CN113907720B - Method, device and processor for measuring vascular functional indexes - Google Patents

Method, device and processor for measuring vascular functional indexes Download PDF

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CN113907720B
CN113907720B CN202110874335.6A CN202110874335A CN113907720B CN 113907720 B CN113907720 B CN 113907720B CN 202110874335 A CN202110874335 A CN 202110874335A CN 113907720 B CN113907720 B CN 113907720B
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resting
blood flow
blood vessel
hyperemic
determining
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CN113907720A (en
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毛益进
张超
赵清华
冯辉
刘伟
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Beijing Yueying Technology Co ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, 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
    • A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, 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
    • A61B5/026—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, 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
    • A61B5/026—Measuring blood flow
    • A61B5/0263—Measuring blood flow using NMR
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computerised tomographs
    • A61B6/037—Emission tomography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50—Clinical applications
    • A61B6/503—Clinical applications involving diagnosis of heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50—Clinical applications
    • A61B6/507—Clinical applications involving determination of haemodynamic parameters, e.g. perfusion CT
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A61B8/065—Measuring blood flow to determine blood output from the heart
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00—Computer-aided design [CAD]
    • G06F30/20—Design optimisation, verification or simulation
    • G06F30/28—Design optimisation, verification or simulation using fluid dynamics, e.g. using Navier-Stokes equations or computational fluid dynamics [CFD]
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/50—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F2113/00—Details relating to the application field
    • G06F2113/08—Fluids
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F2119/00—Details relating to the type or aim of the analysis or the optimisation
    • G06F2119/14—Force analysis or force optimisation, e.g. static or dynamic forces

Abstract

The application provides a method, a device and a processor for measuring vascular functional indexes. The method comprises the steps of obtaining an image of a blood vessel in a resting state; determining resting blood flow volume according to the image, wherein the resting blood flow volume is the blood flow volume of the blood vessel in a resting state; constructing a resting CFD model; constructing a congestion CFD model; determining hyperemia blood flow according to the image in the rest state, the rest CFD model and the hyperemia CFD model, wherein the hyperemia blood flow is the blood flow of the blood vessel in the hyperemia state; and determining functional indexes of the blood vessel at least according to the resting blood flow and the hyperemic blood flow. The problem of can't obtain the blood vessel under the congestion state image among the prior art, and then can't obtain the blood flow volume of congestion is solved.

Description

Method, device and processor for measuring vascular functional indexes
Technical Field
The present application relates to the field of medical imaging, and in particular, to a method, an apparatus, a computer-readable storage medium, and a processor for measuring a vascular functional indicator.
Background
Cardiovascular disease is considered one of the leading causes of death worldwide. Despite the significant improvements in medical imaging technology and diagnostic modalities, the premature morbidity and mortality of cardiovascular diseases remains high. On the one hand, the reason is the limitation of the prior art in application. Such as medical imaging techniques like Quantitative Coronary Angiography (QCA), which visually provide the clinician with intuitive imaging results and describe an anatomical summary including area reduction of the vessel stenosis, lesion length, and minimal lumen diameter, but lack a functional assessment of the effect of vascular blood flow lesions. Compared with angiography, a direct measurement mode, such as invasive Fractional Flow Reserve (FFR) measurement, for a target position by invading a pressure guide wire into a blood vessel can acquire blood flow parameters at the position to calculate the functional influence of blood flow injury of the blood vessel, but has certain risk. Taken together, a single medical imaging technique only assesses morphological significance and has many functional analysis limitations, while invasive functional measurement approaches are often accompanied by the associated risks of intervention.
In order to solve the above problems, in recent years, various methods of calculating a functional vascular index based on a contrast image have been proposed. These methods offer the possibility of different functional flow index analyses of coronary vessels with reduced or avoided invasive measurements. In Coronary artery clinical analysis, the most common functional indices include Fractional Flow Reserve (FFR), index of circulatory Resistance (IMR), and Coronary Flow Reserve (CFR). The functional parameters are calculated mostly on the basis of the blood flow parameters after the maximal hyperemic (hyperemic) state of intravenously administered adenosine/adenosine in the vessel. However, in the clinical setting, there is a risk of imaging the subject under maximal hyperemia. Therefore, the images obtained by the commonly used imaging techniques including Computer Tomography Angiography (CTA) and Digital Subtraction Angiography (DSA) are mostly blood vessels that are not in the maximal hyperemic state (i.e., in the resting state). Most of the existing functional analysis methods are established on the basis of directly acquiring a coronary blood vessel hyperemia image, and the calculation and research of functional indexes on the basis of a resting image acquired in practice are limited. Most of the currently disclosed functional index calculation methods based on the resting state angiography image need to measure or predict the hyperemic blood flow in advance, so as to solve the hyperemic functional index by Computational Fluid Dynamics (CFD) with the hyperemic blood flow and hyperemic pressure boundary as input parameters. In clinical settings, however, the difficulty of measuring blood flow is far greater than measuring pressure. Mean Arterial Pressure (MAP) can be measured very easily in a non-invasive or invasive manner. Compared with the prior art, it is still challenging to calculate the functional index of the blood vessel by using the rest image information and the rest blood flow when the coronary angiography image lacking the hyperemia flow (i.e. the image of the blood vessel in the hyperemia state cannot be obtained) and the accurate hyperemia flow cannot be directly obtained.
