CN116344059A - Method and device for determining coronary artery functional parameters, electronic equipment and storage medium - Google Patents
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Abstract
The application provides a method and a device for determining coronary artery functional parameters, electronic equipment and a storage medium, wherein the method for determining coronary artery functional parameters comprises the following steps: acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient; determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient; acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient; determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; and inputting the coronary three-dimensional model and the boundary condition of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel. By adopting the technical scheme provided by the application, the accuracy of determining the coronary artery functional parameters can be improved.
Description
Technical Field
The present disclosure relates to the field of medical technologies, and in particular, to a method and apparatus for determining coronary artery functional parameters, an electronic device, and a storage medium.
Background
Coronary angiography is an invasive examination for diagnosing heart coronary arteries, and can determine the stenosis part, the stenosis length, the stenosis degree, whether occlusion, thrombus and other problems of the coronary arteries under dynamic conditions, and is an important step of coronary intervention.
At present, the method for determining the functional parameters of the coronary artery is mainly limited to calculating the single blood vessel, but because the coronary artery is provided with branches, and the branches of the blood vessel can separate part of fluid in the blood flow, a large number of assumptions can be introduced by adopting the method for calculating the single blood vessel, which can directly lead to inaccurate functional parameters of the obtained coronary artery and influence the evaluation of postoperative effects; therefore, how to determine coronary functional parameters becomes a urgent problem to be solved.
Disclosure of Invention
In view of this, an object of the present application is to provide a method, an apparatus, an electronic device, and a storage medium for coronary artery functional parameters, which can obtain coronary artery functional parameters of each blood vessel by establishing a three-dimensional model of a plurality of blood vessels, and inputting the three-dimensional model and determined boundary conditions into a hemodynamic simulation model, thereby improving accuracy of determining the coronary artery functional parameters.
The application mainly comprises the following aspects:
in a first aspect, an embodiment of the present application provides a method for determining a coronary artery functional parameter, where the determining method includes:
acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient;
acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient;
determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition;
Inputting the coronary three-dimensional model and boundary conditions of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Further, the step of determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient includes:
determining the length and time of the central line of the blood vessel reached by the contrast agent in the coronary angiography image in the central line of each blood vessel in the coronary three-dimensional model based on the central line of each blood vessel in the coronary three-dimensional model of the target patient;
for each blood vessel, determining the quotient of the central line length and the time of the blood vessel as the flow rate of the blood vessel;
and performing congestion correction on the flow velocity of each blood vessel to obtain the blood vessel flow velocity of each blood vessel in the coronary three-dimensional model.
Further, the step of obtaining a coronary angiography image of the target patient and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient includes:
acquiring a coronary angiography image of a target patient, and extracting a lumen from the coronary angiography image through filtering or deep neural network processing to obtain a vascular lumen of each blood vessel;
Processing the vessel lumen of each vessel through Gaussian difference or deep neural network to obtain the contour and the central line of each vessel;
and carrying out three-dimensional reconstruction on each blood vessel through the contour and the central line of each blood vessel to obtain the coronary three-dimensional model of the target patient.
Further, the hemodynamic simulation model comprises any one model of a reduced order model and a full order model.
Further, the determining method further includes:
determining coronary artery functional parameters obtained before coronary artery operation of the target patient as preoperative parameters;
determining coronary artery functional parameters obtained after coronary artery surgery is performed on the target patient as postoperative parameters;
determining a blood vessel corresponding to the preoperative parameter indicating abnormality as a target blood vessel, and determining whether the postoperative parameter of the target blood vessel is indicated to be normal or not in the postoperative parameters;
if the coronary artery operation effect of the target patient is abnormal, determining that the coronary artery operation effect of the target patient is failed;
if indicated as normal, the effect of the coronary surgery on the target patient is determined to be successful.
Further, an inlet flow boundary condition for a plurality of vessels in the three-dimensional model of coronary artery is determined by:
Obtaining the average area of each blood vessel from the coronary three-dimensional model of the target patient;
determining, for each blood vessel, a product of a blood vessel flow rate of the blood vessel and an average area of the blood vessel as a flow rate of the blood vessel;
and determining the inlet flow obtained by adding the flow of each blood vessel as an inlet flow boundary condition for a plurality of blood vessels in the coronary three-dimensional model.
