CN106539622A - Coronary artery virtual bracket method for implantation and system based on Hemodynamic analysis - Google Patents
Coronary artery virtual bracket method for implantation and system based on Hemodynamic analysis Download PDFInfo
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Abstract
Coronary artery virtual bracket method for implantation and system of the present invention based on Hemodynamic analysis, wherein method include the CTA view data for reading in patient, recognize patch, set up blood vessel 3-dimensional image model, remove and record patch position；Physiological parameter is received, CFD boundary conditions are set, CFD calculating is carried out；According to three-dimensional vascular morphology, Patch properties, blood vessel FFR values everywhere, pathology identification is carried out；Pathology, support Specifications Database and virtual bracket implantation strategy according to identification, generates implantation scheme, and generates new blood vessel 3-D geometric model；Under new 3-D geometric model, fluid calculation is re-started, by default selection standard, the optimum stenter to implant scheme of output.The present invention is automatically performed hemadostewnosis degree and calculates, generates stenter to implant strategy, quantitative evaluation virtual bracket implantation effect, realizes accurate operation plan planning, effectively improves doctor's efficiency of decision-making, reduce the risk by artificial judgment.
Description
Technical field
The present invention relates to a kind of coronary artery virtual bracket method for implantation and system based on Hemodynamic analysis.
Background technology
The minimally invasive Surgery method of drug therapy, operative treatment and conduit be now treat coronary heart disease it is the most frequently used three
The means of kind.Wherein minimally invasive intervention operative treatment is using certain special conduit and apparatus, by percutaneous puncture or by human body
Certain original passage, insertion human body further reach diseased region, come a kind of specific process for being diagnosed to coronary heart disease and being treated.
Post-percutaneous Transluminal Coronary Angioplasty (percutaneous trans luminal angioplasty, PTCA) is current
A kind of minimally invasive interventional therapy of coronary heart disease of wide clinical application.In PTCA surgical procedures, it is used to be implanted into human body coronary artery blood vessel
Interior, holder that is playing the pipe net metal or other materials of propping up and withstand blood vessel is exactly coronary stent.Generally will
Support is arranged in balloon catheter device, under the monitoring of x-ray imaging video recording, is transported to by balloon catheter device narrow
Narrow lesion；Then, by the inflated distending of foley's tube end, strut then support and force the lumen of vessels of stenosis to be opened
Put, blood is enable normal through blood vessel；Balloon-system is withdrawn from finally, intravascular stent is then permanently fixed diseased region, reaches
To the purpose for supporting narrow blood vessel, keeping blood flow unobstructed.
In PTCA endovascular stent implantation surgeries, being accurately positioned for the selection of stent size and implantation mode and support is right
In operation, whether success is very crucial.Clinical conventional diagnostic method is according to X-ray coronary angiography (coronary at present
Angiography, CAG) or CT coronarographies (CT angiography, CTA) image, using some two-dimension analysis skills
Art is estimating the model of the lesion degree and required support of blood vessel.But, the spatial information provided by CAG or CTA images is non-
It is often limited, it is impossible to the actual conditions of true reflection blood vessel and its pathology.And, measurement result is all affected by subjective factor,
Certainly will be that the model for accurately estimating support used brings difficulty.
The actual demand of not enough and clinical practice according to more than, people start to explore exploitation virtual bracket imbedding system, come
Carry out the preoperative planning of arterial bracket.Such as Philip INTEGRIS 3D-RA work stations, by automatic and automanual image
Partition tools, set up the vascular pattern of given patient, and automatically extract in 3-dimensional image model with reference to mess generation instrument
Lumen of vessels center line.Then, virtual bracket is inserted along lumen center line, and interactively adjust the length of support and straight
Footpath, for carrying out surgical planning, for example, simulates support and inserts, simulates blood flow process etc..The method can treat row stent endoprosthesis
Lumen of vessels narrow positions intuitively exhibition stand place effect, support can be changed repeatedly until model is suitable.But it is not enough
It is can not to carry out automatically hemadostewnosis degree calculating, it is impossible to which automatic identification pathology simultaneously generates support strategy, excessively relies on doctor's
Experience, can not predict impact of the stenter to implant to blood flow reserve fraction, it is impossible to which objective evaluation operation improves feelings to patient's state of an illness
Condition.
