CN113040796A - Method and device for acquiring coronary artery functional index - Google Patents
Method and device for acquiring coronary artery functional index Download PDFInfo
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Abstract
The application provides a method and a device for acquiring coronary functional indexes. The method comprises the following steps: acquiring image data of a blood vessel to be measured; obtaining the central arterial pressure of a blood vessel to be measured by a non-invasive measurement method; determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central artery pressure; and determining the functional index of the blood vessel to be measured according to the internal pressure and the flow rate. The noninvasive and accurate detection of the coronary artery physiological functional indexes is realized.
Description
Technical Field
The present application relates to the field of coronary artery physiology, and in particular, to a method, an apparatus, a computer-readable storage medium, and a processor for obtaining a coronary artery functional index.
Background
Coronary artery physiology plays an increasingly important clinical role in cardiology. Coronary functional indicators include: fractional Flow Reserve (FFR), instantaneous wave-free ratio (iFR), Resting Full-cycle ratio (RFR), Index of circulation Resistance (IMR), and vessel Wall Shear Stress (WSS).
In the prior art, the main clinical acquisition means of FFR, iFR, RFR, IMR, WSS and the like are invasive single-point measurements at specified positions in a target vessel using a pressure guide wire. The measurement mode has various intraoperative risks and is expensive, the professional requirement on operators is high, the parameter values of all positions of the coronary artery are difficult to obtain, and the risk and the cost brought by invasiveness are urgently needed to be reduced by a technical upgrading mode. In recent years, a variety of medical imaging techniques have provided assistance in the treatment of coronary vessels, including Digital Silhouette Angiography (DSA), Positron Emission Tomography (PET) and cardiac magnetic resonance, myocardial ultrasound and computed tomography, among others.
The new medical imaging technology can more intuitively and accurately present the geometric information of the real coronary artery and blood flow, and well help the clinician to complete the diagnosis and treatment of the disease condition. However, the accuracy of functional indexes such as FFR, iFR, RFR, IMR, and WSS obtained by the existing medical imaging technology-assisted technology is low.
Disclosure of Invention
The present application mainly aims to provide a method, an apparatus, a computer-readable storage medium, and a processor for acquiring functional indicators of coronary arteries, so as to solve the problem in the prior art that the accuracy of functional indicators such as FFR, iFR, RFR, IMR, and WSS acquired by using the conventional medical imaging technology-assisted technique is low.
In order to achieve the above object, according to one aspect of the present application, there is provided a method of acquiring a coronary artery functional index, comprising: acquiring image data of a blood vessel to be measured; acquiring the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method; determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central artery pressure; and determining a functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
Further, the central arterial pressure of the blood vessel to be measured is obtained by a non-invasive measurement method, which comprises the following steps: obtaining brachial artery pressure, radial artery pressure and carotid artery pressure by the non-invasive measurement method; calculating the central arterial pressure from at least one of the brachial arterial pressure, the radial arterial pressure, and the carotid arterial pressure.
Further, the central arterial pressure of the blood vessel to be measured is acquired by a non-invasive measurement method, and the method further comprises the following steps: acquiring a parameter set of the blood vessel to be measured, wherein the parameter set comprises geometric information, arterial inlet flow, an outlet boundary model and a blood vessel elastic model; determining a one-dimensional fluid mechanics model from the set of parameters; calculating a first pressure waveform at a measuring point according to the one-dimensional fluid mechanics model, wherein the measuring point comprises a radial artery and a brachial artery; acquiring a second pressure waveform at the point of measurement using the non-invasive measurements, the non-invasive measurements including ultrasound and nuclear magnetic; determining a target difference value, the target difference value being a difference value of the first pressure waveform and the second pressure waveform; optimizing the one-dimensional fluid mechanics model according to the target difference value to obtain an optimized one-dimensional fluid mechanics model; determining the central arterial pressure based on the optimized one-dimensional fluid mechanics model.
Further, optimizing the one-dimensional fluid mechanics model according to the target difference value to obtain an optimized one-dimensional fluid mechanics model, including: under the condition that the target difference value is larger than or equal to a preset value, updating each parameter in the parameter set until the target difference value is smaller than the preset value; and determining an optimized one-dimensional fluid mechanics model according to the updated parameter set.
Further, determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure, comprising: determining a geometric model of the blood vessel according to the image data; determining the pressure at the inlet of the blood vessel to be measured according to the central arterial pressure; constructing a 3D coronary CFD model of the blood vessel to be measured according to the geometric model of the blood vessel and the pressure at the inlet of the blood vessel to be measured; determining the internal pressure and the flow velocity of the vessel to be measured according to the 3D coronary CFD model.
