CN112220493A - Carotid arteriosclerosis assessment method - Google Patents

Carotid arteriosclerosis assessment method Download PDF

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Publication number
CN112220493A
CN112220493A CN202010827901.3A CN202010827901A CN112220493A CN 112220493 A CN112220493 A CN 112220493A CN 202010827901 A CN202010827901 A CN 202010827901A CN 112220493 A CN112220493 A CN 112220493A
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CN
China
Prior art keywords
blood flow
assessment
carotid
plaque
stenosis
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Pending
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CN202010827901.3A
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Chinese (zh)
Inventor
王文平
董怡
邱艺杰
毛枫
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Zhongshan Hospital Fudan University
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Zhongshan Hospital Fudan University
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Priority to CN202010827901.3A priority Critical patent/CN112220493A/en
Publication of CN112220493A publication Critical patent/CN112220493A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0891Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007Evaluating blood vessel condition, e.g. elasticity, compliance
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026Measuring blood flow
    • A61B5/0261Measuring blood flow using optical means, e.g. infra-red light
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/085Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5223Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data

Abstract

The technical scheme discloses an assessment method of carotid arteriosclerosis, which is used for obtaining an assessment image by applying a medical image color Doppler ultrasound and comprises the following steps: step S1, performing gray-scale ultrasonic scanning on the carotid artery; step S2, obtaining the plaque position and the stenosis degree according to the scanning result; step S3, performing vector blood imaging on the plaque location; step S4, generating a blood vessel wall stress evaluation threshold value related to the stenosis degree according to the dynamic vector blood flow image; step S5, evaluating the carotid cherry blossom condition of the patient according to the evaluation. According to the technical scheme, the gray-scale ultrasonic scanning and the vector blood flow imaging technology are combined, the hemodynamic change and the blood flow line change situation of the carotid artery stenosis can be visualized, and then the diagnosis threshold with high sensitivity, high specificity and high accuracy is accurately obtained based on big data analysis, so that the method has extremely strong applicability and clinical application value.

