CN106539622B - Coronary artery virtual bracket implant system based on Hemodynamic analysis - Google Patents
Coronary artery virtual bracket implant system based on Hemodynamic analysis Download PDFInfo
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Abstract
The present invention is based on the coronary artery virtual bracket implant systems of Hemodynamic analysis, the system comprises at least one computer systems, at least one described computer system is configured to: reading in the coronary artery CTA image data of patient, identify calcified plaque, coronary artery blood vessel 3-dimensional image model is established, calcified plaque is removed and records calcified plaque position；Receive the physiological parameter, the boundary condition of CFD is set, carry out CFD calculating, obtain the stable speed and pressure of coronary artery blood vessel everywhere, pass through the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere, obtain the FFR (Fractional Flow Reserve, blood flow reserve score) of coronary artery blood vessel everywhere.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 for relying on artificial judgment.
Description
Technical field
The present invention relates to a kind of coronary artery virtual bracket implant system based on Hemodynamic analysis.
Background technique
Drug therapy, operative treatment and the minimally invasive Surgery method of conduit are to treat coronary heart disease most common three now
Kind means.Wherein minimally invasive intervention operative treatment is by percutaneous puncture or to pass through human body using certain special conduit and instrument
Some original channel, insertion human body reach diseased region in turn, a kind of specific process of diagnosing and treating are carried out to coronary heart disease.
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 procedure, it is used to implantation human body coronary artery blood vessel
It is interior, play that prop up and withstand the pipe net metal of blood vessel or the support of other materials be exactly coronary stent.Usually will
Bracket is mounted in balloon catheter device, under the monitoring of x-ray imaging video recording, is transported to by balloon catheter device narrow
Narrow lesion；Then, it by the inflated distending of foley's tube end, then struts bracket and the lumen of vessels of stenosis is forced to be opened
It puts, enables blood normal through blood vessel；Balloon-system is finally withdrawn from, intravascular stent is then permanently fixed diseased region, reaches
To purpose support narrow blood vessel, keep blood flow unobstructed.
In PTCA endovascular stent implantation surgery, the selection of stent size and implantation mode and the accurate positionin pair of bracket
It is whether successful very crucial in operation.Current clinically used diagnostic method is according to X-ray coronary angiography (coronary
Angiography, CAG) or CT coronarography (CT angiography, CTA) image, utilize some two-dimension analysis skills
Art estimates the lesion degree of blood vessel and the model of required bracket.But spatial information provided by CAG or CTA image is non-
It is often limited, it cannot really reflect the actual conditions of blood vessel and its lesion.Moreover, measurement result is all influenced by subjective factor,
Difficulty certainly will be brought for the accurate model for estimating bracket used.
According to above insufficient and clinical application the actual demand, 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 station, pass through automatic and automanual image
Partition tools are established the vascular pattern of given patient in conjunction with grid Core Generator, and are automatically extracted in 3-dimensional image model
Lumen of vessels center line.Then, it is placed in virtual bracket along lumen center line, and interactively adjusts the length of bracket and straight
Diameter, for carrying out surgical planning, such as the merging of simulation bracket, simulation blood flow process etc..This method can be to row stent endoprosthesis
Lumen of vessels narrow positions intuitively exhibition stand place effect, bracket can be replaced repeatedly until model is suitable.But it is insufficient
It is that cannot carry out hemadostewnosis degree calculating automatically, is unable to automatic identification lesion and generates bracket strategy, excessively relies on doctor's
Experience can not predict influence of the stenter to implant to blood flow reserve score, and being unable to objective evaluation operation improves feelings to patient's state of an illness
Condition.
Wherein, blood flow reserve score (Fractional Flow Reserve, FFR) is clinically to determine myocardial ischemia
" goldstandard " is a kind of technology of important diagnosis coronary artery physiological function.FFR passes through measurement coronary artery under maximum congestive state,
The ratio between narrow remote end and pressure of proximal end react the narrow limitation to maximum blood flow, to judge narrow whether induce ischemic.