Further, the image data includes at least one of: CTA images, CTP images, DSA images, OCT images, and IVUS images.
Further, the functional indicator comprises at least one of: FFR, iFR, RFR, IMR and WSS.
According to another aspect of the present application, there is provided an apparatus for obtaining a functional indicator of coronary arteries, comprising: a first acquisition unit for acquiring image data of a blood vessel to be measured; a second acquisition unit for acquiring a central arterial pressure of the blood vessel to be measured by a non-invasive measurement method; a first determination unit for determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure; and the second determination unit is used for determining the functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
According to yet another aspect of the application, a computer-readable storage medium is provided, comprising a stored program, wherein the program, when executed, controls an apparatus in which the computer-readable storage medium is located to perform any one of the methods for obtaining a functional indicator of coronary arteries.
According to yet another aspect of the application, a processor is provided for executing a program, wherein the program is executed for performing any of the methods for obtaining a functional indicator of coronary arteries.
By the technical scheme, the central arterial pressure of the blood vessel to be measured is obtained by a non-invasive measurement method through obtaining the image data of the blood vessel to be measured, the internal pressure and the flow speed of the blood vessel to be measured are determined at least according to the image data and the central arterial pressure, the functional index of the blood vessel to be measured is determined according to the internal pressure and the flow speed, and non-invasive and accurate detection of the coronary artery physiological functional index is realized.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the application and, together with the description, serve to explain the application and are not intended to limit the application. In the drawings:
fig. 1 shows a flow chart of a method of obtaining a coronary functional index according to an embodiment of the present application;
FIG. 2 shows a schematic diagram of a 55-segment human artery network according to an embodiment of the present application;
FIG. 3 illustrates a central arterial pressure waveform according to an embodiment of the present application;
FIG. 4 illustrates a Tube-Load model according to an embodiment of the present application;
fig. 5 shows a schematic diagram of an apparatus for obtaining coronary functional indicators according to an embodiment of the present application.
Detailed Description
It should be noted that the embodiments and features of the embodiments in the present application may be combined with each other without conflict. The present application will be described in detail below with reference to the embodiments with reference to the attached drawings.
In order to make the technical solutions better understood by those skilled in the art, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only partial embodiments of the present application, but not all 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 application.
It should be noted that the terms "first," "second," and the like in the description and claims of this application and in the drawings described above are used for distinguishing between similar elements and not necessarily for describing a particular sequential or chronological order. It should be understood that the data so used may be interchanged under appropriate circumstances such that embodiments of the application described herein may be used. Furthermore, the terms "comprises," "comprising," and "having," and any variations thereof, are intended to cover a non-exclusive inclusion, such that a process, method, system, article, or apparatus that comprises a list of steps or elements is not necessarily limited to those steps or elements expressly listed, but may include other steps or elements not expressly listed or inherent to such process, method, article, or apparatus.
It will be understood that when an element such as a layer, film, region, or substrate is referred to as being "on" another element, it can be directly on the other element or intervening elements may also be present. Also, in the specification and claims, when an element is described as being "connected" to another element, the element may be "directly connected" to the other element or "connected" to the other element through a third element.
As introduced in the background art, in the prior art, the accuracy of functional indicators such as FFR, iFR, RFR, IMR, and WSS obtained by using the conventional medical imaging technology-assisted technology is low, and in order to solve the problem of low accuracy of functional indicators such as FFR, iFR, RFR, IMR, and WSS obtained by using the conventional medical imaging technology-assisted technology, embodiments of the present application provide a method, an apparatus, a computer-readable storage medium, and a processor for obtaining coronary artery functional indicators.
According to an embodiment of the present application, a method of obtaining a coronary functional index is provided.
Fig. 1 is a flowchart of a method for obtaining a coronary functional index according to an embodiment of the present application. As shown in fig. 1, the method comprises the steps of:
step S101, acquiring image data of a blood vessel to be measured;
step S102, obtaining the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
step S103, determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure;
and step S104, determining the functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
Specifically, the central arterial pressure of the blood vessel to be measured can be obtained by non-invasive measurement such as ultrasonic detection, nuclear magnetic detection, and a blood pressure measuring instrument capable of recording waveforms.
Specifically, the image data includes at least one of: CTA images, CTP images, DSA images, OCT images, and IVUS images. Of course, the image data may be other types of image data besides CTA images, CTP images, DSA images, OCT images, and IVUS images.
Specifically, the functional indicator includes at least one of the following: FFR, iFR, RFR, IMR and WSS. Of course, the functional indicators can also be other types of functional indicators besides FFR, iFR, RFR, IMR, and WSS.
