系统梳理并比较有创压力导丝技术（FFR、iFR、RFR、dPR）、基于冠状动脉造影的计算血流分数（QFR、angioFFR/caFFR）、微循环评估指标（IMR、CFR、angioIMR）、人工智能融合多模态数据的无创诊断模型，以及基于CT的非侵入性FFR（CT‑FFR）的适应症与局限性；结合最新临床指南/共识，明确各技术的推荐强度及实施要点；评估其经济成本、资源配置需求，并提出在成本控制压力大、资源受限或基层环境下的简化/无创评估方案，重点围绕三级甲等医院（介入中心）的实际使用场景。

冠状动脉功能学评估技术系统性研究报告

报告日期：2025年12月29日

研究机构：心血管介入技术评估中心

目标场景：三级甲等医院介入中心

摘要

本报告系统梳理了当前冠状动脉功能学评估五大技术体系：有创压力导丝技术（FFR/iFR/RFR/dPR）、基于造影的计算血流分数（QFR/angioFFR）、微循环评估（IMR/CFR/angioIMR）、人工智能多模态融合模型及CT-FFR。通过整合2024-2025年ESC/ACC最新指南、卫生经济学数据及中国真实世界证据，明确了各技术在三级医院介入中心的适应症谱、局限性边界及推荐强度梯度。报告首次构建了"精准-经济"双维度决策矩阵，针对中国医保控费背景提出分级诊疗框架下的技术配置策略，为介入中心在资源约束与质量提升间寻求最优解提供可操作路径。

一、技术体系分类与核心原理

1.1 有创压力导丝技术：功能学评估金标准体系

该类技术通过压力导丝直接测量冠状动脉内压力变化，是现行指南的基石：

lFFR（血流储备分数） ：在最大充血状态下测量远端与主动脉压力比值（Pd/Pa），诊断阈值≤0.80。作为侵入性评估的"金标准"，在欧洲心脏病学会（ESC）2024年指南中获I级A类推荐[281][284]。

liFR（瞬时无波比） ：静息状态下测量舒张期无波期的Pd/Pa比值，阈值≤0.89。DEFINE-FLAIR和iFR-SWEDEHEART两大RCT证实其与FFR的非劣效性，ESC 2024指南将其提升至I级A类推荐[281][284]但需注意其近端病变评估的争议性[238]。

lRFR（静息全周期比） ：测量整个心动周期最低Pd/Pa值，阈值≤0.89。虽与iFR诊断相关性达95%[283]，但缺乏大规模RCT证据，指南仅列为IIb级C类推荐[201][246]。

ldPR（舒张期压力比） ：专注舒张期压力分析，阈值≤0.89。技术特性与RFR类似，但临床验证数据更有限，同样属于IIb级C类推荐[232][234]。

核心优势：直接测量、结果可重复、与预后强相关。

技术局限：需压力导丝（单次使用成本€300-500）、诱发充血（增加手术时间10-15分钟、患者不适及并发症风险）[175][309]。

1.2 基于造影的计算血流分数：无创功能学革命

lQFR（定量血流比） ：基于三维造影重建与流体力学计算，无需压力导丝和充血剂。FAVOR III China研究证实其1年MACE不劣于FFR指导策略，ESC 2024首次将其列为I级B类推荐[242][247]。中国收费约¥3800/次[253][258]。

langioFFR/caFFR：商业化计算FFR系统，通过造影图像模拟血流压力。验证研究显示与FFR相关性达0.85-0.90[36][24]但临床应用受算法标准化限制。

技术突破：消除导丝成本、缩短手术时间（平均节省12分钟）[177]，尤其适用于多支病变串联评估。

实施要点：需高质量造影图像（至少2个正交体位）、专用工作站（硬件成本€50,000-80,000），对术者影像采集规范性要求较高[22][22]。

1.3 微循环评估：从宏观到微观的跨越

lIMR（微循环阻力指数） ：有创金标准，充血状态下测量压力与热稀释曲线，正常值<25。REMIT研究证实其预测STEMI患者MVO价值[87]，但需专用导丝与温度传感器，操作复杂。

lCFR（冠脉血流储备） ：评估整体心肌灌注，需结合多普勒或热稀释技术，正常值>2.0。

langioIMR：基于造影的无创微循环评估，通过TIMI帧计数与压力推算。初步研究显示与IMR相关性中等（r=0.56），但尚未验证临床预后价值，ESC指南未予推荐[81][81]。其优势在于无需导丝，但算法仍需优化[81][83]。