Disclosure of Invention
The present application provides a method, an apparatus, a computer-readable storage medium, and a processor for measuring functional indicators of blood vessels, so as to solve the problem in the prior art that the functional indicators of blood vessels cannot be accurately measured on the premise of lacking a coronary angiography image with hyperemia flow.
To achieve the above object, according to one aspect of the present application, there is provided a method of measuring a vascular functional metric, including: acquiring an image of a blood vessel in a resting state; determining resting blood flow according to the image, wherein the resting blood flow is the blood flow of the blood vessel in a resting state; constructing a resting CFD model; constructing a congestion CFD model; determining hyperemic blood flow, which is the blood flow of the blood vessel in the hyperemic state, according to the image in the resting state, the resting CFD model and the hyperemic CFD model; determining a functional indicator of the vessel based at least on the resting blood flow and the hyperemic blood flow.
Optionally, determining resting blood flow from the imagery includes: determining a three-dimensional blood vessel model according to the image; and determining the resting blood flow according to the three-dimensional blood vessel model.
Optionally, determining a hyperemic blood flow from the image at rest, the rest CFD model, and the hyperemic CFD model, comprises: inputting at least the three-dimensional blood vessel model and the resting blood flow into the resting CFD model, and calculating to obtain resting microvascular resistance; determining hyperemic microvascular resistance from the resting microvascular resistance; and inputting at least the hyperemic microvascular resistance into the hyperemic CFD model, and calculating to obtain the hyperemic blood flow.
Optionally, inputting at least the three-dimensional blood vessel model and the resting blood flow into the resting CFD model, and calculating to obtain resting microvascular resistance, including: obtaining at least one resting pressure value of the blood vessel; and inputting the three-dimensional blood vessel model, the resting blood flow and the resting pressure value into the resting CFD model, and calculating to obtain the resting micro-blood vessel resistance.
Optionally, inputting at least the hyperemic microvascular resistance to the hyperemic CFD model, and calculating to obtain the hyperemic blood flow, comprising: acquiring a real pressure value of a preset congestion pressure point; setting and predicting congestion blood flow; inputting the three-dimensional blood vessel model, the estimated hyperemia blood flow and the hyperemia micro-blood vessel resistance into the hyperemia CFD model, and calculating to obtain a calculated pressure value of the preset hyperemia pressure point; obtaining a difference value between the real pressure value and the calculated pressure value; and adjusting the estimated hyperemic blood flow according to the difference until the difference is smaller than a preset value, and determining the current estimated hyperemic blood flow as the hyperemic blood flow.
Optionally, determining hyperemic microvascular resistance from the resting microvascular resistance comprises: acquiring a total coronary artery resistance index; determining the hyperemic microvascular resistance from the total coronary resistance index and the resting microvascular resistance.
Optionally, determining a functional indicator of the vessel based at least on the resting blood flow and the hyperemic blood flow comprises: determining the CFR of the blood vessel according to the resting blood flow and the hyperemic blood flow; determining a vessel distal pressure, a vessel proximal pressure, and an average blood flow velocity based at least on the hyperemic blood flow; determining the FFR of the blood vessel according to the far-end pressure and the near-end pressure of the blood vessel; determining the length of a blood vessel according to the three-dimensional blood vessel model, wherein the three-dimensional blood vessel model is determined according to the image; determining the IMR of the vessel based on the vessel distal pressure, the length of the vessel, and the average blood flow velocity.
According to another aspect of the present application, there is provided a device for measuring a vascular functional indicator, comprising: the acquisition unit is used for acquiring the image of the blood vessel in a resting state; a first determining unit, configured to determine a resting blood flow volume according to the image, where the resting blood flow volume is a blood flow volume of the blood vessel in a resting state; the first construction unit is used for constructing a resting CFD model; the second construction unit is used for constructing a congestion CFD model; a second determining unit, configured to determine hyperemic blood flow according to the image in a resting state, the resting CFD model, and the hyperemic CFD model, where the hyperemic blood flow is blood flow of the blood vessel in a hyperemic state; and the third determination unit is used for determining the functional indexes of the blood vessels according to at least the resting blood flow and the hyperemic blood flow.