In the scheme, the image data of the blood vessel to be measured is acquired, the central arterial pressure of the blood vessel to be measured is acquired by a non-invasive measurement method, the internal pressure and the flow speed of the blood vessel to be measured are determined at least according to the image data and the central arterial pressure, and the functional index of the blood vessel to be measured is determined according to the internal pressure and the flow speed, so that the non-invasive and accurate detection of the coronary artery physiological functional index is realized.
It should be noted that the steps illustrated in the flowcharts of the figures may be performed in a computer system such as a set of computer-executable instructions and that, although a logical order is illustrated in the flowcharts, in some cases, the steps illustrated or described may be performed in an order different than presented herein.
In one embodiment of the present application, the method for obtaining central arterial pressure of the blood vessel to be measured by non-invasive measurement includes: obtaining brachial artery pressure, radial artery pressure and carotid artery pressure by the non-invasive measurement method; and calculating the central arterial pressure according to at least one of the brachial arterial pressure, the radial arterial pressure and the carotid arterial pressure. Specifically, a brachial artery pressure waveform, a radial artery pressure waveform and a carotid artery pressure waveform can be obtained in a non-invasive measurement manner, and the central artery pressure is calculated according to at least one of the brachial artery pressure waveform, the radial artery pressure waveform and the carotid artery pressure waveform to obtain accurate central artery pressure.
In an embodiment of the present application, the method for obtaining the central arterial pressure of the blood vessel to be measured by non-invasive measurement further includes: acquiring a parameter set of the blood vessel to be measured, wherein the parameter set comprises geometric information, arterial inlet flow, an outlet boundary model and a blood vessel elastic model; determining a one-dimensional fluid mechanics model according to the parameter set; calculating a first pressure waveform at a measuring point according to the one-dimensional fluid mechanics model, wherein the measuring point comprises a radial artery and a brachial artery; acquiring a second pressure waveform at the measurement point using the non-invasive measurement methods, the non-invasive measurement methods including ultrasound and nuclear magnetic methods; determining a target difference value, the target difference value being a difference value between the first pressure waveform and the second pressure waveform; optimizing the one-dimensional fluid mechanics model according to the target difference value to obtain an optimized one-dimensional fluid mechanics model; and determining the central artery pressure based on the optimized one-dimensional fluid mechanics model. In this embodiment, the first pressure waveform and the second pressure waveform are both pressure waveforms in a time domain, that is, the first pressure waveform and the second pressure waveform contain timing information, and compared with a scheme in the prior art in which the radial artery pressure or the brachial artery pressure is only one pressure value, a scheme in the prior art in which a common empirical formula is adopted to obtain an average arterial pressure (accuracy is irrelevant to timing) is compared, the scheme of the present application is a timing waveform, so that the determined central arterial pressure is more accurate; further ensuring the accuracy of the functional index of the blood vessel to be measured.
In a specific embodiment of the present application, acquiring geometric information of a blood vessel to be measured includes: establishing a 55-segment human artery network structure (the 55-segment human artery network structure is shown in fig. 2), and determining initial network structure parameters according to the 55-segment human artery network structure, wherein the initial network structure parameters comprise geometric information such as the length and radius of a blood vessel. The 55 segments of human artery geometric information is shown in table 1.
TABLE 1 human 55 segment arterial geometry information
| Numbering | Arterial name | Length (cm) | Radius of proximal end (cm) | Radius of distal end (cm) |
| 1 | Ascending aorta | 4 | 1.525 | 1.42 |
| 2 | Aortic arch | 3 | 1.42 | 1.342 |
| 3 | Brachiocephalic | 4 | 0.95 | 0.7 |
| 4,15 | R+L Subclavian | 4 | 0.425 | 0.407 |
| 5,11 | R+L Com.carotid | 17 | 0.525 | 0.4 |
| 6,16 | R+L Vertebral | 14 | 0.2 | 0.2 |
| 7,17 | R+L Brachial | 40 | 0.407 | 0.25 |
| 8,19 | R+L Radial | 22 | 0.175 | 0.175 |
| 9,18 | R+L Ulnar | 22 | 0.175 | 0.175 |
| 10 | Aortic arch | 4 | 1.342 | 1.246 |
| 12 | Thoracic aorta | 6 | 1.246 | 1.124 |
| 13 | Thoracic aorta | 11 | 1.124 | 0.924 |