Description

Carotid arteriosclerosis assessment method
Technical Field
The invention relates to the technical field of medical image analysis, in particular to an assessment method for carotid arteriosclerosis.
Background
In the field of medical image acquisition and analysis technology, with the continuous progress of science and technology, for different requirements generated by the analysis of the disease conditions of different diseases, some traditional ultrasonic image acquisition technologies are no longer suitable due to serious limitations: for example, in the field of carotid arteriosclerosis assessment, the following limitations exist in the conventional color doppler ultrasound imaging technology:
1) blood flow velocity measurement and blood flow volume calculation are not accurate: traditional color doppler ultrasound imaging is highly dependent on doppler angle, while in some clinical applications the angle is not irresistible to a given criterion of less than 60 °; in addition, the blood flow measurement always assumes that the blood flow state is laminar, and complex blood flow at the position of the carotid artery cannot be well displayed;
2) hemodynamic information is too little: the frame frequency of color Doppler ultrasound imaging is only 10-20 frames/second, and only blood flow in the ultrasonic beam direction can be displayed, and the displayed blood flow is also only the average blood flow of contraction and relaxation, and can not reflect more details of hemodynamics.
Therefore, in view of the above-mentioned existing problems, it is highly desirable to provide an assessment method for carotid arteriosclerosis to meet the new clinical diagnosis requirement.
Disclosure of Invention
In view of the above problems in the prior art, a method for evaluating carotid arteriosclerosis is provided, and the specific technical solution is as follows:
an assessment method of carotid arteriosclerosis, which adopts a medical image color ultrasound to obtain an assessment image;
the evaluation method comprises the following steps:
step S1, performing gray-scale ultrasonic scanning on the carotid artery through medical image color ultrasound, and outputting a scanning result;
step S2, obtaining the plaque position corresponding to the carotid artery and the stenosis degree corresponding to the plaque position according to the scanning result;
step S3, vector blood flow imaging is carried out on each plaque position one by one through medical image color photography, and corresponding dynamic vector blood flow images are output;
step S4, generating a blood vessel wall stress evaluation threshold value related to the stenosis degree according to the dynamic vector blood flow image and the stenosis degree;
in step S5, the carotid arteriosclerosis of the patient is evaluated based on the vessel wall stress evaluation threshold.
Preferably, in the evaluating method, in step S1, the scanning result includes longitudinal scanning imaging and transverse scanning imaging of both common carotid artery, internal carotid artery and external carotid artery.
Preferably, the evaluation method, wherein when the medical image color photograph performs vector blood flow imaging on any plaque position, the image acquisition frame frequency interval is [400, 600] frames/second.
Preferably, the evaluation method, wherein when the medical image color photographs any plaque position to perform vector blood flow imaging, the minimum flow rate display threshold is 50 cm/sec.
Preferably, the evaluation method, wherein the dynamic vector blood flow image comprises a plurality of dynamically moving arrowhead-shaped blood flow indicative markers;
in each blood flow indication mark, the arrow direction represents the blood flow direction, the arrow length represents the blood flow velocity, the arrow color represents the blood flow volume, and the darker the arrow color, the larger the blood flow volume.
Preferably, the evaluation method wherein the arrow density is 10%.
Preferably, the assessment method wherein the arrow lifetime is 25 ms.
Preferably, in the evaluation method, in step S4, the quantitative values of the stress of the blood vessel wall are measured at the plaque position and at positions before and after the plaque position, respectively, located in the carotid artery systolic phase.
Preferably, the assessment method wherein the quantitative value of the vessel wall stress at the carotid stenosis is proportional to the stenosis intensity.
Preferably, the assessment method, wherein the vessel wall stress assessment threshold is 0.79pa when the stenosis degree is more than 30%.
This technical scheme has following advantage or beneficial effect:
according to the technical scheme, the gray-scale ultrasonic scanning and the vector blood flow imaging technology are combined, the hemodynamic change and the blood flow line change situation of the carotid artery stenosis can be visualized, and then the diagnosis threshold with high sensitivity, high specificity and high accuracy is accurately obtained based on big data analysis, so that the method has extremely strong applicability and clinical application value.
Drawings
FIG. 1 is a schematic flow chart of an assessment method of carotid arteriosclerosis according to the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It should be noted that the embodiments and features of the embodiments may be combined with each other without conflict.
The invention is further described with reference to the following drawings and specific examples, which are not intended to be limiting.
In view of the above problems in the prior art, a method for evaluating carotid arteriosclerosis is provided, and the specific technical solution is as follows:
an assessment method of carotid arteriosclerosis, which adopts a medical image color ultrasound to obtain an assessment image;
as shown in fig. 1, this evaluation method includes the steps of:
step S1, performing gray-scale ultrasonic scanning on the carotid artery through medical image color ultrasound, and outputting a scanning result;
step S2, obtaining the plaque position corresponding to the carotid artery and the stenosis degree corresponding to the plaque position according to the scanning result;
step S3, vector blood flow imaging is carried out on each plaque position one by one through medical image color photography, and corresponding dynamic vector blood flow images are output;
step S4, generating a blood vessel wall stress evaluation threshold value related to the stenosis degree according to the dynamic vector blood flow image and the stenosis degree;
in step S5, the carotid arteriosclerosis of the patient is evaluated based on the vessel wall stress evaluation threshold.
In a preferred embodiment, the evaluation method, wherein in step S1, the scanning results include longitudinal scanning imaging and transverse scanning imaging of the bilateral common carotid artery, internal carotid artery and external carotid artery.
In a preferred embodiment of the present invention, in step S1, the preliminary grayscale ultrasound scanning for the carotid artery includes longitudinal-plane scanning imaging and transverse-plane scanning imaging for the common carotid artery, the internal carotid artery and the external carotid artery on both sides, so as to obtain a grayscale ultrasound image of the neck in all directions, and further obtain each potential plaque position in all directions, thereby ensuring all aspects of the examination and diagnosis for the patient.
