuracy was examined by the receiver operating characteristic (ROC) curve. For statistical analysis, chi-square test was performed to analyze influence data, and a P-value less than 0.05 was considered statistically significant. Results: In 68 cases evaluated in this study, the average scan dose of CCTA was 3.02 ± 1.15 millisievert (mSv). There were 28 cases with stenosis ≥ 70%. The optimal cutoff value of MBFI and CCTA was 0.111 and 70%, respectively. Also, the area under the curve (AUC) for MBFI and CCTA was 0.857 and 0.621 (Z = 2.091, P = 0.0365), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 92.31%, 92.86%, 88.89%, and 95.12% for MBFI and 61.54%, 78.57%, 64.00%, and 76.74% for CCTA, respectively. The diagnostic accuracy was also estimated at 92.65% for MBFI and 72.06% for CCTA (χ2 = 9.844, P = 0.0017). Conclusion: In this study, MBFI performed better than CCTA in identifying lesions with stenosis ≥ 70%. A lower MBFI indicated the need for an upcoming active intervention, while a higher MBFI suggested avoiding unnecessary invasive testing.en
DOIhttps://doi.org/10.5812/iranjradiol-123693en
KeywordCoronary Artery Diseaseen
KeywordInvasive Coronary Angiographyen
KeywordMyocardial Blood Flow Indexen
KeywordFunctional Assessmenten
KeywordDiagnostic Testen
PublisherBrieflandsen
TitleEvaluation of the Advantages of Myocardial Blood Flow Index in the Diagnosis of Chronic Obstructive Coronary Artery Disease Versus Coronary Computed Tomography Angiography: A Feasibility Studyen
TypeResearch Articleen

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