| 14 | Intercostals | 7 | 0.63 | 0.5 |
| 20 | Celiac axis | 2 | 0.35 | 0.3 |
| 21 | Hepatic | 2 | 0.3 | 0.25 |
| 22 | Hepatic | 7 | 0.275 | 0.25 |
| 23 | Gastric | 6 | 0.175 | 0.15 |
| 24 | Splenic | 6 | 0.2 | 0.2 |
| 25 | Abdominal aorta | 5 | 0.924 | 0.838 |
| 26 | Superior mesenteric | 5 | 0.4 | 0.35 |
| 27 | Abdominal aorta | 2 | 0.838 | 0.814 |
| 28,30 | R+L Renal | 3 | 0.275 | 0.275 |
| 29 | Abdominal aorta | 2 | 0.814 | 0.792 |
| 31 | Abdominal aorta | 13 | 0.792 | 0.627 |
| 32 | Inferior mesenteric | 4 | 0.2 | 0.175 |
| 33 | Abdominal aorta | 8 | 0.627 | 0.55 |
| 34,47 | R+L External iliac | 6 | 0.4 | 0.37 |
| 35,48 | R+L Femoral | 15 | 0.37 | 0.314 |
| 36,49 | R+L Internal iliac | 5 | 0.2 | 0.2 |
| 37,50 | R+L Deep femoral | 11 | 0.2 | 0.2 |
| 38,51 | R+L Femoral | 44 | 0.314 | 0.2 |
| 39,40,52,53 | R+L Ext.+Int.carotid | 16 | 0.275 | 0.2 |
| 41,54 | R+L Post.tibial | 32 | 0.125 | 0.125 |
| 42,55 | R+L Ant.tibial | 32 | 0.125 | 0.125 |
| 43,46 | R+L Interosseous | 7 | 0.1 | 0.1 |
| 44,45 | R+L Ulnar | 17 | 0.2 | 0.2 |
In a specific embodiment of the present application, acquiring the arterial inlet flow of the blood vessel to be measured comprises: determining the flow-time relation at the entrance of the arterial tree in a complete heartbeat cycle, and determining the arterial entrance flow of the blood vessel to be measured according to the flow-time relation. The flow-time relationship can be determined through the fitting relationship of a large amount of data, namely, a plurality of flows at the entrance of an arterial tree are obtained, and the plurality of flows are fitted in a time domain to obtain the flow-time relationship in a complete heartbeat cycle; the flow-time relation in a complete heartbeat cycle can also be obtained by non-invasive measurement modes such as ultrasonic detection or nuclear magnetic detection.
In a specific embodiment of the present application, obtaining an exit boundary model of a blood vessel to be measured comprises: and estimating parameters of each cut blood vessel at the outlet of the arterial tree based on the impedance, the capacitive reactance and the like of the circuit model, and determining an outlet boundary model of the blood vessel to be measured according to the parameters of the impedance, the capacitive reactance and the like.
In a specific embodiment of the present application, obtaining a vascular elasticity model of a blood vessel to be measured comprises: constructing a one-dimensional hemodynamic control equation based on a three-dimensional non-compressible flow Navier-Stokes (NS) equation:
wherein A is the cross-sectional area of the blood vessel, q is the blood flow, v is the kinematic viscosity, δ is the boundary layer thickness, r0The pressure p is determined by an equation of state based on an elastic model for the radius of the vessel when it is undeformed
Calculation of p0,A0Respectively, the pressure and the cross-sectional area of the blood vessel when the blood vessel is not deformed, E represents the Young modulus of the blood vessel wall, h represents the thickness of the blood vessel wall, wherein the cross-sectional area of the blood vessel is determined according to the radius of the blood vessel, and the blood flow is determined according to the flow-time relation at the entrance of an arterial tree in a complete heartbeat cycle.
In an alternative embodiment of the present application, the one-dimensional hemodynamic control equation can also be expressed as follows:
where α is the Coriolis coefficient, μ is the kinetic viscosity, γvIs a parameter defining the radial distribution of velocity. When α ═ 1, the equation can also be written in the form of a, u:
where u is the axial velocity.
The elastic model-based equation of state can also be written as:
wherein v is the poisson's ratio.
In addition, the equation of state has a form based on a visco-elastic model:
wherein gamma issIs the coefficient of viscoelasticity.
Of course, the one-dimensional hemodynamic control equations and state equations may have other forms and are not limited to those listed herein.
In a specific embodiment of the present application, optimizing the one-dimensional fluid mechanics model according to the target difference to obtain an optimized one-dimensional fluid mechanics model, includes: under the condition that the target difference value is larger than or equal to a preset value, updating each parameter in the parameter set until the target difference value is smaller than the preset value; and determining an optimized one-dimensional fluid mechanics model according to the updated parameter set. Namely, by continuously adjusting each parameter in the parameter set until the target difference is smaller than the predetermined value, the current one-dimensional fluid mechanics model is determined to be closer to the real vascular fluid mechanics model under the condition that the target difference is smaller, so that the central artery pressure is determined more accurately based on the optimized one-dimensional fluid mechanics model.
