CN107411767A - A kind of non-invasive methods based on coronary artery CT angiographic assessment stenotic lesions resistances of blood flow - Google Patents
A kind of non-invasive methods based on coronary artery CT angiographic assessment stenotic lesions resistances of blood flow Download PDFInfo
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Abstract
The present invention is directed to coronary artery CT angiograms (cCTA) image, propose a kind of non-invasive methods that stenotic lesions resistance of blood flow is assessed based on cCTA, belong to the auxiliary diagnosis field based on medical image, relate generally to the haemodynamics simulating analysis based on cCTA.The present invention comprises the steps of：(1) three-dimensional reconstruction of coronary arteries is carried out based on cCTA images, extracts stenotic lesions 3D models；(2) 7 groups of boundary conditions under the conditions of the corresponding different total CBFs of structure；(3) the stenotic lesions 3D models obtained to step (1), apply the 7 groups of boundary conditions obtained by step 2, and utilize corresponding stable state blood distribution situation under each boundary condition of Fluid Mechanics Computation (CFD) method simulation calculation；(4) pressure drop blood flow curve is extracted from 7 simulation results, and extraction characterizes four parameters that curve is slow, steep from curve, to assess resistance of blood flow.The present invention combines cCTA and CFD technologies, and extraction characterizes the pressure drop blood flow curve and its characteristic parameter of stenotic lesions resistance of blood flow, feasible in principle.The present invention need not estimate that resistance of blood flow corresponding to patient's maximum congestive state is distributed, so being better than existing method, and the lifting to assessing accuracy be ensured from principle.
Description
Technical field
The present invention utilizes coronary artery CT angiograms (cCTA) image, establishes coronal based on pressure drop-blood flow curve assessment
The non-intrusion type new method of arteriarctia focus resistance of blood flow, it is main the invention belongs to the auxiliary diagnosis field based on medical image
It is related to the haemodynamics simulating analysis based on cCTA.
Background technology
Coronary atherosclerotic heart disease (coronary heart disease) is to endanger the serious disease of human health, percutaneous coronary
It is the effective means clinically treated to it to intervene (PCI), and only 2013 whole nations complete PCI and amount to 454505 altogether.Give
The premise for giving rational therapy is the accurate evaluation to coronary artery stenosis focus function assessment meaning, but regrettably, anatomically
Form it is narrow with haemodynamics meaning on false stricture and direct corresponding relation, simple coronary artery is not present
Radiography (coronary angiography, CAG) can not be assessed false stricture exactly, so as to cause
Optimal therapic opportunity is missed in unnecessary intervention to non-functional stenotic lesions to the stenotic lesions with function conspicuousness.
Therefore, state is turned into by the pay attention to day by day of domestic and international academia to the evaluation studies of coronary artery stenosis focus function assessment meaning
The focus and advanced subject of border academia research.
Existing " goldstandard " blood flow reserve fraction (FFR) is by measuring stenotic lesions remote pressure under myocardium congestive state
Coronary artery stenosis is assessed with aortic root pressure ratio, can truly reflect influence of the stenotic lesions to blood supply function.
But it is invasive detection means, need to be measured in the state of drug-induced coronary artery hyperemia, expensive and presence
Certain risk, these all significantly limit FFR clinical practice.With Fluid Mechanics Computation (computational
Fluid dynamics, CFD) development, CFD is combined by researchers with Medical Imaging, it is proposed that non-intrusion type is commented
Estimate method FFRCT.This method accurately reconstructs 3D models coronarius using cCTA images, by building personalized 0D-
3D coupling CFD simulation models, which calculate, obtains IC blood flow and pressure distribution under congestive state, and according to FFR definition
Calculate that stenotic lesions are remote, the pressure ratio of near-end, as FFRCT.Greatest problem present in this method is：It needs accurate
Acquisition maximum congestive state corresponding with patient under resistance of blood flow distribution, and at present this method use a series of physiological models
(empirical equation), indirectly estimate that the resistance of blood flow under maximum congestive state is distributed by cCTA images, so can not take into full account
The individuation difference of different patients, while its accuracy is also greatly limited to the estimation to resistance of blood flow distribution.
Based on above research background, the present invention combines cCTA and CFD, it is proposed that coronal based on pressure drop-blood flow curve assessment
The non-intrusion type new method of arteriarctia focus resistance of blood flow, to aid in the diagnosis to false stricture.The new appraisal procedure is not
Need to estimate the resistance of blood flow distribution under maximum congestive state from cCTA images, so independent of limitation FFRCTAccurately
A series of physiological models that degree and individuation otherness are assessed, lift the accuracy of assessment.