Wherein, blood flow reserve fraction (Fractional Flow Reserve, FFR) is clinically to judge myocardial ischemia
" goldstandard ", is a kind of technology of important diagnosis coronary artery physiological function.FFR passes through to measure coronary artery under maximum congestive state,
Narrow remote end reacts the narrow restriction to maximum blood flow with the ratio of the pressure of near-end, so as to judge narrow whether induce ischemic.
There are a large amount of clinical testings to provide evidence-based medicine EBM foundation up till now, pointed out FFR to can be used for assessing stenotic lesion function meaning
Justice, the selection especially for critical stenosis lesions treatment scheme have important directive significance.But the measurement of FFR is invasive,
Researchers start with limited element analysis technique has carried out mechanical analysis and research to inserting stented vessel, with qualitative assessment support
Improvement to blood flow.The 3-D geometric model that specific method is namely based on blood vessel carries out Fluid Mechanics Computation
(computational fluid dynamics, CFD) is analyzed.CFD is to solve fluid mechanics equation based on computer program
Method, CFD is calculated to be needed to know the mechanics parameter of the shape of flow region and fluid itself.Can be by by CT and MRI technique
The 3D shape of blood vessel is rebuild, and carries out the separation of blood vessel and surrounding tissue according to the gray scale of CT and MRI image, is then further continued for drawing
Subnetting lattice, grid are combined by tetrahedron or hexahedron, and are calculated.Whole CFD is calculated and is built upon solving partial differential
On the basis of equation, can pass through to adjust spatial resolution, temporal resolution to reach the computational accuracy for meeting requirement.
The content of the invention
It is an object of the invention to provide one kind can be automatically performed hemadostewnosis degree calculate, generate stenter to implant strategy,
Quantitative evaluation virtual bracket is implanted into effect, reduces the dependence to personal experience, improves doctor's efficiency of decision-making, reduces doctor's decision-making wind
The coronary artery virtual bracket method for implantation based on Hemodynamic analysis and system of danger.
Coronary artery virtual bracket method for implantation of the present invention based on Hemodynamic analysis, methods described include：
The coronary artery CTA view data of patient is read in, calcified plaque is recognized, is set up coronary artery blood vessel 3-dimensional image model, removed
Calcified plaque simultaneously records calcified plaque position；
Receive the physiological parameter, the boundary condition of CFD is set, carry out CFD calculating, obtain coronary artery blood vessel everywhere
Stable blood flowing speed and pressure, by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain
Coronary artery blood vessel FFR everywhere；
It is according to three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel FFR values everywhere, three-dimensional in the coronary artery blood vessel
Pathology identification is carried out on iconic model；
Pathology, support Specifications Database and default virtual bracket implantation strategy according to identification, generates virtual bracket and plants
Enter scheme, after carrying out virtual bracket implantation, generate new blood vessel 3-D geometric model；
Under the new blood vessel 3-D geometric model, CFD calculating is re-started, new FFR numerical value is obtained, by default
Virtual bracket is implanted into Scheme Choice standard, exports optimum virtual stenter to implant scheme.
A kind of embodiment of the invention, carries out pathology in the blood vessel 3-dimensional image model and knows method for distinguishing
For：
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessels diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal blood vessels area；
All points for meeting Severity of Coronary Artery Stenosis ＞ 50% are found out, these points different narrow sections is combined into, for list
Section blood vessel, according to default distance threshold, merges adjacent narrow section；To crotch, according to stenosis and position, press
Medina classification is divided into seven types；
Pathology on coronary artery vascular tree is one of following two：
Pathology (original position, final position) on (a) single hop blood vessel；
B (bifurcated terminating point is two) for starting point, bifurcated terminating point one for () bifurcated lesions；
Further according to the FFR after pathology, the pathology of FFR ＞ 0.8 is removed, remaining pathology then needs to carry out stenter to implant.
A kind of embodiment of the invention, the stenosis diameter are obtained by area of section conversion：Stenosis are straight
Footpath=4* areas of section/girth, normal blood vessels diameter are obtained by being fitted the diametral curve of whole blood vessel.