Specifically, in the calculation of the functional index, the intravascular arterial pressure is an indispensable parameter, and the arterial pressure related parameter is derived from the cardiac functional index. Conventionally, Mean Arterial Pressure (MAP) is obtained through an empirical formula in a statistical sense, and FFR and other parameters are estimated according to the Mean Arterial Pressure (MAP), for example, the empirical formula is:
wherein HR, SBP, DBP represent the heart rate, systolic blood pressure, diastolic blood pressure of the patient, respectively. This empirical formula does not completely reflect patient-specific physiological parameters. The one-dimensional computational fluid mechanics method corrects parameters related to a patient in a one-dimensional computational fluid mechanics model based on the non-invasive measured upper limb artery by establishing an arterial tree of a human body. The patient-specific parameters are continuously adjusted in such a reciprocating way, so that an optimal model can be obtained for the current patient. Therefore, the central arterial pressure is calculated from the model, and the pressure related parameters can be calculated more accurately. On the other hand, this method can obtain a complete central artery pressure waveform in one heart cycle, as shown in fig. 3, not only high and low pressure, but also average pressure. This is very advantageous for CFD simulation of transients, providing a complete pressure boundary condition within one cycle.
Specifically, a one-dimensional computational fluid dynamics method corrects patient-related parameters in a one-dimensional computational fluid dynamics model based on non-invasively measured upper extremity arteries by building an arterial tree of a human body. The patient-specific parameters are continuously adjusted in such a reciprocating way, so that an optimal model can be obtained for the current patient. Therefore, the central arterial pressure is calculated from the model, and the pressure related parameters can be calculated more accurately.
In an embodiment of the present application, determining the internal pressure and the flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure includes: determining a geometric model of the blood vessel according to the image data; determining the pressure at the inlet of the blood vessel to be measured according to the central arterial pressure; constructing a 3D coronary CFD model of the blood vessel to be measured according to the geometric model of the blood vessel and the pressure at the inlet of the blood vessel to be measured; and determining the internal pressure and the flow velocity of the blood vessel to be measured according to the 3D coronary CFD model.
In one embodiment of the present application, calculating the central arterial pressure according to at least one of the brachial arterial pressure, the radial arterial pressure, and the carotid arterial pressure includes: and calculating the central arterial pressure by adopting a transfer function method, a one-dimensional hemodynamics method or a Tube-Load method according to at least one of the brachial arterial pressure, the radial arterial pressure and the carotid arterial pressure.
Specifically, the Tube-Load method comprises the following specific steps: 1) building a Tube-Load model as shown in FIG. 4, where pc(T) is the pressure of the central arterial pressure over time, TdIs the pulse wavePropagation time, Z, of propagation to the measurement point (radial artery) at the entrance of the central arterycIs the characteristic impedance of the artery, R is the peripheral resistance; 2) according to the formula
Calculating pulse wave reflection coefficients; 3) according to TdThe physiological range of Γ, i.e. Td∈[0,0.15](unit: sec), Γ ∈ [0,1 ]]At an interval Δ Td＝5×10-3,ΔΓ＝5×10-2Generation (T)dΓ) pairs; 4) measuring the pressure waveform p at the brachial or radial artery over timer(t); 5) by the formula T-0.4 (1-e)-2T) Calculating a diastolic interval corresponding to the central arterial pressure waveform, wherein T is 60/HR, and HR is the heart beat frequency per minute; 6) each one (T)dΓ) pair according to the formula:
calculating a corresponding central arterial pressure waveform, and smoothing by a low-pass filter; 7) for each pair of (T)dΓ) the smoothed central arterial pressure waveform, the pressure corresponding to the diastolic interval is logarithmically transformed, and a straight line is fitted by linear regression, and all (T) s are recordeddΓ) fitting error of the pair; 8) the central arterial pressure waveform with the minimum fitting error is the final waveform.
In an embodiment of the present application, calculating the central arterial pressure by using a transfer function method according to at least one of the brachial arterial pressure, the radial arterial pressure, and the carotid arterial pressure includes: collecting a carotid pressure waveform and a radial pressure waveform; constructing a narrow transfer function from the radial artery to the carotid artery according to the carotid artery pressure waveform and the radial artery pressure waveform; averaging a plurality of the narrow transfer functions to obtain a generalized transfer function; the central arterial pressure is calculated using the generalized transfer function.