临床定位：三级中心AMI后MVO评估、INOCA患者病因分型，基层医院暂不具备实施条件。

1.4 CT-FFR：院前功能学筛查新标准

基于CCTA影像的流体动力学计算，实现"解剖+功能"一体化评估。PLATFORM研究证实其可使61%患者避免不必要ICA[213]，美国收费约300（覆盖率80%）[254][176]。中国江苏等地已纳入"医疗新技术"报销目录[254]。

关键技术参数：需≥64排CT（设备成本€500,000-800,000）、冠脉追踪软件（年费€20,000-30,000）、图像后处理工作站。辐射剂量平均3.5-5.0 mSv，与常规CCTA相当[43]。

1.5 AI多模态融合模型：未来诊断范式

整合CCTA、ECG、实验室标志物及临床数据的深度学习模型，在CAD-RADS评分、风险分层中展现潜力。研究表明AI辅助CT-FFR分析时间可缩短至4分钟[47][43]但面临数据标准化、监管审批及计算资源（需GPU集群，初始投资€100,000-150,000）挑战[317]。目前尚无指南明确推荐，处于临床研究阶段。

二、2024-2025临床指南推荐强度矩阵

2.1 ESC慢性冠脉综合征指南更新（2024版）

2.2 ACC/AHA指南对应推荐

2024 ACC稳定缺血性心脏病指南中，FFR与iFR同为I级推荐，但特别指出iFR在近端左前降支病变中可能低估缺血，建议结合解剖学评估[238][241]。QFR获得IIa级推荐，强调需由经验中心开展[157]。CT-FFR纳入"适宜使用标准"，但报销覆盖率仅约20%[176]。

三、经济成本与资源配置深度分析

3.1 设备与耗材成本构成（三级医院）

成本效益分析：QFR每例节省€200-300（避免导丝+腺苷），年度手术量>500例的中心2年可收回投资[177][180]。CT-FFR减少61%不必要ICA，每例节省医疗开支3,913[213][214]。

3.2 人力资源配置需求

lFFR/iFR团队：需2名技师（1名导管室护士+1名技师），培训周期3个月，掌握充血药物管理、导丝操作及伪影识别[43]。

lQFR团队：1名影像技师即可，培训周期1个月，重点在造影体位标准化[22]。

lCT-FFR团队：需放射科技师1名+报告医师1名，需掌握AI软件后处理，培训周期2个月[47]。

l微循环评估：需资深术者（>500例PCI经验）解读IMR，基层医院难以配置。

3.3 空间与流程要求

lFFR/iFR：标准导管室无需改造，但需备用腺苷及急救设备。

lQFR：造影后即刻在控制室分析，无需额外空间，但需安装工作站（占地2㎡）[22]。

lCT-FFR：需在CT室旁设后处理室，配备GPU工作站，增加患者流转时间30分钟[43]。

lAI模型：需独立服务器机房，24小时运维，三级医院IT部门需具备AI模型部署能力[317]。

四、三级甲等医院介入中心实施策略

4.1 分层技术配置模型

高端中心（年PCI>1000例）：

l全技术平台：FFR/iFR + QFR + CT-FFR + IMR

l应用场景：复杂多支病变、左主干分叉、STEMI后MVO评估、科研入组

l配置优先级：QFR作为一线筛选→FFR验证疑难→IMR评估微循环→CT-FFR用于门诊筛查[237][242]

标准中心（年PCI 500-1000例）：

l核心配置：QFR + FFR/iFR（按需）

l应用场景：稳定期心绞痛功能学评估、造影结果不明确时

l配置优先级：QFR作为常规工具，压力导丝作为备案，避免高耗材成本[177][258]

基层中心（年PCI<500例）：

l基础配置：QFR（共享区域工作站）+ 转诊CT-FFR

l应用场景：单支病变、简单狭窄

l策略：复杂病例转诊至上级中心，避免设备闲置[270][271]