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 measuring a vascular functional metric.
According to yet another aspect of the application, a processor for running a program is provided, wherein the program is run for performing any of the methods of measuring a vascular functional indicator.
By applying the technical scheme of the application, the resting blood flow is determined according to the image of the blood vessel in the resting state by obtaining the image of the blood vessel in the resting state; and constructing a rest CFD model, constructing a congestion CFD model, and determining the congestion blood flow according to the image in the rest state, the rest CFD model and the congestion CFD model. It is realized that the blood flow volume of blood can be obtained even when the image in the state of blood congestion cannot be obtained. And further determining the functional index of the blood vessel. The problem of in the prior art under the condition that can't obtain the image of blood vessel under the state of congestion, can't obtain the blood flow volume of congestion is solved.
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 measuring a vascular functionality indicator according to an embodiment of the present application;
fig. 2 shows a schematic view of a device for measuring a functional indicator of blood vessels according to an embodiment of the present application;
fig. 3 shows a 2D resting DSA image map according to an embodiment of the application;
FIG. 4 shows a 3D resting CTA image map according to an embodiment of the application;
FIG. 5 shows a flow chart for computing a functional metric according to an embodiment of the present application;
fig. 6 shows a schematic coronary vessel view according to an embodiment of the 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 described in the background, the prior art cannot accurately measure the functional indicators of blood vessels on the premise of coronary angiography images (i.e., images of blood vessels in a hyperemic state) lacking hyperemic flux. In order to solve the above problem that the functional indicator of the blood vessel cannot be accurately measured on the premise of coronary angiography image lacking hyperemia flow, embodiments of the present application provide a method, an apparatus, a computer-readable storage medium, and a processor for measuring the functional indicator of the blood vessel.
According to an embodiment of the present application, a method of measuring a vascular functional indicator is provided.
Fig. 1 is a flow chart of a method of measuring a functional indicator of a blood vessel according to an embodiment of the present application. As shown in fig. 1, the method comprises the steps of:
step S101, obtaining an image of a blood vessel in a resting state;
step S102, determining a resting blood flow volume according to the image, wherein the resting blood flow volume is the blood flow volume of the blood vessel in a resting state;
step S103, constructing a resting CFD model;
step S104, constructing a congestion CFD model;
step S105, determining a hyperemic blood flow volume according to the image in a resting state, the resting CFD model and the hyperemic CFD model, wherein the hyperemic blood flow volume is the blood flow volume of the blood vessel in the hyperemic state;
and step S106, determining functional indexes of the blood vessels according to at least the resting blood flow and the hyperemic blood flow.
Specifically, the resting CFD model is a CFD model of the blood vessel in a resting state, and the congestive CFD model is a CFD model of the blood vessel in a congestive state. And combining the image in the resting state and the resting CFD model to obtain a relevant parameter (such as blood vessel pressure) of the blood vessel in the resting state. The relative parameters of the blood vessel in the rest state are related to the relative parameters of the blood vessel in the hyperemia state, so that the relative parameters of the blood vessel in the hyperemia state are determined according to the relative parameters of the blood vessel in the rest state, and then the blood flow of the blood vessel in the hyperemia state is determined according to the relative parameters of the blood vessel in the hyperemia state and the hyperemia CFD model.
In the scheme, the resting blood flow is determined by acquiring the image of the blood vessel in the resting state and then according to the image in the resting state; and (3) constructing a rest CFD model, constructing a congestion CFD model, and determining congestion blood flow according to the image in the rest state, the rest CFD model and the congestion CFD model. It is realized that the blood flow volume of blood can be obtained even when the image in the state of blood congestion cannot be obtained. And further determining the functional index of the blood vessel. The problem of in the prior art under the condition that can't obtain the image of blood vessel under the state of congestion, can't obtain the blood flow volume of congestion is solved.
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 an alternative embodiment of the present application, the resting blood flow may be measured directly by cardiac ultrasound (MCE) or Single Photon Emission Computed Tomography (SPECT) or Positron Emission Tomography (PET) or cardiac nuclear Magnetic Resonance (MRI) or CT perfusion.
In an embodiment of the present application, determining a resting blood flow according to the image includes: determining a three-dimensional blood vessel model according to the image; and determining the resting blood flow according to the three-dimensional blood vessel model. Namely, a three-dimensional blood vessel model is determined according to the image of the blood vessel in a resting state, and then resting blood flow is determined according to the three-dimensional blood vessel model. In particular, the resting blood flow may be determined from the rate of volume change of the three-dimensional vessel model. And dividing the volume difference of the three-dimensional blood vessel models at two adjacent moments by the time difference to obtain the resting blood flow of the blood vessel.