Specifically, the method using the transfer function includes the following steps: 1) collecting carotid artery pressure waveform and brachial (radial) motionA set of pulse pressure waveforms; 2) constructing personal transfer function y (t) + a from radial artery to carotid artery based on autoregressive exogenous model1y(t-1)+…+anay(t-na)＝b1u(t-nk)+…+bnbu (t-nb-nk +1) + e (t), where na, nb are the order of the model, nk is the time delay of the model, e (t) is the white noise disturbance, u (t) is the input radial artery pressure, y (t) is the output carotid artery pressure; 3) averaging the individual transfer functions in all measured data sets to finally obtain a general transfer function (generalized transfer function), and applying the general transfer function to the clinically measured brachial artery blood pressure waveform to obtain the central artery pressure waveform.
The embodiment of the present application further provides an apparatus for acquiring a coronary functional index, and it should be noted that the apparatus for acquiring a coronary functional index of the embodiment of the present application may be used to execute the method for acquiring a coronary functional index provided by the embodiment of the present application. The device for acquiring coronary functional indicators provided by the embodiments of the present application will be described below.
Fig. 5 is a schematic diagram of an apparatus for obtaining coronary functional indicators according to an embodiment of the present application. As shown in fig. 5, the apparatus includes:
a first acquisition unit 10 for acquiring image data of a blood vessel to be measured;
a second acquisition unit 20 for acquiring a central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
a first determining unit 30 for determining the internal pressure and flow rate of the blood vessel to be measured based on at least the image data and the central artery pressure;
a second determining unit 40, configured to determine a functional indicator of the blood vessel to be measured according to the internal pressure and the flow rate.
Specifically, the central arterial pressure of the blood vessel to be measured can be obtained by non-invasive measurement such as ultrasonic detection, nuclear magnetic detection, and a blood pressure measuring instrument capable of recording waveforms.
Specifically, the image data includes at least one of: CTA images, CTP images, DSA images, OCT images, and IVUS images. Of course, the image data may be other types of image data besides CTA images, CTP images, DSA images, OCT images, and IVUS images.
Specifically, the functional indicator includes at least one of the following: FFR, iFR, RFR, IMR and WSS. Of course, the functional indicators can also be other types of functional indicators besides FFR, iFR, RFR, IMR, and WSS.
In the scheme, the first acquisition unit acquires image data of a blood vessel to be measured, the second acquisition unit acquires central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method, the first determination unit determines internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central arterial pressure, and the first determination unit determines functional indexes of the blood vessel to be measured according to the internal pressure and the flow rate, so that non-invasive and accurate detection of the coronary artery physiological functional indexes is realized.
In one embodiment of the present application, the second acquisition unit includes a first acquisition unit for acquiring brachial artery pressure, radial artery pressure, and carotid artery pressure using the above-mentioned noninvasive measurement method; the first calculating unit is used for calculating the central arterial pressure according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure. Specifically, a brachial artery pressure waveform, a radial artery pressure waveform and a carotid artery pressure waveform can be obtained in a non-invasive measurement manner, and the central artery pressure is calculated according to at least one of the brachial artery pressure waveform, the radial artery pressure waveform and the carotid artery pressure waveform to obtain accurate central artery pressure.
In an embodiment of the present application, the second obtaining unit further includes a second obtaining module, a first determining module, a second calculating module, a third obtaining module, a second determining module, an optimizing module, and a third determining module, where the second obtaining module is configured to obtain a parameter set of the blood vessel to be measured, where the parameter set includes geometric information, an arterial inlet flow, an outlet boundary model, and a vascular elasticity model; the first determining module is used for determining a one-dimensional fluid mechanics model according to the parameter set; the second calculation module is used for calculating a first pressure waveform at a measuring point according to the one-dimensional fluid mechanics model, wherein the measuring point comprises a radial artery and a brachial artery; a third acquisition module for acquiring a second pressure waveform at the measurement point by the non-invasive measurement method, wherein the non-invasive measurement method comprises an ultrasonic method and a nuclear magnetic method; a second determining module for determining a target difference, the target difference being a difference between the first pressure waveform and the second pressure waveform; the optimization module is used for optimizing the one-dimensional fluid mechanics model according to the target difference value to obtain an optimized one-dimensional fluid mechanics model; the third determining module is used for determining the central artery pressure based on the optimized one-dimensional fluid mechanics model. In this embodiment, the first pressure waveform and the second pressure waveform are both pressure waveforms in a time domain, that is, the first pressure waveform and the second pressure waveform contain timing information, and compared with a scheme in the prior art in which the radial artery pressure or the brachial artery pressure is only one pressure value, a scheme in the prior art in which a common empirical formula is adopted to obtain an average arterial pressure (accuracy is irrelevant to timing) is compared, the scheme of the present application is a timing waveform, so that the determined central arterial pressure is more accurate; further ensuring the accuracy of the functional index of the blood vessel to be measured.