In another preferred embodiment of the present invention, in the diagnosis process of carotid artery sclerosis stenosis, besides applying vector blood flow imaging technology and conventional gray-scale ultrasound scanning, technical means such as doppler ultrasound can be assisted, so as to more comprehensively understand the carotid artery sclerosis stenosis degree and corresponding hemodynamic change conditions in the plaque position region, and help further analyze the disease development of the patient.
In a preferred embodiment, the evaluation method, when the medical image color photographs any plaque position to perform vector blood flow imaging, the image acquisition frame rate interval is [400, 600] frames/second.
In another preferred embodiment of the present invention, compared to the frame rate of 10-20 frames/second of the conventional color Doppler imaging, the high frame rate of 400-600 frames/second in the vector flow imaging technique provided by the present invention can satisfy the high-speed blood flow display at the carotid stenosis to extract more hemodynamic information.
In the preferred embodiment, in the dynamic display process, the 20-fold slow release can be realized to satisfy the detail capture of the high frame rate imaging image by human eyes.
In a preferred embodiment, the evaluation method wherein the minimum flow rate display threshold is 50 cm/sec when the medical image is used for color imaging of vector blood flow at any plaque position.
In another preferred embodiment of the present invention, in order to improve the sensitivity of blood flow display, the minimum flow rate display range needs to be as low as possible during the processing of vector blood flow imaging; in the above preferred embodiment, the recommended setting value may be 50 cm/s, and the user may also adaptively adjust the minimum flow rate display range according to the actual condition of the patient, which is not limited herein.
In a preferred embodiment, the evaluation method, wherein the dynamic vector blood flow image comprises a plurality of dynamically moving arrowhead-shaped blood flow markers;
in each blood flow indication mark, the arrow direction represents the blood flow direction, the arrow length represents the blood flow velocity, the arrow color represents the blood flow volume, and the darker the arrow color, the larger the blood flow volume.
As a preferred embodiment, the evaluation method, wherein the arrow density is 10%.
As a preferred embodiment, the evaluation method wherein the arrow lifetime is 25 ms.
In another preferred embodiment of the present invention, the vector flow imaging technique is adopted, which can collect abundant hemodynamic information: by presenting vectorized arrows, the flow velocity, magnitude and direction of blood flow at various points in the real-time blood flow can be accurately depicted in real time. Completely and visually displaying direct current, vortex or countercurrent; in addition, the special high frame rate imaging is favorable for visually describing blood flow characteristics, particularly the complicated blood flow conditions such as the bending or bifurcation of the blood vessel.
In the above preferred embodiment, the arrow density should be increased by a proper amount, and the recommended value is 10%, and the user may also adaptively adjust the arrow density according to the actual condition of the patient, which is not limited herein.
In the above preferred embodiment, the user can analyze the change of the blood flow streamline according to the arrow length around the plaque position, the arrow color and the distribution and change of the arrow density, and further determine whether complex blood flow (vortex or turbulent flow) is formed near the plaque position according to the change process and the change result of the blood flow streamline, and use the complex blood flow as one of the diagnostic parameters.
In a preferred embodiment, in step S4, the vessel wall stress quantification values at the plaque position and the positions before and after the plaque position are measured, respectively, while the carotid artery is located in the systolic phase.
In another preferred embodiment of the present invention, in step S4, it is further required to locate the position of the carotid plaque and the quantitative values of the vessel wall stress at the anterior and posterior positions thereof as the diagnosis parameters.
In the above preferred embodiment, the vector flow imaging technique has better stability and repeatability for the measurement of the anterior wall vessel wall stress of carotid artery, and the vessel wall stress of the carotid arteriosclerosis patient at the position is within the range of 0.2pa to 0.3pa, which is also used as one of the diagnostic criteria.
In a preferred embodiment, the assessment method wherein the quantitative value of the vessel wall stress at the carotid stenosis is proportional to the stenosis intensity.
In another preferred embodiment of the present invention, according to the big data analysis statistics, in the patient population with obvious carotid artery stenosis (which often means stenosis degree is more than 30%), the quantitative value of the vessel wall stress increases with the increase of stenosis degree and is in a direct proportion relationship; in some patients with severe carotid stenosis, the quantitative value of the vessel wall stress at the stenosis fluctuates in a decreasing way due to the too large obstruction of the blood flow by the stenosed carotid artery.
In another preferred embodiment of the present invention, the quantitative value of the stress of the blood vessel wall obtained by the vector flow imaging technique is inversely related to the age of the patient according to the statistical result of the big data analysis, so that the diagnosis needs to be performed by performing the hierarchical stenosis assessment according to the age hierarchy of the patient.
As a preferred embodiment, this evaluation method, wherein the vessel wall stress evaluation threshold is 0.79pa when the stenosis degree is more than 30%.
In another preferred embodiment of the invention, in a patient population with obvious carotid stenosis with a stenosis degree of more than 30%, the sensitivity of diagnosing carotid arteriosclerotic stenosis is 91%, the specificity is 86% and the accuracy is 92% by taking the quantitative value of the stress of the blood vessel wall of more than 0.79pa as a diagnosis threshold value, so that the clinical application significance is excellent.
In conclusion, the technical scheme combines the gray-scale ultrasonic scanning and the vector blood flow imaging technology, can visualize the hemodynamic change and the blood flow line change condition at the carotid artery stenosis part, further accurately obtains the diagnosis threshold with high sensitivity, specificity and accuracy based on big data analysis, and has extremely strong applicability and clinical application value.
While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention.