In an embodiment of the present application, determining a hyperemic blood flow volume according to the image in a resting state, the resting CFD model and the hyperemic CFD model includes: inputting at least the three-dimensional blood vessel model and the resting blood flow volume into the resting CFD model, and calculating to obtain resting microvascular resistance; determining hyperemia microvascular resistance based on the resting microvascular resistance; and inputting at least the hyperemic microvascular resistance into the hyperemic CFD model, and calculating to obtain the hyperemic blood flow. Namely, hyperemia microvascular resistance is determined according to resting microvascular resistance, and then the hyperemia microvascular resistance is input into a hyperemia CFD model for calculation, so that hyperemia blood flow can be obtained.
In one embodiment of the present application, the method of calculating a resting microvascular resistance by inputting at least the three-dimensional blood vessel model and the resting blood flow volume to the resting CFD model includes: obtaining at least one resting pressure value of said blood vessel; and inputting the three-dimensional blood vessel model, the resting blood flow and the resting pressure value into the resting CFD model, and calculating to obtain the resting microvascular resistance.
In one embodiment of the present application, the obtaining the hyperemic blood flow by inputting at least the hyperemic microvascular resistance into the hyperemic CFD model and calculating includes: acquiring a real pressure value of a preset congestion pressure point; setting and estimating congestion blood flow volume; inputting the three-dimensional blood vessel model, the estimated hyperemia blood flow and the hyperemia microvascular resistance into the hyperemia CFD model, and calculating to obtain a calculated pressure value of the preset hyperemia pressure point; obtaining the difference value between the real pressure value and the calculated pressure value; and adjusting the estimated hyperemia blood flow according to the difference until the difference is smaller than a preset value, and determining the current estimated hyperemia blood flow as the hyperemia blood flow. The method comprises the steps of firstly setting a predicted hyperemic blood flow volume, then inputting a three-dimensional blood vessel model, the predicted hyperemic blood flow volume and hyperemic micro-blood vessel resistance into the hyperemic CFD model, calculating to obtain a calculated pressure value of a preset hyperemic pressure point, continuously adjusting the predicted hyperemic blood flow volume according to a difference value between a real pressure value and the calculated pressure value, and regarding the predicted hyperemic blood flow volume as real hyperemic blood flow volume under the condition that the real pressure value is infinitely close to the calculated pressure value so as to realize accurate determination of the hyperemic blood flow volume.
Specifically, if the predetermined hyperemia pressure point is an aortic outlet, the real pressure value of the point can be obtained by invasive pressure or non-invasive arterial pressure calculation.
In one embodiment of the present application, determining hyperemic microvascular resistance based on the aforementioned resting microvascular resistance comprises: acquiring a total coronary artery resistance index; determining said hyperemic microvascular resistance based on said total coronary resistance index and said resting microvascular resistance. Specifically, resting microvascular resistance is multiplied by the total coronary resistance index to obtain hyperemic microvascular resistance.
In one embodiment of the present application, determining a functional indicator of the blood vessel based on at least the resting blood flow and the hyperemic blood flow comprises: determining the CFR of the blood vessel according to the resting blood flow and the hyperemic blood flow; determining a blood vessel distal pressure, a blood vessel proximal pressure and an average blood flow velocity based at least on the hyperemic blood flow volume; determining the FFR of the blood vessel according to the far-end pressure of the blood vessel and the near-end pressure of the blood vessel; determining the length of a blood vessel according to the three-dimensional blood vessel model, wherein the three-dimensional blood vessel model is determined according to the image; and determining the IMR of the blood vessel according to the far-end pressure of the blood vessel, the length of the blood vessel and the average blood flow velocity. And the determination of functional indexes CFR, FFR and IMR is realized.
Optionally, also according to the definition of IMR: IMR = Pd _ hyper/maximal hyperemic blood flow IMR can be calculated by simplifying the calculation to IMR = Pd _ hyper × Tmn if the mean transit time in the hyperemic state Tmn can be measured directly in practice. Where Pd _ hyper represents the vessel distal pressure.
The embodiment of the present application further provides a device for measuring a functional vascular indicator, and it should be noted that the device for measuring a functional vascular indicator according to the embodiment of the present application may be used to execute the method for measuring a functional vascular indicator provided in the embodiment of the present application. The following describes a device for measuring a functional indicator of blood vessels according to an embodiment of the present application.
Fig. 2 is a schematic diagram of a device for measuring a functional indicator of blood vessels according to an embodiment of the present application. As shown in fig. 2, the apparatus includes:
an acquisition unit 10 for acquiring an image of a blood vessel in a resting state;
a first determining unit 20, configured to determine a resting blood flow volume from the image, where the resting blood flow volume is a blood flow volume of the blood vessel in a resting state;
a first construction unit 30, configured to construct a resting CFD model;
a second construction unit 40 for constructing a hyperemic CFD model;
a second determining unit 50, configured to determine a hyperemic blood flow volume according to the image in a resting state, the resting CFD model and the hyperemic CFD model, where the hyperemic blood flow volume is a blood flow volume of the blood vessel in the hyperemic state;
a third determining unit 60, configured to determine a functional indicator of the blood vessel based on at least the resting blood flow and the hyperemic blood flow.