The content of the invention
To improve the accuracy that the non-intrusion type stenotic lesions resistance of blood flow based on cCTA and CFD is assessed, the present invention proposes
Appraisal procedure based on pressure drop-blood flow curve, the new appraisal procedure need not estimate maximum congested shape from cCTA images
Resistance of blood flow distribution under state, and directly narrow positions resistance of blood flow is assessed.The technical scheme taken is as follows：
1. carrying out three-dimensional reconstruction of coronary arteries based on cCTA images, stenotic lesions 3D models are extracted；
2. boundary condition is built：To the stenotic lesions 3D models of extraction, porch applies pressure boundary condition, each outlet
Place's coupling only includes the lumped parameter model of a resistance unit；7 groups of different exit blood flow Resistance Values are set respectively, to obtain
Boundary condition under the conditions of 7 groups of corresponding different total CBFs；
3. corresponding 7 kinds of set different exit blood flow Resistance Values, distinguish the conditional of simulation calculation 7 using CFD approach
Under stable state blood distribution situation；
4. pair 7 simulation results, corresponding stenotic lesions pressure drop and CBF are extracted respectively, so as to form pressure
Drop-blood flow curve；Extracted from the curve and characterize that curve is slow, steep parameter, evaluation function is narrow：Parameter value is bigger, characterizes
It is narrow more serious, conversely, characterizing narrow slighter.
Brief description of the drawings
Overall flow figures of Fig. 1 based on coronary artery CT angiographic assessment stenotic lesions resistance of blood flow methods.
Fig. 2 are based on cCTA images and carry out three-dimensional reconstruction, only retain stenotic lesions and its neighbouring branch vessel.
Fig. 3 boundary condition schematic diagrames.
Pressure drop-blood flow value (point-like number that 20 cases of Fig. 4 (being divided into three groups by stenosis difference) emulation obtains
According to) and by the curve (curve) obtained after formula (1) recurrence.
Embodiment
The present invention is described in further detail below in conjunction with the accompanying drawings, but the implementation of the present invention is not limited to this.
A kind of bulk flow of the non-invasive methods based on coronary artery CT angiographic assessment stenotic lesions resistances of blood flow
Journey figure is as shown in Figure 1.Embodiment is described in detail below with reference to Fig. 1.
1. three-dimensional reconstruction is carried out based on cCTA images
First, coronary artery 3D models are extracted using algorithm of region growing is automanual, is carried for algorithm vessel borders
Failure or unsatisfied part are taken, vessel borders can be extracted by the way of delineating by hand, and then reconstructs coronary artery 3D moulds
Type；Then, as shown in Fig. 2 only retaining stenotic lesions and its neighbouring branch vessel, remaining blood vessel away from focus point is weeded out
Branch, to reduce CFD simulation calculations region.
2. the structure of boundary condition
A. as shown in figure 3, entrance apply pressure boundary condition, pressure value be arranged to patient blood pressure (if can not obtain,
It is arranged to 88mmHg)；The coupling of each exit includes the lumped parameter model of a resistance unit；
B. total resistance of blood flow of initial setting up outlet branches blood vessel is 240 (mmHg s/cm3), and according to resistance of blood flow with
The rule that vessel radius cube is inversely proportional, total resistance of blood flow is allocated in each branch outlet；
C. total resistance of blood flow of outlet branches blood vessel is reduced to the 87.5% of initial value, 75.0%, 62.5% successively,
50.0%, 37.5% and 25.0%, above-mentioned b processes are repeated, obtain a series of boundary condition (each outlet branches blood vessel
Total corresponding one group of boundary condition of resistance of blood flow value).
3.CFD simulation calculations
The stenotic lesions 3D models obtained to step 1, apply the 7 groups of boundary conditions obtained by step 2；Emulated using CFD
Calculate stable state blood distribution situation corresponding to each boundary condition.Wherein, you can using OpenFOAM etc. increase income CFD platforms carry out
Simulation calculation, also commercial CFD software for calculation such as Fluent, CFX can be used to carry out simulation calculation.
4. parameter extraction and resistance of blood flow are assessed
A. to 7 simulation results, the pressure value of stenotic lesions front-end and back-end is extracted respectively and is flowed through narrow
The CBF of focus；The blood pressure difference of stenotic lesions front-end and back-end is the pressure drop under stenotic lesions respective conditions；So it can obtain
Take 7 groups of pressure drops-CBF value；
B. above-mentioned 7 groups of pressure drops-CBF value forms pressure drop-blood flow curve, it is carried out as follows non-linear
Regression analysis, ask for parameter f and s：
WhereinFor pressure drop,For CBF, f and s are to treat regression parameter；As shown in figure 4,20 cases (press narrow journey
Degree difference is divided into three groups) emulate pressure drop-blood flow value (point-like data) of acquisition and by the curve obtained after formula (1) recurrence
(curve).
C. to two parameters sought out, pressure drop-CBF area under a curve is calculated respectively as follows：
It is 1ml/s and 2ml/s to take q respectively, calculates two area value S1And S2；
D. according to f, s, S1And S2The value of four parameters, assess resistance of blood flow：Parameter value is bigger, characterizes resistance of blood flow and gets over
Greatly；Conversely, characterize narrow slighter.