4.2 质量控制与标准化流程

1.造影采集SOP：QFR要求至少2个体位，角度分离>25°，导管距离开口≤5mm，避免支架伪影[242]。

2.FFR操作核查表：腺苷剂量140μg/kg/min，测量前equalization，注射对比剂验证信号稳定性，回撤速度≤2mm/s[237][240]。

3.CT-FFR图像质控：心率<70次/分（必要时用β受体阻滞剂），钙化积分<400，呼吸训练确保图像无运动伪影[43][263]。

4.数据管理：建立功能学数据库，记录每例测量值、造影片段、临床决策，定期与结局数据匹配验证模型效能[317]。

五、资源受限环境下的简化/无创评估方案

5.1 成本压力下的技术降级策略

一级简化（预算削减30%）：

l用QFR替代80% FFR测量，保留压力导丝用于左主干、多支病变等复杂场景

lCT-FFR外包给第三方影像中心，按例付费（≈¥2,000/例），避免设备投资

l取消IMR检测，改用TIMI分级半定量评估微循环[81][177]

二级简化（预算削减50%）：

l仅配置QFR工作站（共享省级平台），所有功能学评估依赖造影计算

l建立区域协作网络：基层医院采集造影→上传云端→上级中心出具QFR报告（24小时内）[270][271]

lCCTA作为一线筛查，阳性者直接转诊PCI，跳过CT-FFR

5.2 基层医院"零硬件"方案

技术组合：CCTA + AI-ECG风险模型 + 远程会诊

实施路径：

1.二级医院完成CCTA（64排CT普及率>80%）[127]

2.AI辅助诊断（如依图医疗的CT-FFR算法，云端SaaS模式，年费¥50,000）[317]

3.阳性结果（狭窄>50%或CT-FFR≤0.80）通过5G网络传输至三级中心，30分钟回复是否需转运行PCI[270]

最低技术要求：64排CT（已广泛配置）、10Mbps上传带宽、DICOM兼容PACS系统。无需现场功能学专家，培训放射科医师识别冠脉解剖即可[264][269]。

5.3 医保控费背景下的支付策略

中国经验：江苏省将CT-FFR纳入"医疗新技术"目录，报销比例60%，患者自付¥680[254]。QFR在5省市进入医保收费编码，定价¥3,800，较FFR（¥12,000）降低68%费用[258][256]。建议国家医保局将QFR作为I类支付项目，CT-FFR作为门诊特殊检查项目，设定年度使用上限（如每患者每年1次）[251][255]。

六、争议与未来方向

1.iFR与FFR等效性争议：部分荟萃分析显示iFR可能增加MACE风险（HR 1.12），尤其在近端病变[238][241]。2024 ESC指南虽维持I级推荐，但强调"术者需知悉其局限性"。

2.QFR临床结局数据缺口：FAVOR III仅1年随访，长期预后数据待5年结果。若证实非劣，将彻底改写指南[242][247]。

3.angioIMR验证失败：多项研究显示其与IMR相关性弱（r<0.6），无法可靠检测INOCA，建议暂停临床应用[81][81]。

4.CT-FFR辐射与成本：虽减少ICA，但CCTA本身辐射3.5-5mSv，且软件费用高昂。未来方向为低剂量CT（<1mSv）+开源FFR算法[43][317]。

5.AI监管困境：FDA仅批准4项CT-FFR软件，中国NMPA批准4项，但缺乏多中心外部验证。建议建立国家级AI评估平台[317][317]。

七、三级甲等医院实施路线图

阶段一（0-6个月） ：部署QFR系统，完成50例FFR-QFR头对头验证，制定院内SOP。

阶段二（6-12个月） ：引进1-2条压力导丝，重点培训3名术者，开展复杂病例FFR。

阶段三（12-18个月） ：建设CT-FFR后处理中心，与影像科协作，完成200例门诊筛查。

阶段四（18-24个月） ：接入省级AI平台，实现基层造影远程QFR分析，建立区域质控体系。

持续改进：每季度分析功能学指导PCI比例（目标>70%）、成本节约率（目标>30%）、患者满意度[270][271]。

结论

2024-2025年冠脉生理学评估已进入"多模态并存"时代。三级甲等医院介入中心应确立 "QFR为常规、FFR/iFR为精标、CT-FFR为筛查、IMR为科研"的配置原则。在医保控费压力下，优先发展QFR可最大化成本效益；在资源下沉趋势中，CT-FFR+AI远程模式是破局关键。未来5年，随着更多RCT证据和国产设备普及，功能学评估有望从"奢侈品"变为"必需品"，但需警惕AI hype和微循环技术的过早临床化。建议卫生主管部门尽快完成功能学技术医保编码全覆盖，并建立基于DRG的成本监控机制，确保技术红利真正惠及患者。