In the scheme, the acquisition unit acquires an image of a blood vessel in a resting state, and the first determination unit determines resting blood flow according to the image in the resting state; the first construction unit constructs a rest CFD model, the second construction unit constructs a congestion CFD model, and the second determination unit determines congestion blood flow according to the image in the rest state, the rest CFD model and the congestion CFD model. It is realized that the blood flow volume of blood can be obtained even when the image in the state of blood congestion cannot be obtained. And further determining the functional index of the blood vessel. The problem that the hyperemic blood flow volume cannot be obtained under the condition that the image of the blood vessel in the hyperemic state cannot be obtained in the prior art is solved.
In an embodiment of the present application, the first determining unit includes a first determining module and a second determining module, and the first determining module is configured to determine a three-dimensional blood vessel model according to the image; and the second determining module is used for determining the resting blood flow according to the three-dimensional blood vessel model. In particular, the resting blood flow may be determined from the volume change rate of the three-dimensional vessel model. And dividing the volume difference of the three-dimensional blood vessel models at two adjacent moments by the time difference to obtain the resting blood flow of the blood vessel.
In an embodiment of the present application, the second determining unit includes a first calculating module, a third determining module, and a second calculating module, where the first calculating module is configured to input at least the three-dimensional blood vessel model and the resting blood flow volume to the resting CFD model, and perform calculation to obtain resting microvascular resistance; the third determination module is used for determining hyperemia microvascular resistance according to the resting microvascular resistance; and the second calculation module is used for inputting at least the hyperemia microvascular resistance into the hyperemia CFD model and calculating to obtain the hyperemia blood flow. The hyperemic microvascular resistance is determined according to the resting microvascular resistance, and then the hyperemic microvascular resistance is input into a hyperemic CFD model for calculation, so that the hyperemic blood flow can be obtained.
In an embodiment of the present application, the first calculation module includes a first obtaining sub-module and a first calculation sub-module, and the first obtaining sub-module is configured to obtain at least one resting pressure value of the blood vessel; and the first calculation submodule is used for inputting the three-dimensional blood vessel model, the resting blood flow and the resting pressure value into the resting CFD model and calculating to obtain the resting micro-blood vessel resistance.
In an embodiment of the application, the second calculation module includes a second obtaining submodule, a setting submodule, a second calculation submodule, a third obtaining submodule, and an adjustment submodule, and the second obtaining submodule is configured to obtain a true pressure value of the predetermined hyperemia pressure point; the setting submodule is used for setting the predicted hyperemic blood flow; the second calculation submodule is used for inputting the three-dimensional blood vessel model, the estimated hyperemia blood flow and the hyperemia micro-blood vessel resistance into the hyperemia CFD model, and calculating to obtain a calculated pressure value of the preset hyperemia pressure point; the third obtaining submodule is used for obtaining a difference value between the real pressure value and the calculated pressure value; the adjusting submodule is used for adjusting the estimated hyperemic blood flow according to the difference until the difference is smaller than a preset value, and determining the current estimated hyperemic blood flow as the hyperemic blood flow. The method comprises the steps of firstly setting a predicted hyperemic blood flow volume, then inputting a three-dimensional blood vessel model, the predicted hyperemic blood flow volume and hyperemic micro-blood vessel resistance into the hyperemic CFD model, calculating to obtain a calculated pressure value of a preset hyperemic pressure point, continuously adjusting the predicted hyperemic blood flow volume according to a difference value between a real pressure value and the calculated pressure value, and regarding the predicted hyperemic blood flow volume as real hyperemic blood flow volume under the condition that the real pressure value is infinitely close to the calculated pressure value so as to realize accurate determination of the hyperemic blood flow volume.
In one embodiment of the application, the third determining module comprises a fourth obtaining submodule and a determining submodule, wherein the fourth obtaining submodule is used for obtaining the total coronary artery resistance index; the determining submodule is configured to determine the hyperemic microvascular resistance based on the total coronary resistance index and the resting microvascular resistance. Specifically, resting microvascular resistance is multiplied by the total coronary resistance index to obtain hyperemic microvascular resistance.