To there are a large amount of clinical tests to provide evidence-based medicine EBM foundation at present, FFR is prompted to can be used for assessing stenotic lesion function meaning
Justice has important directive significance especially for the selection of critical stenosis lesions treatment scheme.But the measurement of FFR be it is invasive,
Researchers start with limited element analysis technique and have carried out mechanical analysis and research to merging stented vessel, bracket is quantitatively evaluated
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) analysis.CFD is to solve fluid mechanics equation based on computer program
Method, CFD calculate the mechanics parameter of the shape and fluid itself that need to know flow region.It can be incited somebody to action by CT and MRI technique
The 3D shape of blood vessel is rebuild, and the separation of blood vessel and surrounding tissue is carried out according to the gray scale of CT and MRI image, is then further continued for drawing
Subnetting lattice, grid are composed of tetrahedron or hexahedron, and are calculated.Entire CFD calculating is built upon solution partial differential
It, can be by adjusting spatial resolution, temporal resolution to reach the computational accuracy met the requirements on the basis of equation.
Summary of the invention
The purpose of the present invention is 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 wind
The coronary artery virtual bracket implant system based on Hemodynamic analysis of danger.
The present invention is based on the coronary artery virtual bracket method for implantation of Hemodynamic analysis, which comprises
The coronary artery CTA image data of patient is read in, calcified plaque is identified, establishes coronary artery blood vessel 3-dimensional image model, is removed
Calcified plaque simultaneously records calcified plaque position；
It the physiological parameter is received, the boundary condition of CFD is set, carries out CFD calculating, obtain coronary artery blood vessel everywhere
Stable blood flowing speed and pressure is obtained by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere
The FFR of coronary artery blood vessel everywhere；
It is three-dimensional in the coronary artery blood vessel according to the FFR value of three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel everywhere
Lesion identification is carried out on iconic model；
It is implanted into strategy according to the lesion of identification, bracket Specifications Database and preset virtual bracket, virtual bracket is generated and plants
Enter scheme, 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 preset
Virtual bracket is implanted into Scheme Choice standard, exports optimum virtual stenter to implant scheme.
A kind of embodiment according to the present invention carries out lesion in the blood vessel 3-dimensional image model and knows method for distinguishing
Are as follows:
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessel diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal vessel area；
All points for meeting Severity of Coronary Artery Stenosis > 50% are found out, these points are combined into different narrow sections, for list
Section blood vessel merges adjacent narrow section according to preset distance threshold；Crotch is pressed according to stenosis and position
Medina classification is divided into seven seed types；
Lesion on coronary artery vascular tree is one of following two:
(a) lesion on single hop blood vessel (initial position, final position)；
(b) bifurcated lesions (starting point, bifurcated terminating point one, bifurcated terminating point two)；
Further according to the FFR after lesion, the lesion of FFR > 0.8 is removed, remaining lesion then needs to carry out stenter to implant.
A kind of embodiment according to the present invention, the stenosis diameter convert to obtain by area of section: stenosis is straight
Diameter=4* area of section/perimeter, normal blood vessels diameter are obtained by the diametral curve of whole blood vessel of fitting.
A kind of embodiment according to the present invention, the data that the bracket Specifications Database saves include the bracket of each manufacturer
The complete expanded diameter of specifications and models, bracket, length；The stenter to implant strategy are as follows:
The bracket strategy for bifurcated lesions that the bifurcated lesions use Chen Ji woods to arrange；
Lesion if necessary to processing contains calcified plaque, and calcified plaque is in main branch proximal segment, and close to side shoot
Side, the distance between calcified plaque and side shoot are less than or equal to 10mm, then side shoot is also required to carry out bracket protection, i.e. side shoot also needs
Stenter to implant is carried out, bracket is implanted into prevent main branch, crushes patch, broken patch blocks downwards side shoot with blood flow；
The complete opening dimension of bracket is not less than the average diameter of the normal blood vessels of lesion fitting, and quasi- no more than lesion
The average diameter of the normal blood vessels of conjunction and the product of preset threshold.
A kind of embodiment according to the present invention, the preset virtual bracket implantation Scheme Choice standard is virtual bracket
After implantation FFR > 0.8 and implantation number of holders it is minimum.