A kind of embodiment of the invention, the data that the support Specifications Database is preserved include the support of each manufacturer
The complete expanded diameter of specifications and models, support, length；The stenter to implant strategy is：
The support strategy for bifurcated lesions that the bifurcated lesions are arranged using Chen Ji woodss；
Pathology if necessary to process contains calcified plaque, and calcified plaque is in main proximal segment, and near side shoot
The distance between side, calcified plaque and side shoot are less than or equal to 10mm, then side shoot is also required to carry out support protection, i.e. side shoot also need
Stenter to implant to be carried out, in case main implantation support, crushes patch, broken patch blocks downwards side shoot with blood flow；
Average diameter of the complete opening dimension of support not less than the normal blood vessels of lesion fitting, and no more than lesion is intended
The average diameter of the normal blood vessels of conjunction and the product of predetermined threshold value.
A kind of embodiment of the invention, the default virtual bracket implantation Scheme Choice standard is virtual bracket
After implantation FFR ＞ 0.8 and be implanted into number of holders it is minimum.
Coronary artery virtual bracket implant system of the present invention based on Hemodynamic analysis, the system include at least one meter
Calculation machine system, at least one computer system are configured to：
The coronary artery CTA view data of patient is read in, calcified plaque is recognized, is set up coronary artery blood vessel 3-dimensional image model, removed
Calcified plaque simultaneously records calcified plaque position；
Receive the physiological parameter, the boundary condition of CFD is set, carry out CFD calculating, obtain coronary artery blood vessel everywhere
Stable speed and pressure, by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain coronary artery blood vessel
FFR everywhere；
It is according to three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel FFR values everywhere, three-dimensional in the coronary artery blood vessel
Pathology identification is carried out on iconic model；
Pathology, support Specifications Database and default virtual bracket implantation strategy according to identification, generates virtual bracket and plants
Enter scheme, carry out virtual bracket implantation, generate new blood vessel 3-D geometric model；
Under the new blood vessel 3-D geometric model, CFD calculating is re-started, new FFR numerical value is obtained, by default
Virtual bracket is implanted into Scheme Choice standard, exports optimum virtual stenter to implant scheme.
A kind of embodiment of the invention, carries out the side of pathology identification in the coronary artery blood vessel 3-dimensional image model
Method is：
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessels diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal blood vessels area；
All points for meeting Severity of Coronary Artery Stenosis ＞ 50% are found out, these points different narrow sections is combined into, for list
Section blood vessel, according to default distance threshold, merges adjacent narrow section；To crotch, according to stenosis and position, press
Medina classification is divided into seven types；
It is one of following two all of pathology on coronary artery vascular tree：
Pathology (original position, final position) on (a) single hop blood vessel；
B (bifurcated terminating point is two) for starting point, bifurcated terminating point one for () bifurcated lesions；
Further according to the FFR after pathology, the pathology of FFR ＞ 0.8 is removed, remaining pathology then needs to carry out stenter to implant.
A kind of embodiment of the invention, the stenosis blood vessel diameter DXObtained by area of section S conversions：
DX=4*S/L
In formula, S is area of section, and L is girth；
Normal blood vessels diameter is obtained by being fitted the diametral curve of whole blood vessel.
A kind of embodiment of the invention, the data that the support Specifications Database is preserved include the support of each manufacturer
The complete expanded diameter of specifications and models, support, length；The stenter to implant strategy is：
The support strategy for bifurcated lesions that the bifurcated lesions are arranged using Chen Ji woodss；
Pathology if necessary to process contains calcified plaque, and calcified plaque is in main proximal segment, and near side shoot
The distance between side, calcified plaque and side shoot are less than or equal to 10mm, then side shoot is also required to carry out support protection, i.e. side shoot also need
Stenter to implant to be carried out, in case main implantation support, crushes patch, broken patch blocks downwards side shoot with blood flow；
Average diameter of the complete opening dimension of support not less than the normal blood vessels of lesion fitting, and no more than lesion is intended
The average diameter of the normal blood vessels of conjunction and the product of predetermined threshold value.
A kind of embodiment of the invention, the default virtual bracket implantation Scheme Choice standard is virtual bracket
After implantation FFR ＞ 0.8 and be implanted into number of holders it is minimum.
Coronary artery virtual bracket method for implantation and system of the present invention based on Hemodynamic analysis, its advantage are as follows：
(1) present invention can carry out stenosis calculating automatically, and can avoid what manual measurement in prior art was brought
The low problem of experience deviation, efficiency, its treatment effeciency are very high.There is the image post processing software of many CT equipment vendors can at present
To aid in doctor to carry out manual measurement to Severity of Coronary Artery Stenosis, the experienced deviation of manual measurement, inefficiency in addition.