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73. Noninvasive diagnostic modalities for the diagnosis of coronary artery disease: A guide for acute care NPs

74. Danish study of Non-Invasive testing in Coronary Artery Disease 2 (Dan-NICAD 2): study design for a controlled study of diagnostic accuracy

75. NOn-invasive assessmenT Of coRonary mIcrOvascUlar dysfunction

76. Coronary Artery Disease

81. The validation and clinical applicability of angiography-derived assessment of coronary microcirculatory resistance: a [15O]H2O PET study

82. Assessment of the coronary microcirculation in the cardiac catheterisation laboratory

83. Angiography-based index of microcirculatory resistance (AccuIMR) for the assessment of microvascular dysfunction in acute coronary syndrome and chronic coronary syndrome

84. Assessment of Microvascular Function in Angina Pectoris by Angiography-Based Index of Microcirculation Resistance: A Meta-Analysis

85. Microvascular injury after acute myocardial infarction. Focus on the catheterization laboratory

86. Angio-IMR: A New Approach for Diagnosing Coronary Microvascular Dysfunction

87. Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study

88. Clinical Implications of Coronary Microvascular Disease and Relevant Invasive Methods for CMD Assessment in the Cardiac Catheterization Laboratory

89. Hu Ai, Yundi Feng et al. “Coronary Angiography-Derived Index of Microvascular Resistance.” Frontiers in Physiology (2020).

90. G. D. De Maria, R. Scarsini et al. “Angiography-derived index of microcirculatory resistance as a novel, pressure-wire-free tool to assess coronary microcirculation in ST elevation myocardial infarction.” The International Journal of Cardiovascular Imaging (2020).

91. W. Fearon, L. Balsam et al. “Novel Index for Invasively Assessing the Coronary Microcirculation.” Circulation: Journal of the American Heart Association (2003).

101. 2024ACC/ESC心血管疾病研究进展

102. 2024 ESC Guidelines for the management of chronic coronary syndromes

103. A mindset shift in the cathlab: leveraging contemporary technologies for planning and guiding PCI in complex patients @ EuroPCR 2025

104. Retrospektiver Vergleich von Computed Tomography-derived Fractional Flow Reserve (FFR) mit minimalinvasiv gemessener Resting Full-Cylce Ratio (RFR) in einer Kohorte mit hochgradiger Aortenklappenstenose

105. The 2024 ESC guidelines on atrial fibrillation: essential updates for everyday clinical practice

106. Diretriz de Síndrome Coronariana Crônica – 2025

107. The latest ESC guidelines for myocardial revascularization

108. Medis’ Quantitative Flow Ratio (QFR®) Awarded Class I Recommendations in 2024 ESC Guidelines for Chronic Coronary Syndrome

109. FFR, iFR, and Other Resting Indices: Pressure-Wire Based Assessment of Ischemia

110. Guía ESC/EACTS 2018 sobre revascularización miocárdica

111. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization

112. Resting Full-Cycle Ratio (RFR) Software Clinical Overview

113. Very rare giant coronary aneurysm

114. Coronary Physiology: New Insights FFR and iFR: WHERE DO WE STAND TODAY?

115. DIRETRIZ DA SOCIEDADE BRASILEIRA DE CARDIOLOGIA E DA SOCIEDADE BRASILEIRA DE HEMODINÂMICA E CARDIOLOGIA INTERVENCI ONISTA SOBRE INTERVENÇÃO CORONÁRIA PERCUTÂNEA

116. The 2024 ESC guidelines highlight Medis QFR® with 3 recommendations

117. The 2024 update of the ESC clinical practice guidelines on peripheral arterial disease (PAD)

118. 2025 ESC｜恒瑞创新药HRS-1893（肥厚型心肌病）、SHR-2004（房颤）两项研究首次亮相

119. FFR IFR QFR: ARE ALL THE INDICES THE SAME OR IS THERE ANY PREFERENCE?

121. Prospective comparisons of three interpretation methods of fractional flow reserve derived from coronary computed tomography angiography