The present invention is based on the coronary artery virtual bracket implant systems of Hemodynamic analysis, and the system comprises at least one meters
Calculation machine system, at least one described computer system are configured to:
The coronary artery CTA image data of patient is read in, calcified plaque is identified, establishes coronary artery blood vessel 3-dimensional image model, is removed
Calcified plaque simultaneously records calcified plaque position；
It the physiological parameter is received, the boundary condition of CFD is set, carries out CFD calculating, obtain coronary artery blood vessel everywhere
Stable speed and pressure obtains coronary artery blood vessel by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere
FFR everywhere；
It is three-dimensional in the coronary artery blood vessel according to the FFR value of three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel everywhere
Lesion identification is carried out on iconic model；
It is implanted into strategy according to the lesion of identification, bracket Specifications Database and preset virtual bracket, virtual bracket is generated and plants
Enter scheme, carries 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 preset
Virtual bracket is implanted into Scheme Choice standard, exports optimum virtual stenter to implant scheme.
A kind of embodiment according to the present invention carries out the side of lesion identification in the coronary artery blood vessel 3-dimensional image model
Method are as follows:
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessel diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal vessel area；
All points for meeting Severity of Coronary Artery Stenosis > 50% are found out, these points are combined into different narrow sections, for list
Section blood vessel merges adjacent narrow section according to preset distance threshold；Crotch is pressed according to stenosis and position
Medina classification is divided into seven seed types；
It is one of following two lesion all on coronary artery vascular tree:
(a) lesion on single hop blood vessel (initial position, final position)；
(b) bifurcated lesions (starting point, bifurcated terminating point one, bifurcated terminating point two)；
Further according to the FFR after lesion, the lesion of FFR > 0.8 is removed, remaining lesion then needs to carry out stenter to implant.
A kind of embodiment according to the present invention, the stenosis blood vessel diameter DXIt converts to obtain by area of section S:
DX=4*S/L
S is area of section in formula, and L is perimeter；
Normal blood vessels diameter is obtained by the diametral curve of whole blood vessel of fitting.
A kind of embodiment according to the present invention, the data that the bracket Specifications Database saves include the bracket of each manufacturer
The complete expanded diameter of specifications and models, bracket, length；The stenter to implant strategy are as follows:
The bracket strategy for bifurcated lesions that the bifurcated lesions use Chen Ji woods to arrange；
Lesion if necessary to processing contains calcified plaque, and calcified plaque is in main branch proximal segment, and close to side shoot
Side, the distance between calcified plaque and side shoot are less than or equal to 10mm, then side shoot is also required to carry out bracket protection, i.e. side shoot also needs
Stenter to implant is carried out, bracket is implanted into prevent main branch, crushes patch, broken patch blocks downwards side shoot with blood flow；
The complete opening dimension of bracket is not less than the average diameter of the normal blood vessels of lesion fitting, and quasi- no more than lesion
The average diameter of the normal blood vessels of conjunction and the product of preset threshold.
A kind of embodiment according to the present invention, the preset virtual bracket implantation Scheme Choice standard is virtual bracket
After implantation FFR > 0.8 and implantation number of holders it is minimum.
The present invention is based on the coronary artery virtual bracket implant system of Hemodynamic analysis, its advantages are as follows:
(1) present invention can carry out stenosis calculating automatically, and can avoid brought by manual measurement in the prior art
The problem of experience deviation, low efficiency, treatment effeciency is very high.There is the image post processing software of many CT equipment manufacturers can at present
To assist doctor to carry out manual measurement, the experienced deviation of manual measurement, in addition inefficiency to Severity of Coronary Artery Stenosis.
(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 reduce provisional decision bring risk in art to improve doctor's efficiency of decision-making.
(3) present invention can be implanted into scheme works to coronary artery virtual bracket and carry out quantitative evaluation, and can recommend optimal branch automatically
Frame scheme reduces the risk of policy making that doctor leans on experience.By quantifying coronary blood pipe stenosis, lesion locations and range it is accurate
Present and stenter to implant after Hemodynamic evaluation, quantify bracket implant surgery to a certain extent to the improvement of the state of an illness,
Accurate operation plan planning is realized, the risk for relying on artificial judgment is reduced.