(2) present invention can automatically generate stenter to implant strategy, can form multiple complete hands in stenter to implant operation consent
Art scheme, including stenter to implant alternative, to improve doctor's efficiency of decision-making, the risk that provisional decision brings in reduction art.
(3) present invention can carry out quantitative evaluation to coronary artery virtual bracket implantation scheme works, and can recommend automatically optimum
Frame scheme, reduces risk of policy making of the doctor by experience.By quantifying the accurate of coronary blood pipe stenosis, lesion locations and scope
Present, and the Hemodynamic evaluation after stenter to implant, quantify improvement of the support implant surgery to the state of an illness to a certain extent,
Accurate operation plan planning is realized, the risk by artificial judgment is reduced.
Below in conjunction with the accompanying drawings to the coronary artery virtual bracket method for implantation based on Hemodynamic analysis of the invention and system
It is described in further detail.
Description of the drawings
Fig. 1 is a kind of coronary artery virtual bracket method for implantation flow chart based on Hemodynamic analysis in the present invention；
Fig. 2 is the blood vessel diameter matched curve figure in one embodiment of the present invention；
Fig. 3 is the Medina classification schematic diagrames with regard to bifurcated lesions；
Fig. 4 is the pathology schematic diagram containing calcified plaque；
Fig. 5 be an embodiment of the present invention in virtual bracket implantation after to the effect after grid filling is carried out on former three-dimensional grid
Fruit is schemed.
Specific embodiment
Referring to Fig. 1, coronary artery virtual bracket method for implantation of the present invention based on Hemodynamic analysis, method include：
S1. the DICOM image files of the CT scan of patient are read in, is automatically positioned by human assistance or computer software
Seed point is selected in method such as machine learning, generates the 3-dimensional image model of coronary artery blood vessel, a tool by image growth algorithm
The method that body is generated can be found in patent application：Application No. 2015103631541, a kind of entitled coronary artery three-dimensional image segmentation
Method.
In image growth, according to the higher feature of calcified plaque brightness, by arranging threshold value, Patches information is obtained, from trouble
The calcified plaque positional information of removal is removed and is recorded in the 3-dimensional image model of person's coronary artery blood vessel, obtains patient-specific hat
Arteries and veins blood flow threedimensional model.
Then software is processed by 3-D view, smooth and gridding is carried out to coronary blood flow threedimensional model and is processed, such as
It is divided into the tetrahedron of very little, center line generation etc., and obtains vascular bifurcation and diameter information.
S2. physiological parameter is received, the boundary condition of fluid calculation is set, obtain coronary artery blood vessel stable blood everywhere
Liquid flowing velocity and pressure, by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain coronary artery blood vessel
FFR everywhere.
Boundary condition is used for the flow characteristic of the boundary for being described in coronary artery threedimensional model anatomical structure, including blood flow
Speed, pressure etc..Boundary condition changes because of patient's physiological condition, because the blood flow through heart can be because of patient's physiological condition
It is different.Because the blood flow reserve fraction FFR of patient is measured under congested physiological condition, also can be by pharmacological modality, example
Such as induced with adenosine, so the boundary condition of fluid calculation should also be the boundary condition under the conditions of hyperemia.And can get
Physiological parameter such as heart rate, blood pressure etc., substantially under patient's quiescent condition, this is accomplished by defining patient life
Reason parameter model, simulates physiological parameter from tranquillization to the change of congested situation.
Physiological parameter model can be obtained by existing medical knowledge or medical statistics.Existing medical knowledge, than
Such as total CBF and the relation of myocardial mass.Medical statistics by enough clinical samples amounts, and can gather their physiology
Parameter, by regression analysis, sets up the relation between physiological parameter, so as to from known parameters, such as age, heart rate, body weight, blood pressure
Deng derivation unknown parameter such as coronary artery inlet pressure.
After setting boundary condition, hydrodynamics method method is called, such as Na Wei-Stokes (Navier-
Stokes) equation, i.e. N-S equations carry out fluid calculation, obtain the VPV and pressure of each grid on blood vessel.
