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冠状动脉AI诊断系统在高海拔地区CHD患者评估中的应用价值

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目的 探讨冠状动脉人工智能(AI)诊断系统在高海拔地区冠状动脉粥样硬化性心脏病(CHD)患者评估中的应用价值。方法 前瞻性收集2022年1-12月在该院接受冠状动脉CT血管造影(CTA)检查的患者318例。按患者来源地区海拔梯度,分为2 000~3 000 m组、>3 000 m组。以冠状动脉造影(CAG)为金标准,验证AI诊断系统的诊断性能;并应用冠状动脉AI诊断系统及CT无创血流储备分数(CT-FFR)测量系统,对两组患者的斑块结构特征及血流动力学改变进行评价。结果>3 000 m组钙化斑块、易损斑块数量多于2 000~3 000 m组(χ2=3。976、6。482,P=0。046、0。011)。>3 000 m组冠状动脉多支病变、中度狭窄、重度狭窄、完全闭塞发生率均高于2 000~3 000 m组,2 000~3 000 m组冠状动脉单支病变、轻度狭窄发生率高于>3 000 m组(P<0。05)。>3 000 m组血管节段CT-FFR值≤0。80、<0。70的比例均高于2 000~3 000 m组(χ2=4。782、28。118,P=0。029、<0。001)。以金标准对该系统进行诊断效能评价,显示其对诊断冠脉斑块及狭窄具有较好灵敏度及特异性,诊断一致性高(P<0。001)。结论 冠状动脉AI诊断系统对系统评估高海拔地区CHD患者的冠状动脉特征及血流动力学改变有一定的价值。
Application of AI diagnostic system in the evaluation of CHD patients in high-altitude areas
Objective To explore the application of diagnostic system with artificial intelligence(AI)in the evaluation of patients with coronary heart disease(CHD)at high altitude.Methods A total of 318 pa-tients underwent coronary CT angiography(CTA)at the hospital from January to December 2022 were pro-spectively collected.According to the altitude gradient,the patients were divided into the 2 000-3 000 m group and>3 000 m group.Coronary angiography(CAG)was used as the gold standard to verify the diag-nostic performance of AI diagnostic system.Coronary artery diagnosis system with AI technology and CT de-rived fractional flow reserve(CT-FFR)measurement system were used to evaluate the plaque structure char-acteristics and hemodynamic changes in the two groups of patients.Results Calcified plaques and vulnerable plaques in the>3 000 m group were more than those in the 2 000-3 000 m group(χ2=3.976,6.482,P= 0.046,0.011).The incidence of multi-vessel coronary artery disease,moderate stenosis,severe stenosis and complete occlusion in the>3 000 m group was higher than that in the 2 000-3 000 m group,and the inci-dence of single-vessel coronary artery disease and mild stenosis in the 2 000-3 000 m group was higher than that in the>3 000 m group(P<0.05).The incidence of CT-FFR≤0.80 and<0.70 in the>3 000 m group was higher than that in the 2 000-3 000 m group(χ2=4.782,28.118,P=0.029,<0.001).The comparison with the gold standard showed that this method has high sensitivity,specificity,and diagnostic consistency(P<0.001).Conclusion The coronary diagnosis system with AI technology has certain value in the system-atic evaluation of coronary artery characteristics and hemodynamic changes in CHD patients at high altitude.

artificial intelligencehigh altitudecoronary arteryCT angiographyhemodynamics

王雪燕、鲍海华、温生宝、曹云太、李伟霞、颜梅

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青海大学附属医院医学影像中心,西宁 810000

人工智能 高海拔 冠状动脉 CT血管成像 血流动力学

青海省卫生健康委员会医药卫生科技项目指导性计划课题

2021-wjzdx-40

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(5)
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