Coronary artery virtual bracket method for implantation and system to of the invention based on Hemodynamic analysis with reference to the accompanying drawing
It is described in further detail.
Detailed description of the invention
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 diagram about bifurcated lesions；
Fig. 4 is the lesion schematic diagram containing calcified plaque；
Fig. 5 be an embodiment of the present invention in virtual bracket implantation after on former three-dimensional grid carry out the filled effect of grid
Fruit figure.
Specific embodiment
Referring to Fig. 1, the present invention is based on the coronary artery virtual bracket method for implantation of Hemodynamic analysis, method includes:
S1. the DICOM image file for reading in the CT scan of patient is automatically positioned by human assistance or computer software
Seed point is selected in method such as machine learning, and the 3-dimensional image model of coronary artery blood vessel, a tool are generated by image growth algorithm
The method that body generates can be found in patent application: application No. is 2015103631541, a kind of entitled coronary artery three-dimensional image segmentation
Method.
In image growth, Patches information is obtained, from trouble by the way that threshold value is arranged according to the higher feature of calcified plaque brightness
The calcified plaque location information that removal is removed and 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 by 3-D image processing software, smooth and gridding is carried out to coronary blood flow threedimensional model and is handled, 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, obtains the stable blood of coronary artery blood vessel everywhere
Liquid flowing velocity and pressure obtain coronary artery blood vessel by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere
FFR everywhere.
Boundary condition is used to describe the flow characteristic in the boundary of 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 by heart can be due to patient's physiological condition
It is different.Because the blood flow reserve score FFR of patient is measured under congested physiological condition, pharmacological modality, example can also be passed through
It is such as induced with adenosine, so the boundary condition of fluid calculation should also be the boundary condition under the conditions of hyperemia.And it can get
Physiological parameter such as heart rate, blood pressure etc., substantially under patient's quiescent condition, it is raw that this just needs to define a patient
Parameter model is managed, to simulate physiological parameter from tranquillization to the variation of congested situation.
Physiological parameter model can be obtained by existing medical knowledge or medical statistics.Existing medical knowledge, than
Such as the relationship of total blood flow and myocardial mass.Medical statistics can be by enough clinical samples amounts, and acquire their physiology
Parameter establishes the relationship between physiological parameter by regression analysis, thus from known parameters, such as age, heart rate, weight, blood pressure
Deng derivation unknown parameter such as coronary artery inlet pressure.
After setting boundary condition, hydrodynamics method method, such as Na Wei-Stokes (Navier- are called
Stokes) equation, i.e. N-S equation carry out fluid calculation, obtain the blood flow velocity and pressure of each grid on blood vessel.
Shown in N-S equation such as formula (1) and formula (2).
Formula (1) is the N-S equation of incompressible Newtonian fluid, and formula (2) is momentum conservation equation.Wherein,It is La Pu
Laplacian operater, ρ are fluid densities, 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 speed and pressure of blood flow obtain numerical solution by the method for variation and finite element.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 equation and obtains speed and pressure, considers the interaction between tetrahedron, obtains blood vessel everywhere by iterative calculation
Stable blood flowing speed and pressure.
It is defined by FFR, FFR=Pd/Pa, Pd: narrow remote end coronary artery mean pressure under maximum congestive state, Pa: maximum
AoMP under congestive state.By the ratio of blood stream pressure at grid and AoMP power, the blood flow of grid is obtained
Lay in score FFR.
S3, according to the FFR value of three-dimensional vascular morphology, Patch properties, coronary artery blood vessel everywhere, in coronary artery blood vessel 3-D image mould
Lesion identification classification is carried out in type.