Shown in N-S equations such as formula (1) and formula (2).
Formula (1) is the N-S equations of incompressible Newtonian fluid, and formula (2) is momentum conservation equation.Wherein,It is La Pu
Laplacian operater, ρ is fluid density, and p is pressure, and u is the speed of fluid, and F is external force, and μ depends on the property of fluid, is called viscosity
Coefficient.The method that the speed of blood flow passes through variation and finite element with pressure obtains numerical solution.According to above-mentioned principle, by three-dimensional blood vessel
Model is split, and the fluid field of blood vessel is changed into the space of the tetrahedron filling of limited quantity, the number on each tetrahedron
Value solves N-S equations and obtains speed and pressure, it is considered to the interaction between tetrahedron, obtains blood vessel everywhere by iterating to calculate
Stable blood flowing speed and pressure.
Define by FFR, FFR=Pd/Pa, Pd：The mean pressure of narrow remote end coronary artery, Pa under maximum congestive state：It is maximum
AoMP under congestive state.By blood stream pressure at grid and the ratio of AoMP power, the blood flow of grid is obtained
Deposit fraction FFR.
S3, according to three-dimensional vascular morphology, Patch properties, coronary artery blood vessel FFR values everywhere, in coronary artery blood vessel 3-D view mould
Pathology identification classification is carried out in type.
The assessment of Severity of Coronary Artery Stenosis is the necessary condition for carrying out stent procedure.Severity of Coronary Artery Stenosis can adopt diameter or
Area is defined, that is, calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessels diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal blood vessels area；
On the basis of coronary artery three-dimensional blood vessel model is obtained, center line is obtained by calculating, carry out coronary artery face along center line
Product and diameter are calculated.Because coronary artery blood vessel is not necessarily regular cylindrical, diameter can be obtained by area conversion, by equivalent diameter
Computational methods, such as diameter=4* areas of section/girth.In order to obtain on blood vessel the concrete stenosis of any on center line,
Need to obtain normal blood vessels caliber, i.e., caliber when blood vessel is not narrow, the diametral curve that can pass through to be fitted whole blood vessel are obtained,
Referring to Fig. 2.Normal blood vessels approximating method can first remove the abnormity point on blood vessel, because patch causes the blood vessel of three-dimensional reconstruction
It is narrow or wide, such as remove 2 times of average diameter or 1/2 point, then carry out the caliber that linear fit obtains normal blood vessels.
On blood vessel, the stenosis of per can use 1- blood vessel diameters/fitting normal blood vessels diameter, in such as Fig. 2,1-d2/
d1.Find out and be combined into different little narrow sections by the point all stenosis more than 50%.And according to it is default away from
From threshold value, such as 2mm, the little narrow section apart less than 2mm is merged into big narrow section.
Crotch it is narrow, according to stenosis and position, be divided into altogether by Medina classification relatively more current in the world
Seven types, can be merged into a big pathology by Medina classification referring to the multiterminal pathology of Fig. 3, i.e. crotch.
So, on coronary artery vascular tree, all of pathology will be one of following two：
Pathology (original position, final position) on (a) single hop blood vessel
B (bifurcated terminating point is two) for starting point, bifurcated terminating point one for () bifurcated lesions
Bifurcated lesions also need to supplement calcified plaque information, and the position of calcified plaque will have influence on stenter to implant plan below
Slightly, it is related to whether side shoot needs protection problem.
Further according to the FFR values crossed after pathology, FFR is removed>0.8 pathology, illustrates that these pathologies will not bring ischemic, is not required to
Stenter to implant to be carried out.Remaining pathology needs to carry out virtual bracket implantation and assessment.
S4, the pathology, support Specifications Database and default virtual bracket implantation strategy according to identification, generates virtual bracket
Implantation scheme, after carrying out virtual bracket implantation, generates new blood vessel 3-D geometric model.