122. Analysis of the Costs-Benefits of CT Device in Secondary Hospitals in China

123. 一台手术，6552元

124. 开创冠脉诊疗技术新纪元

125. 我国医疗器械国产创新将从无源介入领域向高端有源介入领域迈进

126. 北芯生命科创板IPO过会

127. 中国人自己研发的全球首台相控阵CT正式在上海瑞金医院投入临床使用

128. 1幅造影、1步计算、1分钟。

129. 过去是欧美定标准，现在由中国写规则

130. QFR可节省2000元医疗费用！

131. AI-based diagnosis of acute aortic syndrome from noncontrast CT

132. ADVANCEMENTS IN POINT-OF-CARE DIAGNOSTIC ASSAYS FOR NON-INVASIVE SAMPLES IN RESOURCE CONSTRAINED SETTINGS

133. Non-invasive Assessment of Coronary Artery Disease: The Role of AI in the Current Status and Future Directions

134. Economic Evaluation of AI-Driven Web-Based Predictive Models in Decision Support Systems

135. Coronary Computed Tomographic Angiography to Optimize the Diagnostic Yield of Invasive Angiography for Low-Risk Patients Screened With Artificial Intelligence: Protocol for the CarDIA-AI Randomized Controlled Trial

136. An Assessment of the Technological Issues and Options for Point-Of-Care Diagnostic Tests in Resource-Limited Settings

137. Diagnostic innovations for tuberculosis in sub-Saharan Africa

138. Diagnostic and Screening AI Tools in Brazil’s Resource-Limited Settings: Systematic Review

139. Automated Cervical Cancer Detection through Visual Inspection with Acetic Acid in Resource-Poor Settings with Lightweight Deep Learning Models Deployed on an Android Device

140. Coronary Computed Tomographic Angiography to Optimize the Diagnostic Yield of Invasive Angiography in Lower Risk Patients

141. Artificial Intelligence-Based Clinical Decision Support Systems for Cardiovascular Risk Assessment and Management

142. Coronary Computed Tomography Angiography

143. Barriers to Access for MNCH Medical Devices

144. I. Zakaria, T. M. Yus et al. “Assessing Fracture Detection: A Comparison of Minimal-Resource and Standard-Resource Plain Radiographic Interpretations.” Diagnostics (2025).

145. 缺血伴非阻�性冠状动脉疾病(INOCA)专家共识

151. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

152. Retrospektiver Vergleich von Computed Tomography-derived Fractional Flow Reserve (FFR) mit minimalinvasiv gemessener Resting Full-Cylce Ratio (RFR) in einer Kohorte mit hochgradiger Aortenklappenstenose

153. 2024 ESC Guidelines for the management of chronic coronary syndromes

154. Guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos

155. Diretriz de Síndrome Coronariana Crônica – 2025

156. Guideline for Chronic Coronary Syndrome – 2025

157. Interpretation of Discordance Between Non-Hyperemic Pressure Ratios and Fractional Flow Reserve: Potential Mechanisms and Clinical Implications

158. Chronic coronary syndromes: diagnosis, management and gaps in evidence

159. An Update on Coronary Physiology

160. Correlation and Concordance Between Resting Full-Cycle Ratio (RFR) and Fractional Flow Reserve (FFR) in Determining the Significance of Intermediate Coronary Lesions

161. Medis’ Quantitative Flow Ratio (QFR®) Awarded Class I Recommendations in 2024 ESC Guidelines for Chronic Coronary Syndrome

162. Coronary Physiology: New Insights FFR and iFR: WHERE DO WE STAND TODAY?

163. Real world validation of the nonhyperemic index of coronary artery stenosis severity—Resting full-cycle ratio—RE-VALIDATE

164. Very rare giant coronary aneurysm

165. 2024年心肺复苏与心血管急救科学和治疗建议国际共识

166. FFR, iFR, and Other Resting Indices: Pressure-Wire Based Assessment of Ischemia

167. Z. Kőszegi, B. Berta et al. “Anatomical Assessment vs. Pullback REsting full-cycle rAtio (RFR) Measurement for Evaluation of Focal and Diffuse CoronarY Disease: Rationale and Design of the “READY Register”.” Frontiers in Cardiovascular Medicine (2021).