The assessment of Severity of Coronary Artery Stenosis is to carry out the necessary condition of stent procedure.Severity of Coronary Artery Stenosis can using diameter or
Area is defined, i.e. calculating Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessel diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal vessel area；
On the basis of obtaining coronary artery three-dimensional blood vessel model, center line is obtained by calculating, carries out coronary artery face along center line
Long-pending and diameter calculation.Because coronary artery blood vessel is not necessarily regular cylindrical, diameter can be converted to obtain by area, by equivalent diameter
Calculation method, such as diameter=4* area of section/perimeter.In order to obtain on blood vessel a bit specific stenosis on center line,
Needing to obtain normal blood vessels caliber, i.e., caliber when blood vessel is not narrow can be obtained by the diametral curve of whole blood vessel of fitting,
Referring to fig. 2.Normal blood vessels approximating method can be the abnormal point first removed on blood vessel, because patch causes the blood vessel of three-dimensional reconstruction
It is narrow or wide, for example remove the point of 2 times of average diameter or 1/2, it then carries out linear fit and obtains the caliber of normal blood vessels.
Every stenosis can use 1- blood vessel diameter/fitting normal blood vessels diameter, in Fig. 2,1-d2/ on blood vessel
d1.It is found out by the point all stenosis greater than 50% and is combined into different small narrow sections.And according to it is preset away from
From threshold value, such as 2mm, the small 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 more current in the world
Seven seed types, referring to Fig. 3, i.e. the multiterminal lesion of crotch can be merged into a big lesion by Medina classification.
In this way, lesion all on coronary artery vascular tree will be one of following two:
(a) lesion on single hop blood vessel (initial position, final position)
(b) bifurcated lesions (starting point, bifurcated terminating point one, bifurcated terminating point two)
Bifurcated lesions also require supplementation with calcified plaque information, and the position of calcified plaque will affect subsequent stenter to implant plan
Slightly, it is related to whether side shoot needs protection problem.
Further according to the FFR value after lesion excessively, the lesion of FFR > 0.8 is removed, illustrates that these lesions will not bring ischemic, is not required to
Carry out stenter to implant.Remaining lesion needs to carry out virtual bracket implantation and assessment.
S4 is implanted into strategy according to the lesion of identification, bracket Specifications Database and preset virtual bracket, generates virtual bracket
Implantation scheme generates new blood vessel 3-D geometric model after carrying out virtual bracket implantation.
The data that bracket Specifications Database saves include the bracket specifications and models of each manufacturer, the complete expanded diameter of bracket, length
Degree.For each lesion, virtual bracket implantation strategy can be executed, the lesion on single hop blood vessel is fairly simple, bifurcated lesions
Strategy be referred to the Guide Book in industry, such as the bracket strategy for bifurcated lesions that country Chen Ji woods arranges, into
Row single-side stand or double bracket implantation.In addition, referring to fig. 4, the bifurcated lesions if necessary to processing contain calcified plaque 1, and calcium
Change patch 1 in main branch proximal segment 2, and close to 3 side of side shoot, calcified plaque 1 and 3 distance a of side shoot is less than or equal to 10mm, then
Side shoot 3 is also required to carry out bracket protection, i.e. side shoot 3 is also required to carry out stenter to implant, is implanted into bracket to prevent main branch, crushes patch,
Broken patch blocks downwards side shoot 3 with blood flow.When carrying out bracket matching, diameter selection model is first passed through, after bracket opens completely
Diameter not less than the normal blood vessels of lesion fitting average diameter, and it is average straight no more than the normal blood vessels of lesion fitting
The product of diameter and preset threshold, such as preset threshold are 1.1, then matched stent diameter should be less than 1.1 and be fitted multiplied by lesion
Normal blood vessels average diameter product.Then number of holders is selected by the length of lesion.One lesion 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 bracket fully opens 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 re-starts fluid calculation under new blood vessel 3-D geometric model, new FFR numerical value is obtained, by preset
Selection criteria, selection criteria can be, FFR > 0.8 after least number of holders and implantation.Such as scheme one, two stands are needed,
FFR value is 0.95 after stenter to implant, and scheme two needs a bracket, and FFR value is 0.9 after stenter to implant, minimum by number of holders
Principle, scheme two are optimal case.Optimal case is exported for reference for clinicians.
The bracket strategy for bifurcated lesions that domestic Chen Ji woods arranges edited referring to Chen Jilin < < coronary artery bifurcated
The interventional therapy of a lesion > > book was published by " People's Health Publisher " in 08 month 2008.