The data that support Specifications Database is preserved include the support specifications and models of each manufacturer, the complete expanded diameter of support, length
Degree.For each pathology, virtual bracket implantation strategy can be performed, the pathology on single hop blood vessel is fairly simple, bifurcated lesions
Strategy be referred to the Guide Book in industry, the support strategy for bifurcated lesions that such as Chen Ji woodss in the country arrange enters
Row single-side stand or double bracket implantation.In addition, referring to Fig. 4, the bifurcated lesions if necessary to process contain calcified plaque 1, and calcium
Change patch 1 in main proximal segment 2, and near 3 side of side shoot, calcified plaque 1 is less than or equal to 10mm apart from a with side shoot 3, then
Side shoot 3 is also required to carry out support protection, i.e. side shoot 3 be also required to carry out stenter to implant, in case a main implantation support, crushes patch,
Broken patch blocks downwards side shoot 3 with blood flow.When carrying out support matching, first pass through diameter and select model, after support opens completely
Average diameter of the diameter not less than the normal blood vessels of lesion fitting, and no more than normal blood vessels of lesion fitting is average straight
Footpath and the product of predetermined threshold value, such as predetermined threshold value are 1.1, then the stent diameter for matching should be less than 1.1 and be multiplied by lesion fitting
Normal blood vessels average diameter product.Then number of holders is selected by the length of pathology.One pathology may have multiple
Virtual bracket is implanted into scheme.
After virtual bracket implantation scheme confirms well, virtual bracket implantation is carried out.Using computer system simulation stenter to implant
Afterwards, the vascular space form after support is fully opened, carries out grid filling on former three-dimensional grid, and referring to Fig. 5, dark parts are
Former blood vessel 4, light-colored part are the fillings 5 after virtual bracket implantation.
After virtual bracket implantation, new blood flow 3-D geometric model is generated.
S5, under new blood vessel 3-D geometric model, re-starts fluid calculation, obtains new FFR numerical value, by default
Selection standard, selection standard can be, minimum number of holders and FFR ＞ 0.8 after being implanted into.Such as scheme one, needs two stands,
After stenter to implant, FFR values are 0.95, and scheme two needs a support, and after stenter to implant, FFR values are 0.9, minimum by number of holders
Principle, scheme two are optimal case.Output optimal case supplies reference for clinicians.
What the support strategy for bifurcated lesions that domestic Chen Ji woodss arrange was edited referring to Chen Jilin<<Coronary artery bifurcated
The PCI of pathology>>One book, is published in 08 month 2008 by " People's Health Publisher ".
Claims (10)
1. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis, it is characterised in that methods described includes：
The coronary artery CTA view data of patient is read in, calcified plaque is recognized, coronary artery blood vessel 3-dimensional image model is set up, calcification is removed
Patch simultaneously records calcified plaque position；
Receive the physiological parameter, the boundary condition of CFD is set, carry out CFD calculating, obtain coronary artery blood vessel stablizing everywhere
Blood flowing speed and pressure, by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain coronary artery
Blood vessel FFR everywhere；
According to three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel FFR values everywhere, in the coronary artery blood vessel 3-D view
Pathology identification is carried out on model；
Pathology, support Specifications Database and default virtual bracket implantation strategy according to identification, generates virtual bracket implantation side
Case, after carrying out virtual bracket implantation, generates new blood vessel 3-D geometric model；
Under the new blood vessel 3-D geometric model, CFD calculating is re-started, new FFR numerical value is obtained, by default virtual
Stenter to implant Scheme Choice standard, exports optimum virtual stenter to implant scheme.
2. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 1, it is characterised in that
Pathology knowledge method for distinguishing is carried out in the coronary artery blood vessel 3-dimensional image model is：
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessels diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal blood vessels area；
All points for meeting Severity of Coronary Artery Stenosis ＞ 50% are found out, these points different narrow sections is combined into, for single hop blood
Pipe, according to default distance threshold, merges adjacent narrow section；To crotch, according to stenosis and position, by Medina
Classification is divided into seven types；
Pathology on coronary artery vascular tree is one of following two：
Pathology (original position, final position) on (a) single hop blood vessel；
B (bifurcated terminating point is two) for starting point, bifurcated terminating point one for () bifurcated lesions；
Further according to the FFR after pathology, the pathology of FFR ＞ 0.8 is removed, remaining pathology then needs to carry out stenter to implant.
3. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 2, it is characterised in that
The stenosis blood vessel diameter DXObtained by area of section S conversions：
DX=4*S/L
In formula, S is area of section, and L is girth；
Normal blood vessels diameter is obtained by being fitted the diametral curve of whole blood vessel.
4. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 3, it is characterised in that：
The data that the support Specifications Database is preserved include the support specifications and models of each manufacturer, the complete expanded diameter of support, length
Degree；The stenter to implant strategy is：
The support strategy for bifurcated lesions that the bifurcated lesions are arranged using Chen Ji woodss；
Pathology if necessary to process contains calcified plaque, and calcified plaque is in main proximal segment, and in close side shoot side,
The distance between calcified plaque and side shoot are less than or equal to 10mm, then side shoot be also required to carry out support protection, i.e. side shoot be also required to into
Row stenter to implant, in case main implantation support, crushes patch, broken patch blocks downwards side shoot with blood flow；
The complete opening dimension of support not less than lesion fitting normal blood vessels average diameter, and no more than lesion fitting
The average diameter of normal blood vessels and the product of predetermined threshold value.
5. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 4, it is characterised in that：
The default virtual bracket implantation Scheme Choice standard is FFR ＞ 0.8 and to be implanted into number of holders minimum after virtual bracket implantation.
6. the coronary artery virtual bracket implant system based on Hemodynamic analysis, it is characterised in that the system includes at least one
Computer system, at least one computer system are configured to：
The coronary artery CTA view data of patient is read in, calcified plaque is recognized, coronary artery blood vessel 3-dimensional image model is set up, calcification is removed
Patch simultaneously records calcified plaque position；
Receive the physiological parameter, the boundary condition of CFD is set, carry out CFD calculating, obtain coronary artery blood vessel stablizing everywhere
Speed and pressure, by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain coronary artery blood vessel everywhere
FFR (Fractional Flow Reserve, blood flow reserve fraction)；
According to three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel FFR values everywhere, in the coronary artery blood vessel 3-D view
Pathology identification is carried out on model；
Pathology, support Specifications Database and default virtual bracket implantation strategy according to identification, generates virtual bracket implantation side
Case, carries out virtual bracket implantation, generates new blood vessel 3-D geometric model；
Under the new blood vessel 3-D geometric model, CFD calculating is re-started, new FFR numerical value is obtained, by default virtual
Stenter to implant Scheme Choice standard, exports optimum virtual stenter to implant scheme.
7. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 6, it is characterised in that
Pathology knowledge method for distinguishing is carried out in the coronary artery blood vessel 3-dimensional image model is：
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessels diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal blood vessels area；
All points for meeting Severity of Coronary Artery Stenosis ＞ 50% are found out, these points different narrow sections is combined into, for single hop blood
Pipe, according to default distance threshold, merges adjacent narrow section；To crotch, according to stenosis and position, by Medina
Classification is divided into seven types；
It is one of following two all of pathology on coronary artery vascular tree：
Pathology (original position, final position) on (a) single hop blood vessel；
B (bifurcated terminating point is two) for starting point, bifurcated terminating point one for () bifurcated lesions；
Further according to the FFR after pathology, the pathology of FFR ＞ 0.8 is removed, remaining pathology then needs to carry out stenter to implant.
8. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 7, it is characterised in that
The stenosis blood vessel diameter DXObtained by area of section S conversions：
DX=4*S/L
In formula, S is area of section, and L is girth；
Normal blood vessels diameter is obtained by being fitted the diametral curve of whole blood vessel.
9. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 8, it is characterised in that：
The data that the support Specifications Database is preserved include the support specifications and models of each manufacturer, the complete expanded diameter of support, length
Degree；The stenter to implant strategy is：
The support strategy for bifurcated lesions that the bifurcated lesions are arranged using Chen Ji woodss；
Pathology if necessary to process contains calcified plaque, and calcified plaque is in main proximal segment, and in close side shoot side,
The distance between calcified plaque and side shoot are less than or equal to 10mm, then side shoot be also required to carry out support protection, i.e. side shoot be also required to into
Row stenter to implant, in case main implantation support, crushes patch, broken patch blocks downwards side shoot with blood flow；
The complete opening dimension of support not less than lesion fitting normal blood vessels average diameter, and no more than lesion fitting
The average diameter of normal blood vessels and the product of predetermined threshold value.
10. the coronary artery virtual bracket method for implantation based on Hemodynamic analysis according to claim 9, its feature exist
In：The default virtual bracket implantation Scheme Choice standard is FFR ＞ 0.8 and to be implanted into number of holders most after virtual bracket implantation
It is few.
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