Further, an outlet resistance boundary condition for a plurality of vessels in the three-dimensional model of coronary artery is determined by:
determining the quotient of the aortic pressure and the inlet flow as the total resistance of a plurality of blood vessels in the coronary three-dimensional model;
and distributing the total resistance by adopting a Mueller shunt law of the area of the blood vessel to obtain the outlet resistance of each blood vessel, and determining the outlet resistance of each blood vessel as an outlet resistance boundary condition aiming at a plurality of blood vessels in the coronary three-dimensional model.
In a second aspect, embodiments of the present application further provide a device for determining a coronary artery functional parameter, where the determining device includes:
the first processing module is used for acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
A second processing module for determining a vessel flow rate of each vessel in the three-dimensional coronary model based on the three-dimensional coronary model of the target patient;
the third processing module is used for acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient;
a fourth processing model for determining boundary conditions for a plurality of vessels in the coronary three-dimensional model based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition;
the determining module is used for inputting the coronary three-dimensional model and the boundary condition of the target patient into the hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
In a third aspect, embodiments of the present application further provide an electronic device, including: a processor, a memory and a bus, said memory storing machine-readable instructions executable by said processor, said processor and said memory communicating over the bus when the electronic device is running, said machine-readable instructions when executed by said processor performing the steps of the method of determining coronary functional parameters as described above.
In a fourth aspect, embodiments of the present application also provide a computer readable storage medium having stored thereon a computer program which, when executed by a processor, performs the steps of a method of determining coronary functioning parameters as described above.
The embodiment of the application provides a method, a device, electronic equipment and a storage medium for determining coronary artery functional parameters, wherein the method for determining the coronary artery functional parameters comprises the following steps: acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient; determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient; acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient; determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition; inputting the coronary three-dimensional model and boundary conditions of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Therefore, by means of the technical scheme, the three-dimensional model of the plurality of blood vessels can be built, the three-dimensional model and the determined boundary conditions are input into the hemodynamic simulation model, coronary artery functional parameters of each blood vessel are obtained, and accuracy of determining the coronary artery functional parameters is improved.
In order to make the above objects, features and advantages of the present application more comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments will be briefly described below, it being understood that the following drawings only illustrate some embodiments of the present application and therefore should not be considered limiting the scope, and that other related drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a flow chart of a method for determining coronary functional parameters according to an embodiment of the present application;
FIG. 2 is a flow chart illustrating another method for determining coronary functional parameters provided by embodiments of the present application;
FIG. 3 shows one of the block diagrams of a device for determining coronary functional parameters according to an embodiment of the present application;
FIG. 4 is a diagram showing a second embodiment of a device for determining coronary artery functional parameters;
fig. 5 shows a schematic structural diagram of an electronic device according to an embodiment of the present application.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present application more clear, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it should be understood that the accompanying drawings in the present application are only for the purpose of illustration and description, and are not intended to limit the protection scope of the present application. In addition, it should be understood that the schematic drawings are not drawn to scale. A flowchart, as used in this application, illustrates operations implemented according to some embodiments of the present application. It should be appreciated that the operations of the flow diagrams may be implemented out of order and that steps without logical context may be performed in reverse order or concurrently. Moreover, one or more other operations may be added to the flow diagrams and one or more operations may be removed from the flow diagrams as directed by those skilled in the art.
In addition, the described embodiments are only some, but not all, of the embodiments of the present application. The components of the embodiments of the present application, which are generally described and illustrated in the figures herein, may be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the present application, as provided in the accompanying drawings, is not intended to limit the scope of the application, as claimed, but is merely representative of selected embodiments of the application. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present application without making any inventive effort, are intended to be within the scope of the present application.
In order to enable one skilled in the art to use the present disclosure, the following embodiments are provided in connection with a particular application scenario "determination of coronary functional parameters", and it will be apparent to one skilled in the art that the general principles defined herein may be applied to other embodiments and application scenarios without departing from the spirit and scope of the present disclosure.