In an embodiment of the present application, the third determining unit includes a fourth determining module, a fifth determining module, a sixth determining module, a seventh determining module, and an eighth determining module, and the fourth determining module is configured to determine a CFR of the blood vessel according to the resting blood flow and the hyperemic blood flow; the fifth determining module is used for determining the far-end pressure of the blood vessel, the near-end pressure of the blood vessel and the average blood flow velocity according to the blood flow volume; the sixth determining module is used for determining the FFR of the blood vessel according to the far-end pressure of the blood vessel and the near-end pressure of the blood vessel; the seventh determining module is configured to determine a length of a blood vessel according to the three-dimensional blood vessel model, where the three-dimensional blood vessel model is determined according to the image; the eighth determining module is configured to determine an IMR of the blood vessel according to the blood vessel distal pressure, the length of the blood vessel, and the average blood flow velocity. And the determination of functional indexes CFR, FFR and IMR is realized.
The device for measuring the vascular functional indicator comprises a processor and a memory, wherein the acquisition unit, the first determination unit, the first construction unit, the second determination unit, the third determination 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 may be set to one or more values that allow hyperemic blood flow in the absence of an image of the hyperemic state by adjusting kernel parameters.
The memory may include 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), including 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 where the computer-readable storage medium is located is controlled to execute the method for measuring a vascular functional indicator.
An embodiment of the present invention provides a processor, where the processor is configured to execute a program, where the program executes the method for measuring a vascular functional indicator during execution.
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, obtaining an image of a blood vessel in a resting state;
step S102, determining a resting blood flow volume according to the image, wherein the resting blood flow volume is the blood flow volume of the blood vessel in a resting state;
step S103, constructing a resting CFD model;
step S104, constructing a congestion CFD model;
step S105, determining a hyperemic blood flow volume according to the image in a resting state, the resting CFD model and the hyperemic CFD model, wherein the hyperemic blood flow volume is the blood flow volume of the blood vessel in the hyperemic state;
and step S106, determining the functional index of the blood vessel according to at least the resting blood flow and the hyperemic blood flow.
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, obtaining an image of a blood vessel in a resting state;
step S102, determining a resting blood flow volume according to the image, wherein the resting blood flow volume is the blood flow volume of the blood vessel in a resting state;
step S103, constructing a resting CFD model;
step S104, constructing a congestion CFD model;
step S105, determining a hyperemic blood flow volume according to the image in a resting state, the resting CFD model and the hyperemic CFD model, wherein the hyperemic blood flow volume is the blood flow volume of the blood vessel in the hyperemic state;
and step S106, determining the functional index of the blood vessel according to at least the resting blood flow and the hyperemic blood flow.
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 flowchart illustrations and/or block diagrams, and combinations of flows and/or blocks in the flowchart illustrations 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 permanent and non-permanent, removable and non-removable media, may implement the 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 phrases "comprising one of 8230; \8230;" 8230; "does not exclude the presence of additional like elements in a process, method, article, or apparatus that comprises the element.
Example 1
The present embodiment relates to a specific method for determining a functional index of a blood vessel, as shown in fig. 5, including the following steps:
step 1: obtaining 2D DSA images (as shown in figure 3) of the blood vessel in a resting state, and constructing a three-dimensional blood vessel model by adopting the 2D DSA images at different angles;
specifically, preprocessing a 2D DSA image under multiple angles, extracting a central line, segmenting blood vessels and extracting a blood vessel outline to obtain a 2D target blood vessel, constructing a three-dimensional blood vessel model by adopting a plurality of 2D target blood vessels, and constructing the three-dimensional blood vessel model by applying an antipodal geometric principle; preprocessing a 2D DSA image by adopting a neural network algorithm, extracting a blood vessel central line by adopting a fast marching algorithm, segmenting a blood vessel by adopting a level set algorithm, and extracting a blood vessel contour by adopting OpenCV;
and 2, step: calculating resting blood flow;
for the sequentially transformed contrast images, the resting blood flow can be calculated from the volume change of the blood vessel over a certain time. For the single vessel model, resting blood flow is the rate of change of vessel volume over an interval: q = V (volume)/t (time difference); for multiple blood vessel models, the total blood flow can also be obtained according to the total volume change in a given time, and the flow of each sub-blood vessel can be obtained according to the blood flow distribution model as follows:
Figure BDA0003189796690000101
the obtained value is Qi, Q and r are the blood flow of a certain blood vessel, the equivalent radius of the blood vessel and the flow distribution coefficient, and the obtained value can also be obtained according to the change of the volume of the blood vessel in a given time.
