定量血流分数与颅外段颈动脉粥样硬化性狭窄灌注的关系*

付璐迪; 吴迎春

doi:10.16833/j.cnki.jbmc.2026.02.012

包头医学院学报 >

2026 , Vol. 42 >Issue 2: 65 - 71

DOI: https://doi.org/10.16833/j.cnki.jbmc.2026.02.012

临床医学论著

定量血流分数与颅外段颈动脉粥样硬化性狭窄灌注的关系^*

付璐迪 ,
吴迎春

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1.内蒙古科技大学包头医学院,内蒙古包头 014040;
2.鄂尔多斯市中心医院神经内科

吴迎春

收稿日期: 2025-06-18

网络出版日期: 2026-04-22

基金资助

* 内蒙古自治区科技计划(重点研发和成果转化计划)(2022YFSH0131);鄂尔多斯市科技创新领军人才项目;内蒙古自治区留学人员创新创业项目;内蒙古医学医科院联合基金(重点课题)(2024GLLH1329);2024年包头医学院科研创新项目(BYKYCX202419)

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Relationship between quantitative flow ratio and perfusion of extracranial carotid atherosclerotic stenosis

FU Ludi ,
WU Yingchun

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1. Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014040, China;
2. Department of Neurology, Ordos Central Hospital

Received date: 2025-06-18

Online published: 2026-04-22

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摘要

目的:探究基于数字减影血管造影(digital subtraction angiography, DSA)的定量血流分数(murray-law based quantitative flow ratio, μQFR)与弥散加权成像(diffusion-weighted imaging, DWI)提示的灌注之间的关系。方法:采用单中心、前瞻性研究设计,连续纳入因颅外段颈动脉粥样硬化性狭窄就诊的患者,记录其人口学资料及血管危险因素,测量管腔直径狭窄率(diameter stenosis, DS%)、面积狭窄率(area stenosis, AS%) 等参数,利用单一体位DSA图像获取μQFR,与DWI提示的低灌注情况进行对比,评估两者的关联性。采用单因素和多元Logistic回归分析低灌注的影响因素,建立受试者工作特征曲线(ROC曲线),分析μQFR的预测价值。结果:共有126例患者纳入筛选流程,最终100例颅外段颈动脉粥样硬化性狭窄患者纳入统计分析,结果显示μQFR与DWI提示的低灌注情况无显著相关性(r=-0.164,P=0.104),而DS%、AS%与μQFR呈负相关。在预测DWI低灌注脑梗死方面,μQFR最高AUC为0.598(95%CI: 0.487-0.709),对低灌注有一定的预测价值,而DS%和AS%亦在预测低灌注方面具备一定价值,最高AUC分别为0.588(95%CI:0.474-0.701)、0.569(95%CI: 0.454-0.684),三者联合指标预测低灌注,则AUC达到0.611,相较于单一指标的预测性能有一定提升。结论:基于DSA图像的μQFR在评估颅外段颈动脉粥样硬化性狭窄患者的DWI低灌注脑梗死方面表现出良好的术前评价价值,结合功能学及解剖学共同预测模型,可提高卒中风险预测效能。

关键词： 颅外段颈动脉粥样硬化性狭窄; 定量血流分数; 数字减影血管造影

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付璐迪 , 吴迎春 . 定量血流分数与颅外段颈动脉粥样硬化性狭窄灌注的关系^*[J]. 包头医学院学报, 2026 , 42(2) : 65 -71 . DOI: 10.16833/j.cnki.jbmc.2026.02.012

Abstract

Objective: To explore the relationship between murray-law based quantitative flow ratio (μQFR) based on digital subtraction angiography (DSA) and perfusion by diffusion-weighted imaging (DWI). Methods: A single-center, prospective study design was used to continuously include patients with extracranial carotid atherosclerotic stenosis. Demographic data and vascular risk factors were recorded. Parameters such as diameter stenosis (DS%) and area stenosis (AS%) were measured. The μQFR was obtained from a single-position cerebral angiography image, and compared with the low perfusion indicated by DWI to evaluate the correlation between the two. Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of hypoperfusion, and the receiver operating characteristic curve (ROC curve) was established to analyze the predictive value of μQFR. Results: A total of 126 patients were included in the screening process, and 100 patients with extracranial carotid atherosclerotic stenosis were included in the statistical analysis. The results showed that there was no significant correlation between μQFR and low perfusion indicated by DWI (r=-0.164, P=0.104), while DS% and AS% were negatively correlated with μQFR. In the prediction of DWI hypoperfusion cerebral infarction, the highest AUC of μQFR was 0.598(95%CI: 0.487-0.709), which had certain predictive value for hypoperfusion, while DS% and AS% also had certain value in predicting hypoperfusion, the highest AUC was 0.588(95%CI: 0.474-0.701) and 0.569(95%CI: 0.454-0.684), respectively. The AUC of the three combined indicators for predicting hypoperfusion reached 0.611, which was better than the prediction performance of a single indicator. Conclusion: μQFR based on DSA images has shown good preoperative evaluation ability in the evaluation of DWI hypoperfusion cerebral infarction in patients with extracranial carotid atherosclerotic stenosis, and can improve the prediction of stroke risk by combining functional and anatomical prediction models.

Key words： Extracranial carotid atherosclerotic stenosis; Quantitative flow ratio; Digital subtraction angiography

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