Claims (5)
1. the coronary artery virtual bracket implant system based on Hemodynamic analysis, it is characterised in that the system comprises at least one
Computer system, at least one described computer system are configured to:
The coronary artery CTA image data of patient is read in, identifies calcified plaque, establishes coronary artery blood vessel 3-dimensional image model, removes calcification
Patch simultaneously records calcified plaque position；
The physiological parameter is received, the boundary condition of CFD is set, carries out CFD calculating, obtains the stabilization of coronary artery blood vessel everywhere
Speed and pressure coronary artery blood vessel is obtained everywhere by the ratio of coronary artery blood vessel blood stream pressure and AoMP power everywhere
FFR (Fractional Flow Reserve, blood flow reserve score)；
According to the FFR value of three-dimensional vascular morphology, calcified plaque feature, coronary artery blood vessel everywhere, in the coronary artery blood vessel 3-D image
Lesion identification is carried out on model；
It is implanted into strategy according to the lesion of identification, bracket Specifications Database and preset virtual bracket, 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 preset virtual
Stenter to implant Scheme Choice standard exports optimum virtual stenter to implant scheme.
2. the coronary artery virtual bracket implant system according to claim 1 based on Hemodynamic analysis, it is characterised in that
Lesion is carried out in the coronary artery blood vessel 3-dimensional image model knows method for distinguishing are as follows:
Calculate Severity of Coronary Artery Stenosis G
G=1-DX/DZ,
D in formulaXFor stenosis blood vessel diameter, DZFor normal blood vessel diameter；
Or G=1-SX/SZ
S in formulaXFor stenosis vessel area, SZFor normal vessel area；
All points for meeting Severity of Coronary Artery Stenosis > 50% are found out, these points are combined into different narrow sections, for single hop blood
Pipe merges adjacent narrow section according to preset distance threshold；To crotch, according to stenosis and position, by Medina
Classification is divided into seven seed types；
It is one of following two lesion all on coronary artery vascular tree:
(a) lesion on single hop blood vessel；
(b) bifurcated lesions；
Further according to the FFR after lesion, the lesion of FFR > 0.8 is removed, remaining lesion then needs to carry out stenter to implant.
3. the coronary artery virtual bracket implant system according to claim 2 based on Hemodynamic analysis, it is characterised in that
The stenosis blood vessel diameter DXIt converts to obtain by area of section S:
DX=4*S/L
S is area of section in formula, and L is perimeter；
Normal blood vessels diameter is obtained by the diametral curve of whole blood vessel of fitting.
4. the coronary artery virtual bracket implant system according to claim 3 based on Hemodynamic analysis, it is characterised in that:
The data that the bracket Specifications Database saves include the bracket specifications and models of each manufacturer, the complete expanded diameter of bracket, length
Degree；The stenter to implant strategy are as follows:
The bracket strategy for bifurcated lesions that the bifurcated lesions use Chen Ji woods to arrange；
Lesion if necessary to processing contains calcified plaque, and calcified plaque is in main branch proximal segment, and close to side shoot side,
The distance between calcified plaque and side shoot be less than or equal to 10mm, then side shoot be also required to carry out bracket protection, i.e., side shoot be also required into
Row stenter to implant is implanted into bracket to prevent main branch, crushes patch, and broken patch blocks downwards side shoot with blood flow；
The complete opening dimension of bracket is not less than the average diameter of the normal blood vessels of lesion fitting, and no more than lesion fitting
The average diameter of normal blood vessels and the product of preset threshold.
5. the coronary artery virtual bracket implant system according to claim 4 based on Hemodynamic analysis, it is characterised in that:
The preset virtual bracket implantation Scheme Choice standard is FFR > 0.8 and implantation number of holders is minimum after virtual bracket implantation.
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| US11523744B2 (en) * | 2017-03-31 | 2022-12-13 | Koninklijke Philips N.V. | Interaction monitoring of non-invasive imaging based FFR |
| US11589924B2 (en) * | 2017-08-01 | 2023-02-28 | Siemens Healthcare Gmbh | Non-invasive assessment and therapy guidance for coronary artery disease in diffuse and tandem lesions |
| CN108334732B (en) * | 2017-08-31 | 2022-06-07 | 上海联影医疗科技股份有限公司 | Blood vessel positioning method and device in medical image |
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