The present invention is based on cCTA and CFD, extracts pressure drop-blood flow curve of stenotic lesions, the curve truly reflects narrow
The resistance of blood flow of narrow focus.Present invention foundation pressure drop-blood flow curve, extracts four parameters for characterizing that curve is slow, steep respectively, its
Explicit physical meaning --- characterize the resistance of blood flow size of stenotic lesions.Value of the present invention according to above-mentioned 4 each parameters, is realized
The assessment stenotic lesions resistance of blood flow by cCTA image synthesises of non-intrusion type.
Claims (5)
1. one kind assesses the non-invasive methods of stenotic lesions resistance of blood flow based on coronary artery CT angiograms (cCTA), including
Following steps：
(1) three-dimensional reconstruction of coronary arteries is carried out based on cCTA images, extracts stenotic lesions 3D models；
(2) 7 groups of boundary conditions under the conditions of the corresponding different total CBFs of structure：(a) total blood of initial setting up outlet branches blood vessel
Flow resistance power is 240 (mmHg s/cm3), and the rule being inversely proportional according to resistance of blood flow and vessel radius cube, total blood flow is hindered
Power is allocated in each branch outlet；(b) total resistance of blood flow of outlet branches blood vessel is reduced to the 87.5% of initial value successively,
75.0%, 62.5%, 50.0%, 37.5% and 25.0%, above-mentioned b processes are repeated, obtain a series of boundary condition；
(3) the stenotic lesions 3D models obtained to step (1), apply the 7 groups of boundary conditions obtained by step 2, and utilize calculating
Corresponding stable state blood distribution situation under each boundary condition of hydrodynamics (CFD) method simulation calculation；
(4) pressure drop-blood flow curve is extracted from 7 simulation results, nonlinear regression analysis is carried out as follows to it, asked
Take parameter f and s：
WhereinFor pressure drop,For CBF, f and s are to treat regression parameter；To two the parameters f and s sought out, by following public affairs
Formula calculates pressure drop-CBF area under a curve respectively：
It is 1ml/s and 2ml/s to take q respectively, calculates two area value S1And S2；
(5) according to f, s, S1And S2The value of four parameters, assess resistance of blood flow size；Parameter value is bigger, characterizes resistance of blood flow and gets over
Greatly；Conversely, it is smaller to characterize resistance of blood flow.
2. assessment algorithm as claimed in claim 1, it is characterised in that：Multigroup boundary condition is preset, different CBFs are obtained with emulation
Under the conditions of pressure drop corresponding to stenotic lesions, so as to obtain characterize stenotic lesions Hydrodynamic character pressure drop-blood flow curve.
3. assessment algorithm as claimed in claim 1, it is characterised in that：To pressure drop-blood flow curve, carried out non-linear time by formula (1)
Return analysis, seek out the parameter f and s for characterizing curve characteristic.
4. assessment algorithm as claimed in claim 1, it is characterised in that：To the parameter f and s sought out, asking for q by formula (2) is
Corresponding pressure drop-blood flow curve surrounds the area S in region with X-axis during 1ml/s and 2ml/s1And S2。
5. assessment algorithm as claimed in claim 1, it is characterised in that：According to f, s, S1And S2The value of four parameters, assess blood flow resistance
Power size：Parameter value is bigger, and it is bigger to characterize resistance of blood flow；Conversely, it is smaller to characterize resistance of blood flow.
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| CN109616200A (en) * | 2018-11-06 | 2019-04-12 | 北京三普威盛科技有限公司 | For the method for coronary stenosis assessment, device, storage medium and electronic equipment |
| CN109770930A (en) * | 2019-01-29 | 2019-05-21 | 浙江大学 | A kind of determination method and apparatus of coronary artery microcirculation resistance |
| CN110916640A (en) * | 2019-11-06 | 2020-03-27 | 广州新脉科技有限公司 | FFR-based coronary artery stenosis functional ischemia detection method and device |
| CN112535466A (en) * | 2020-12-16 | 2021-03-23 | 成都全景恒升科技有限公司 | Blood flow reserve fraction calculation method based on blood vessel image |
| CN113017667A (en) * | 2021-02-05 | 2021-06-25 | 上海市第六人民医院 | Method, device and equipment for quantifying vascular stenosis and readable storage medium |
| CN113693579A (en) * | 2021-07-23 | 2021-11-26 | 西北工业大学 | Normalized coronary artery microcirculation resistance index calculation method |
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| CN112535466A (en) * | 2020-12-16 | 2021-03-23 | 成都全景恒升科技有限公司 | Blood flow reserve fraction calculation method based on blood vessel image |
| CN113017667A (en) * | 2021-02-05 | 2021-06-25 | 上海市第六人民医院 | Method, device and equipment for quantifying vascular stenosis and readable storage medium |
| CN113693579A (en) * | 2021-07-23 | 2021-11-26 | 西北工业大学 | Normalized coronary artery microcirculation resistance index calculation method |
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