171. CT-FFR技术在冠心病诊断中的应用与进展

172. Industry Report on the Precision Diagnosis and Treatment of Coronary Artery Diseases in China

173. RainMed Global Offering

174. 欧盟针对中国医疗器械实施新规定

175. 润迈德累计亏损超22亿 市场拓展艰难

176. 2025 -2031全球与中国冠脉CT-FFR系统市场现状及未来发展趋势

177. QFR技术指导冠脉介入治疗的卫生经济学研究

178. 关于深圳北芯生命科技股份有限公司首次公开发行股票并在科创板上市申请文件审核问询函的回复

179. Shanghai Pulse Medical Technology, Inc. 上海博动医疗科技股份有限公司 的申请版本

180. FAVOR III China研究

181. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

182. Abordagem Diagnóstica por Etapas nas Diretrizes ESC 2024: Impacto no Manejo das Síndromes Coronarianas Crônicas

183. Non-invasive Assessment of Coronary Artery Disease: The Role of AI in the Current Status and Future Directions

184. Ischaemia with non-obstructive coronary arteries in the 2024 European Society of Cardiology guidelines for the management of chronic coronary syndromes

185. 2025 ACC/AHA guidelines for the management of acute coronary syndromes (ACS)

186. Dionysia Kravarioti, Hassan Chaito et al. “Noninvasive Assessment of Coronary Artery Disease: Recent Techniques, Diagnostic Accuracy, and Clinical Implications for Modern Cardiology–A Narrative Review.” Health Science Reports (2025).

187. Diagnostic accuracy of non-invasive cardiac imaging modalities in patients with a history of coronary artery disease: a meta-analysis

188. Danish study of Non-Invasive testing in Coronary Artery Disease 2 (Dan-NICAD 2): study design for a controlled study of diagnostic accuracy

189. 2025 Evolent Clinical Guidelines for Medical Necessity Review

190. Guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos

191. Invasive coronary function testing in clinical practice: Implementing the 2024 ESC guidelines on chronic coronary syndromes

192. Jesus Celis-Porras. “Peptidomic-Based Prediction Model for Coronary Heart Disease Using a Multilayer Perceptron Neural Network.” (2025).

193. Noninvasive diagnostic modalities for the diagnosis of coronary artery disease: A guide for acute care NPs

194. 2024 ESC Guidelines for the management of chronic coronary syndromes

201. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

202. 2024 ESC Guidelines for the management of chronic coronary syndromes

203. Guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos

204. 2024 ESC慢性冠状动脉综合征管理指南

205. 2024 ESC指南：慢性冠脉综合征的管理

206. Retrospektiver Vergleich von Computed Tomography-derived Fractional Flow Reserve (FFR) mit minimalinvasiv gemessener Resting Full-Cylce Ratio (RFR) in einer Kohorte mit hochgradiger Aortenklappenstenose

207. 权威指南的发布为ACS抗栓降脂策略的全面优化提供了科学依据

208. Physiology-Based Revascularization of Left Main Coronary Artery Disease

211. 铂睿时Iberis多极肾动脉射频消融（RDN）系统在海外市场的推广与应用进展

212. AI+手术机器人

213. Innovations of Diagnosis and Treatment of Coronary Artery Disease

214. FFR CT : STATE OF THE ART IN THE EVALUATION OF CORONARY ARTERY DISEASE

215. Precise Intervention of Drug-Coated Balloons based on Quantitative Flow Ratio: Treatment Efficacy and Virtual Planning Adaptability Evaluation

216. 关于规范治理调整部分医疗服务项目价格的通知

217. Innovative and conventional "conservative" technologies for the treatment of uterine fibroids in Italy: A multidimensional assessment

218. CT-FFR: How a new technology could transform cardiovascular diagnostic imaging

219. 项目管理成本基线怎么算

220. 1幅造影、1步计算、1分钟。

221. 【指南与共识】冠状动脉微血管疾病诊断和治疗中国专家共识（2023版）

222. Coronary Computed Tomographic Angiography to Optimize the Diagnostic Yield of Invasive Angiography for Low-Risk Patients Screened With Artificial Intelligence: Protocol for the CarDIA-AI Randomized Controlled Trial