In an embodiment of the application, the optimization module is further configured to update each parameter in the parameter set until the target difference is smaller than the predetermined value, when the target difference is greater than or equal to the predetermined value; and determining an optimized one-dimensional fluid mechanics model according to the updated parameter set. Namely, by continuously adjusting each parameter in the parameter set until the target difference is smaller than the predetermined value, the current one-dimensional fluid mechanics model is determined to be closer to the real vascular fluid mechanics model under the condition that the target difference is smaller, so that the central artery pressure is determined more accurately based on the optimized one-dimensional fluid mechanics model.
In an embodiment of the present application, the first determining unit includes a fourth determining module, a fifth determining module, a constructing module, and a sixth determining module, where the fourth determining module is configured to determine a geometric model of a blood vessel according to the image data; the fifth determining module is used for determining the pressure at the inlet of the blood vessel to be measured according to the central arterial pressure; the construction module is used for constructing a 3D coronary artery CFD model of the blood vessel to be measured according to the geometric model of the blood vessel and the pressure at the inlet of the blood vessel to be measured; a sixth determining module is configured to determine the internal pressure and the flow rate of the blood vessel to be measured according to the 3D coronary CFD model.
The device for acquiring coronary functional indexes comprises a processor and a memory, wherein the first acquiring unit, the second acquiring unit, the first determining unit, the second determining unit and the like are stored in the memory as program units, and the processor executes the program units stored in the memory to realize corresponding functions.
The processor comprises a kernel, and the kernel calls the corresponding program unit from the memory. The kernel can be set to be one or more than one, and the accurate coronary artery functional indexes are obtained by adjusting kernel parameters.
The memory may include volatile memory in a computer readable medium, Random Access Memory (RAM) and/or nonvolatile memory such as Read Only Memory (ROM) or flash memory (flash RAM), and the memory includes at least one memory chip.
The embodiment of the invention provides a computer-readable storage medium, which includes a stored program, and when the program runs, the apparatus on which the computer-readable storage medium is located is controlled to execute the method for acquiring coronary functional indicators.
An embodiment of the present invention provides a processor, which is configured to execute a program, where the program executes the method for acquiring coronary functional indicators.
The embodiment of the invention provides equipment, which comprises a processor, a memory and a program which is stored on the memory and can run on the processor, wherein when the processor executes the program, at least the following steps are realized:
step S101, acquiring image data of a blood vessel to be measured;
step S102, obtaining the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
step S103, determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure;
and step S104, determining the functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
The device herein may be a server, a PC, a PAD, a mobile phone, etc.
The present application further provides a computer program product adapted to perform a program of initializing at least the following method steps when executed on a data processing device:
step S101, acquiring image data of a blood vessel to be measured;
step S102, obtaining the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
step S103, determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure;
and step S104, determining the functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
As will be appreciated by one skilled in the art, embodiments of the present application may be provided as a method, system, or computer program product. Accordingly, the present application may take the form of an entirely hardware embodiment, an entirely software embodiment or an embodiment combining software and hardware aspects. Furthermore, the present application may take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, and the like) having computer-usable program code embodied therein.
The present application is described with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the application. It will be understood that each flow and/or block of the flow diagrams and/or block diagrams, and combinations of flows and/or blocks in the flow diagrams and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.
These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means which implement the function specified in the flowchart flow or flows and/or block diagram block or blocks.
These computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide steps for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.
In a typical configuration, a computing device includes one or more processors (CPUs), input/output interfaces, network interfaces, and memory.
The memory may include forms of volatile memory in a computer readable medium, Random Access Memory (RAM) and/or non-volatile memory, such as Read Only Memory (ROM) or flash memory (flash RAM). The memory is an example of a computer-readable medium.
Computer-readable media, including both non-transitory and non-transitory, removable and non-removable media, may implement information storage by any method or technology. The information may be computer readable instructions, data structures, modules of a program, or other data. Examples of computer storage media include, but are not limited to, phase change memory (PRAM), Static Random Access Memory (SRAM), Dynamic Random Access Memory (DRAM), other types of Random Access Memory (RAM), Read Only Memory (ROM), Electrically Erasable Programmable Read Only Memory (EEPROM), flash memory or other memory technology, compact disc read only memory (CD-ROM), Digital Versatile Discs (DVD) or other optical storage, magnetic cassettes, magnetic tape magnetic disk storage or other magnetic storage devices, or any other non-transmission medium that can be used to store information that can be accessed by a computing device. As defined herein, a computer readable medium does not include a transitory computer readable medium such as a modulated data signal and a carrier wave.
It should also be noted that the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising an … …" does not exclude the presence of other identical elements in the process, method, article, or apparatus that comprises the element.