And step 3: constructing a resting CFD model;
and taking the three-dimensional blood vessel model as a calculation domain, and taking the outlet, the inlet and the blood vessel wall of the blood vessel as boundaries. The three-dimensional vessel model may be the entire coronary system including the ascending aorta as shown in fig. 6, may be a certain coronary tree (e.g., LCA or RCA), or may be a certain one or several of the coronary vessels. The boundary conditions in the resting state are: the boundary condition of the blood vessel wall is a non-sliding wall surface, the outlet or the inlet of the blood vessel adopts a flow/flow velocity boundary, and the rest outlets or inlets are pressure boundaries. The model simulates blood flow to incompressible fluid through a three-dimensional vessel at a given flow rate. The resting CFD model solves parameters such as full-basin pressure, velocity field and the like of the blood vessel model individualized by the testee under the boundary condition individualized by the testee, and calibrates the pressure value of the incompressible fluid in the whole basin through the pressure value of the known pressure point, so as to obtain the full-basin resting pressure (shown as 203 in figure 3 and 302 in figure 4) and velocity.
And 4, step 4: calculating the resistance of the static micro blood vessels;
and (4) obtaining the average resting pressure Pd _ rest at the outlet of each blood vessel according to the full-flow-field resting pressure obtained in the step (3). Calculating the microvascular resistance corresponding to the blood vessel according to Pd _ rest and the resting blood flow Qrest of the blood vessel:
Figure BDA0003189796690000111
and 5: calculating hyperemia microvascular resistance;
and (4) predicting the hyperemia microvascular resistance according to the resting microvascular resistance, an empirical formula, a model and the like. The predictive model may be a heart rate, systolic pressure based model, such as:
rAPV＝0.0009·SBP·HR+5.925
CFVR＝10 a-b·log(rAPV)-c·d
Figure BDA0003189796690000112
where rAPV is the resting mean peak velocity, CFVR is the branch vessel resistance index, TCRI is the total coronary resistance index, a, b, c are the given parameters (LAD: 1.16, 0.48, 0.0025 lcx 1.14, 0.45, 0.0031 rca. A simpler and more reliable TCRI model can also be used:
Figure BDA0003189796690000113
hyperemic microvascular resistance R _ hyper can then be calculated as: r _ hyper = R _ rest × TCRI. R _ rest represents the resting microvascular resistance. Of course, in practical applications, the hyperemic microcirculation resistance can also be predicted by other models or empirical formulas.
Step 6: constructing a congestion CFD model;
and (3) solving the three-dimensional blood vessel calculation domain by the hyperemia CFD, and inputting boundary conditions into a model of hyperemia microvascular resistance. The exit boundary types may be the same or different drag models including the binary Windkessel model shown in fig. 6. The blood vessel inlet boundary is assumed to be a flow/flow rate boundary condition, in the calculation of the hyperemia CFD model, after each calculation is converged, the calculated pressure of the known hyperemia pressure point is compared with the actually measured pressure value, and the inlet flow/flow rate value is adjusted according to the difference until the calculated pressure is equal to the actually measured value. At this time, parameters such as full field pressure, speed, etc. are obtained as the hyperemia parameters. The hyperemic pressures are shown at 204 in fig. 3 and at 303 in fig. 4.
For a given point in the blood vessel where a resting pressure and a hyperemic pressure need to be measured, feature points can be selected, such as choosing the aortic outlet pressure, where p _ rest is the mean arterial pressure at rest and p _ hyper is the mean arterial pressure at hyperemic. In this case, the pressure can be estimated by the heart rate, the systolic pressure and the diastolic pressure in a non-invasive manner, as shown below:
Figure BDA0003189796690000121
wherein HR, SBP and DBP represent the heart rate, systolic blood pressure, diastolic blood pressure of the patient, respectively.
And 7: calculating functional indexes of coronary vessels;
the distal blood vessel pressure (Pd _ hyper), proximal blood vessel pressure (Pa _ hyper), mean blood flow velocity (U _ hyper), and hyperemic blood flow (Q _ hyper) are extracted using the known hyperemic intravascular global pressure, velocity field. The vessel length (L) is obtained from the three-dimensional vessel model. Vascular functional indices were calculated in conjunction with known resting blood flow (Q _ rest), as:
Figure BDA0003189796690000122
Figure BDA0003189796690000123
Figure BDA0003189796690000124
example 2
The embodiment relates to a specific method for determining functional indexes of blood vessels, which comprises the following steps:
step 1: acquiring a 3D CTA image (as shown in FIG. 4) of a blood vessel in a resting state, and segmenting the 3D CTA image by combining a threshold method and a level set segmentation method to obtain a three-dimensional blood vessel model;
steps 2 to 7 in example 2 are the same as in example 1.
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 measuring the vascular functional index comprises the steps of obtaining an image of a blood vessel in a resting state, and then determining resting blood flow according to the image in the resting state; and (3) constructing a rest CFD model, constructing a congestion CFD model, and determining congestion blood flow according to the image in the rest state, the rest CFD model and the congestion CFD model. It is realized that the blood flow volume of blood can be obtained even when the image in the state of blood congestion cannot be obtained. And further determining the functional index of the blood vessel. The problem that the hyperemic blood flow volume cannot be obtained under the condition that the image of the blood vessel in the hyperemic state cannot be obtained in the prior art is solved.