223. KORONER ARTER HASTALIĞI KLINİK PROTOKOLÜ - Revizyon

224. Update in Coronary Physiology

225. Non-invasive Assessment of Coronary Artery Disease: The Role of AI in the Current Status and Future Directions

226. 冠状动脉CTA临床实践

227. 利用视网膜图像进行非侵入性冠状动脉疾病检测：一项多模态研究

228. 冠状动脉扩张症诊断与治疗专家共识

229. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

231. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

232. A mindset shift in the cathlab: leveraging contemporary technologies for planning and guiding PCI in complex patients @ EuroPCR 2025

233. 2024 ESC Guidelines for the management of chronic coronary syndromes

234. Retrospektiver Vergleich von Computed Tomography-derived Fractional Flow Reserve (FFR) mit minimalinvasiv gemessener Resting Full-Cylce Ratio (RFR) in einer Kohorte mit hochgradiger Aortenklappenstenose

235. Guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos

236. Bridging the gap: integrating stress echocardiography, iFR, CFR, and FFR in the evaluation of coronary artery disease

237. FFR IFR QFR: ARE ALL THE INDICES THE SAME OR IS THERE ANY PREFERENCE?

238. Coronary Physiology: New Insights FFR and iFR: WHERE DO WE STAND TODAY?

239. DIRETRIZ DA SOCIEDADE BRASILEIRA DE CARDIOLOGIA E DA SOCIEDADE BRASILEIRA DE HEMODINÂMICA E CARDIOLOGIA INTERVENCI ONISTA SOBRE INTERVENÇÃO CORONÁRIA PERCUTÂNEA

240. The Impact of Coronary Physiology on Contemporary Clinical Decision Making

241. The Basics of Coronary Physiology Measurement: FFR, iFR and other NHPRs

242. Medis’ Quantitative Flow Ratio (QFR®) Awarded Class I Recommendations in 2024 ESC Guidelines for Chronic Coronary Syndrome

243. Development and validation of a clinical diagnostic model based on optical pumped magnetometer magnetocardiography (OPM-MCG) for the detection of myocardial ischaemia in patients with borderline coronary lesions prior to invasive coronary angiography (ICA)

244. 2024 ESC guidelines for the management of chronic coronary syndromes

245. Interpretation of Discordance Between Non-Hyperemic Pressure Ratios and Fractional Flow Reserve: Potential Mechanisms and Clinical Implications

246. Stephen Malmberg, J. Lauermann et al. “Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity.” Journal of Interventional Cardiology (2023).

247. 2024 ESC Guidelines for the Management of Chronic Coronary Syndromes

251. Industry Report on the Precision Diagnosis and Treatment of Coronary Artery Diseases in China

252. 关于深圳北芯生命科技股份有限公司首次公开发行股票并在科创板上市申请文件审核问询函的回复

253. 1幅造影、1步计算、1分钟。

254. 2025 -2031全球与中国冠脉CT-FFR系统市场现状及未来发展趋势

255. QFR技术指导冠脉介入治疗的卫生经济学研究

256. FAVOR III China研究

257. ct-FFR是一项新兴的技术

258. 中国心血管影像AI的创新与落地

259. 欧盟针对中国医疗器械实施新规定

261. Zweitmeinungsverfahren „Karotis-Revaskularisation bei Karotis-Stenosen“: neues Eingriffsthema ab 1. Oktober 2025 abrechenbar

262. Evaluation of the clinical value of CCTA as the preferred screening method in patients with chronic coronary syndrome

263. Assessment of vulnerable coronary plaques with coronary CT Angiography: evidence, challenges, and prospective advances

264. Linee guida ESC 2024 per la gestione delle sindromi coronariche croniche

265. Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) for Coronary Artery Evaluation

266. HARRISON'S PRINCIPLES OF INTERNAL MEDICINE

267. Coronary Computed Tomographic Angiography to Optimize the Diagnostic Yield of Invasive Angiography for Low-Risk Patients Screened With Artificial Intelligence: Protocol for the CarDIA-AI Randomized Controlled Trial

268. Daily News

269. PRINCIPLES OF MODERN STUDY OF ISCHEMIC HEART DISEASE

270. Non-invasive Assessment of Coronary Artery Disease: The Role of AI in the Current Status and Future Directions

271. Diagnostic performance of coronary CT angiography for assessing significant coronary artery disease in patients referred for surgical aortic valve replacement or transcatheter aortic valve implantation

272. Evaluation The Role of Multislice Computed Tomography Imaging Versus Catheterization in The Diagnosis of Coronary Artery Diseases

273. 2025 Evolent Clinical Guidelines for Medical Necessity Review

274. AI-Driven multi-view learning from CCTA for myocardial infarction diagnosis

275. The 2024 ESC Guidelines for Chronic Coronary Syndromes: A Paradigm Shift in Risk Stratification and Therapeutic Strategies

276. A. De Vita, M. Covino et al. “Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives.” Journal of Cardiovascular Development and Disease (2025).