Claims (10)

1. An assessment method of carotid arteriosclerosis, wherein the assessment method adopts a medical image color ultrasound to perform assessment image acquisition;
the method is characterized by comprising the following steps:
step S1, performing gray-scale ultrasonic scanning on the carotid artery through the medical image color ultrasound and outputting a scanning result;
step S2, obtaining the plaque position corresponding to the carotid artery and the stenosis degree corresponding to the plaque position according to the scanning result;
step S3, vector blood flow imaging is carried out on each plaque position one by one through the medical image color photography, and corresponding dynamic vector blood flow images are output;
step S4, generating a blood vessel wall stress evaluation threshold value related to the stenosis degree according to the dynamic vector blood flow image and the stenosis degree;
and step S5, evaluating the carotid arteriosclerosis condition of the patient according to the vascular wall stress evaluation threshold value.
2. The method of claim 1, wherein in step S1, the scanning results include longitudinal scanning imaging and transverse scanning imaging of both common carotid artery, internal carotid artery and external carotid artery.
3. The assessment method according to claim 1, wherein when said medical image color photographs any of said plaque locations for vector flow imaging, an image acquisition frame rate interval is [400, 600] frames/sec.
4. The assessment method of claim 1, wherein when said medical image color photographs vector blood flow imaging any of said plaque locations, the minimum flow rate display threshold is 50 cm/sec.
5. The assessment method of claim 1, wherein said dynamic vector blood flow image comprises a plurality of dynamically moving arrowhead-like blood flow indicative markers;
in each of the blood flow indication marks, an arrow direction represents a blood flow direction, an arrow length represents a blood flow velocity, an arrow color represents a blood flow volume, and the deeper the arrow color is, the larger the blood flow volume is.
6. The method of claim 5, wherein the arrow density is 10%.
7. The evaluation method of claim 5, wherein the arrow lifetime is 25 ms.
8. The method of claim 1, wherein in step S4, the vessel wall stress quantification values at the plaque location and at positions before and after the plaque location are measured, respectively, during carotid systole.
9. The assessment method of claim 1, wherein the quantitative value of vessel wall stress at the carotid stenosis is directly proportional to the stenosis.
10. The assessment method of claim 1, wherein the vessel wall stress assessment threshold is 0.79pa when the stenosis degree is greater than 30%.
CN202010827901.3A 2020-08-17 2020-08-17 Carotid arteriosclerosis assessment method Pending CN112220493A (en)

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Application Number Priority Date Filing Date Title
CN202010827901.3A CN112220493A (en) 2020-08-17 2020-08-17 Carotid arteriosclerosis assessment method

Publications (1)

Publication Number Publication Date
CN112220493A true CN112220493A (en) 2021-01-15

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