From the above description, it can be seen that the above-described embodiments of the present application achieve the following technical effects:
1) the method for acquiring the functional indexes of the coronary artery obtains the central arterial pressure of the blood vessel to be measured by a noninvasive measuring method through obtaining the image data of the blood vessel to be measured, determines the internal pressure and the flow rate of the blood vessel to be measured at least according to the image data and the central arterial pressure, determines the functional indexes of the blood vessel to be measured according to the internal pressure and the flow rate, and realizes noninvasive and accurate detection of the physiological functional indexes of the coronary artery.
2) The device for acquiring coronary artery functional indexes comprises a first acquisition unit, a second acquisition unit, a first determination unit and a second determination unit, wherein the first acquisition unit acquires image data of a blood vessel to be measured, the second acquisition unit acquires central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method, the first determination unit determines the internal pressure and the flow speed of the blood vessel to be measured at least according to the image data and the central arterial pressure, the first determination unit determines the functional indexes of the blood vessel to be measured according to the internal pressure and the flow speed, and non-invasive and accurate detection of the coronary artery physiological functional indexes is realized.
The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like made within the spirit and principle of the present application shall be included in the protection scope of the present application.
Claims (10)
1. A method of obtaining a functional indicator of coronary arteries, comprising:
acquiring image data of a blood vessel to be measured;
acquiring the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central artery pressure; and determining a functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
2. The method according to claim 1, wherein the central arterial pressure of the blood vessel to be measured is obtained by non-invasive measurement, comprising:
obtaining brachial artery pressure, radial artery pressure and carotid artery pressure by the non-invasive measurement method;
calculating the central arterial pressure from at least one of the brachial arterial pressure, the radial arterial pressure, and the carotid arterial pressure.
3. The method according to claim 1, wherein the central arterial pressure of the blood vessel to be measured is acquired by non-invasive measurement, further comprising:
acquiring a parameter set of the blood vessel to be measured, wherein the parameter set comprises geometric information, arterial inlet flow, an outlet boundary model and a blood vessel elastic model;
determining a one-dimensional fluid mechanics model from the set of parameters;
calculating a first pressure waveform at a measuring point according to the one-dimensional fluid mechanics model, wherein the measuring point comprises a radial artery and a brachial artery;
acquiring a second pressure waveform at the point of measurement using the non-invasive measurements, the non-invasive measurements including ultrasound and nuclear magnetic;
determining a target difference value, the target difference value being a difference value of the first pressure waveform and the second pressure waveform;
optimizing the one-dimensional fluid mechanics model according to the target difference value to obtain an optimized one-dimensional fluid mechanics model;
determining the central arterial pressure based on the optimized one-dimensional fluid mechanics model.
4. The method of claim 3, wherein optimizing the one-dimensional fluid mechanics model based on the target difference to obtain an optimized one-dimensional fluid mechanics model comprises:
under the condition that the target difference value is larger than or equal to a preset value, updating each parameter in the parameter set until the target difference value is smaller than the preset value;
and determining an optimized one-dimensional fluid mechanics model according to the updated parameter set.
5. The method of claim 1, wherein determining the internal pressure and flow rate of the blood vessel to be measured from at least the image data and the central artery pressure comprises:
determining a geometric model of the blood vessel according to the image data;
determining the pressure at the inlet of the blood vessel to be measured according to the central arterial pressure;
constructing a 3D coronary CFD model of the blood vessel to be measured according to the geometric model of the blood vessel and the pressure at the inlet of the blood vessel to be measured;
determining the internal pressure and the flow velocity of the vessel to be measured according to the 3D coronary CFD model.
6. The method of any of claims 1 to 5, wherein the image data comprises at least one of:
CTA images, CTP images, DSA images, OCT images, and IVUS images.
7. The method of any one of claims 1 to 5, wherein the functional indicator comprises at least one of:
FFR, iFR, RFR, IMR and WSS.
8. An apparatus for obtaining a functional indicator of coronary arteries, comprising:
a first acquisition unit for acquiring image data of a blood vessel to be measured;
a second acquisition unit for acquiring a central arterial pressure of the blood vessel to be measured by a non-invasive measurement method;
a first determination unit for determining the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central artery pressure;
and the second determination unit is used for determining the functional index of the blood vessel to be measured according to the internal pressure and the flow speed.
9. A computer-readable storage medium, comprising a stored program, wherein when the program is run, the computer-readable storage medium controls an apparatus to perform the method for obtaining a functional indicator of coronary arteries according to any one of claims 1 to 7.
10. A processor configured to execute a program, wherein the program is configured to execute the method for obtaining a functional indicator of coronary arteries according to any one of claims 1 to 7.
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