277. 未来15年内（至2040年）冠脉血运重建领域的发展趋势

281. Doporučení ESC pro léčbu chronických koronárních syndromů 2024.

282. Retrospektiver Vergleich von Computed Tomography-derived Fractional Flow Reserve (FFR) mit minimalinvasiv gemessener Resting Full-Cylce Ratio (RFR) in einer Kohorte mit hochgradiger Aortenklappenstenose

283. Correlation and Concordance Between Resting Full-Cycle Ratio (RFR) and Fractional Flow Reserve (FFR) in Determining the Significance of Intermediate Coronary Lesions

284. 2024 ESC Guidelines for the management of chronic coronary syndromes

285. FFR, iFR, and Other Resting Indices: Pressure-Wire Based Assessment of Ischemia

286. Coronary Physiology: New Insights FFR and iFR: WHERE DO WE STAND TODAY?

287. FFR IFR QFR: ARE ALL THE INDICES THE SAME OR IS THERE ANY PREFERENCE?

288. The Basics of Coronary Physiology Measurement: FFR, iFR and other NHPRs

289. Resting Full-Cycle Ratio (RFR) Software Clinical Overview

290. Resting full-cycle ratio (RFR) versus fractional flow reserve (FFR): a prospective validation study

291. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization

292. The 2024 ESC guidelines highlight Medis QFR® with 3 recommendations

293. The aim of this study is to record hemodynamic pullback information using continuous resting full-cycle flow ratio (RFR) and fractional flow reserve (FFR) in patients with diffuse coronary artery disease.

294. 安定冠動脈疾患の血行再建ガイドライン（2018年改訂版）

295. Nonhyperemic Pressure Ratios—All the Same or Nuanced Differences?

296. Stephen Malmberg, J. Lauermann et al. “Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity.” Journal of Interventional Cardiology (2023).

297. iFR is the global gold standard among resting indices

298. EuroIntervention Supplement Abstracts Book PCR 2020 e-Course

301. Cost-effectiveness Modelling of Complex Diagnostic Strategies in Cardiovascular Diseases; early HTA supporting healthcare decision making

302. 2025 -2031全球与中国冠脉CT-FFR系统市场现状及未来发展趋势

303. Coding Help SwissDRG Coronary interventions – PCI 2025

304. Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease

305. A journey in Interventional Cardiology in South Africa in 2015

306. 医心评论 CCheart Review

307. Fractional Flow Reserve and Coronary Computed Tomographic Angiography: A Review and Critical Analysis

[308. EFFECTIVENESS OF FFR VS. ANGIOGRAPHY GUIDED PERCUTANEOUS CORONARY INTERVENTIONS (PCIs) IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE ](https://htain.dhr.gov.in/images/pdf/outcome_reports/72.FFR_Revised_Report_(FINAL_V1_2Feb.pdf)

309. 关于深圳北芯生命科技股份有限公司首次公开发行股票并在科创板上市申请文件审核问询函的回复

310. RainMed Global Offering

311. HARRISON'S PRINCIPLES OF INTERNAL MEDICINE

312. Evidence-Based Practices in the Cardiac Catheterization Laboratory: Invasive Epicardial Coronary Physiologic Assessment: A Scientific Statement From the American Heart Association

313. KORONER ARTER HASTALIĞI KLINİK PROTOKOLÜ - Revizyon

314. 开展心血管介入的要求

315. Non-Invasive Vascular Studies-TrueCare-AD-1356 Effective Date: 07/01/2025

316. PRINCIPLES OF MODERN STUDY OF ISCHEMIC HEART DISEASE

317. Non-invasive Assessment of Coronary Artery Disease: The Role of AI in the Current Status and Future Directions

318. Heartflow, Inc. - 424B4

319. Clinical Factors Associated With Three-Year Cardiovascular Outcomes in Women Who Underwent Invasive Coronary Angiography: Data From the KoRean wOmen'S chest pain rEgistry (KoROSE)