2) The device for measuring the functional index of the blood vessel comprises an acquisition unit, a first determination unit and a second determination unit, wherein the acquisition unit acquires an image of the blood vessel in a resting state, and the first determination unit determines resting blood flow according to the image in the resting state; the first construction unit constructs a rest CFD model, the second construction unit constructs a congestion CFD model, and the second determination unit determines the congestion blood flow according to the image in the rest state, the rest CFD model and the congestion CFD model. It is realized that the blood flow volume of blood can be obtained even when the image in the state of blood congestion cannot be obtained. And further determining the functional index of the blood vessel. The problem that the hyperemic blood flow volume cannot be obtained under the condition that the image of the blood vessel in the hyperemic state cannot be obtained in the prior art is solved.
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 (8)

1. A device for measuring a functional indicator of a blood vessel, comprising:
the acquisition unit is used for acquiring the image of the blood vessel in a resting state;
a first determining unit, configured to determine a resting blood flow volume according to the image, where the resting blood flow volume is a blood flow volume of the blood vessel in a resting state;
the first construction unit is used for constructing a resting CFD model;
a second construction unit for constructing a congestion CFD model;
a second determining unit, configured to determine hyperemic blood flow according to the image in a resting state, the resting CFD model, and the hyperemic CFD model, where the hyperemic blood flow is blood flow of the blood vessel in a hyperemic state;
a third determination unit, configured to determine a functional indicator of the blood vessel based on at least the resting blood flow and the hyperemic blood flow;
the second determination unit comprises a second calculation module, and the second calculation module is used for inputting at least hyperemic microvascular resistance into the hyperemic CFD model and calculating to obtain the hyperemic blood flow;
the second calculation module includes:
the second acquisition submodule is used for acquiring a real pressure value of the preset hyperemia pressure point;
a setting submodule for setting the estimated hyperemic blood flow;
the second calculation submodule is used for inputting the three-dimensional blood vessel model, the estimated hyperemia blood flow and the hyperemia micro-blood vessel resistance into the hyperemia CFD model, and calculating to obtain a calculated pressure value of the preset hyperemia pressure point;
a third obtaining submodule, configured to obtain a difference between the actual pressure value and the calculated pressure value;
and the adjusting submodule is used for adjusting the estimated hyperemic blood flow according to the difference until the difference is smaller than a preset value, and determining the current estimated hyperemic blood flow as the hyperemic blood flow.
2. The apparatus according to claim 1, wherein the first determining unit comprises:
the first determining module is used for determining a three-dimensional blood vessel model according to the image;
and the second determining module is used for determining the resting blood flow according to the three-dimensional blood vessel model.
3. The apparatus according to claim 2, wherein the second determining unit comprises:
the first calculation module is used for inputting at least the three-dimensional blood vessel model and the resting blood flow volume into the resting CFD model for calculation to obtain resting micro-vascular resistance;
and the third determination module is used for determining hyperemia microvascular resistance according to the resting microvascular resistance.
4. The apparatus of claim 3, wherein the first computing module comprises:
a first obtaining submodule for obtaining at least one resting pressure value of the blood vessel;
and the first calculation submodule is used for inputting the three-dimensional blood vessel model, the resting blood flow and the resting pressure value into the resting CFD model for calculation to obtain the resting micro-vascular resistance.
5. The apparatus of claim 3, wherein the third determining module comprises:
a fourth obtaining submodule, configured to obtain a total coronary resistance index;
a determination sub-module for determining the hyperemic microvascular resistance based on the total coronary resistance index and the resting microvascular resistance.
6. The apparatus according to any one of claims 2 to 5, characterized in that the third determination unit comprises:
a fourth determining module for determining the CFR of the blood vessel according to the resting blood flow and the hyperemic blood flow;
a fifth determining module for determining a blood vessel distal pressure, a blood vessel proximal pressure and an average blood flow velocity based on at least the hyperemic blood flow volume;
a sixth determining module, configured to determine an FFR of the blood vessel according to the blood vessel distal pressure and the blood vessel proximal pressure;
a seventh determining module, configured to determine a length of a blood vessel according to the three-dimensional blood vessel model, where the three-dimensional blood vessel model is determined according to the image;
an eighth determining module, configured to determine an IMR of the blood vessel according to the blood vessel distal pressure, the length of the blood vessel, and the average blood flow velocity.
7. A computer-readable storage medium, comprising a stored program, wherein the program when executed controls the apparatus of any one of claims 1 to 6 in which the computer-readable storage medium is located to perform a method of measuring a vascular functional metric.
8. A processor for executing a program, wherein the program is executed to cause the apparatus according to any one of claims 1 to 6 to perform a method of measuring a vascular functionality indicator.
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