The method, apparatus, electronic device or computer readable storage medium described below in the embodiments of the present application may be applied to any scenario in which a coronary artery functional parameter needs to be determined, and the embodiments of the present application are not limited to specific application scenarios, and any scheme using the method, apparatus, electronic device and storage medium for determining a coronary artery functional parameter provided in the embodiments of the present application is within the scope of protection of the present application.
It is noted that coronary angiography is an invasive examination for diagnosing cardiac coronary arteries, and can determine the stenosis and the stenosis length, the stenosis degree, whether there are occlusion and thrombus, etc. of the coronary arteries under dynamic conditions, and is an important step of coronary intervention.
At present, the method for determining the functional parameters of the coronary artery is mainly limited to calculating the single blood vessel, but because the coronary artery is provided with branches, and the branches of the blood vessel can separate part of fluid in the blood flow, a large number of assumptions can be introduced by adopting the method for calculating the single blood vessel, which can directly lead to inaccurate functional parameters of the obtained coronary artery and influence the evaluation of postoperative effects; therefore, how to determine coronary functional parameters becomes a urgent problem to be solved.
Based on the above, the application provides a method, a device, an electronic device and a storage medium for determining coronary artery functional parameters, wherein the method for determining coronary artery functional parameters comprises the following steps: acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient; determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient; acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient; determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition; inputting the coronary three-dimensional model and boundary conditions of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Therefore, by means of the technical scheme, the three-dimensional model of the plurality of blood vessels can be built, the three-dimensional model and the determined boundary conditions are input into the hemodynamic simulation model, coronary artery functional parameters of each blood vessel are obtained, and accuracy of determining the coronary artery functional parameters is improved.
In order to facilitate understanding of the present application, the technical solutions provided in the present application will be described in detail below with reference to specific embodiments.
Referring to fig. 1, fig. 1 is a flowchart of a method for determining coronary artery functional parameters according to an embodiment of the present application, as shown in fig. 1, the method includes:
s101, acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
the method for obtaining the coronary angiography image of the target patient and performing data processing on the coronary angiography image to obtain the coronary three-dimensional model of the target patient comprises the following steps:
s1011, acquiring a coronary angiography image of a target patient, and extracting a lumen from the coronary angiography image through filtering or deep neural network processing to obtain a vascular lumen of each blood vessel;
S1012, processing the vessel lumen of each vessel through a Gaussian difference or deep neural network to obtain the outline and the central line of each vessel;
s1013, carrying out three-dimensional reconstruction on each blood vessel through the outline and the central line of each blood vessel to obtain a coronary three-dimensional model of the target patient.
In step S1011 to step S1013, based on the imaging examination, i.e. coronary angiography, acquiring data of a coronary angiography image to be processed, based on the data of the coronary angiography image to be processed, lumen extraction may be performed through franki filtering or deep neural network, a contour of a blood vessel may be obtained by producing the contour of the blood vessel through gaussian difference or deep neural network, a center line may be obtained, and finally three-dimensional reconstruction of a plurality of blood vessels may be performed through three-dimensional spatial geometrical relations of the blood vessel and corresponding branches; here, the coronary angiography to be processed comprises at least two images, which may be angled more than 25 °.
S102, determining the blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient;
in the step, based on coronary angiography, according to filling and required time of a coronary angiography agent in a blood vessel, combining the coronary three-dimensional model of the blood vessel reconstruction, calculating the specific blood vessel flow rate of a coronary inlet patient by adopting methods including but not limited to TIMI number frames, contrast agent, peak arrival time and the like, and adopting a congestion correction formula to correct the calculated congestion; here, specificity refers to the adoption of different boundary conditions according to different patients.
It should be noted that, referring to fig. 2, fig. 2 is a flowchart of another method for determining coronary artery functional parameters according to an embodiment of the present application, as shown in fig. 2, the step of determining a blood vessel flow rate of each blood vessel in the coronary artery three-dimensional model based on the coronary artery three-dimensional model of the target patient includes:
s201, determining the central line length and time of a blood vessel reached by a contrast agent in a coronary angiography image in the central line of each blood vessel in the coronary three-dimensional model based on the central line of each blood vessel in the coronary three-dimensional model of the target patient;
s202, determining the quotient of the central line length and the time of each blood vessel as the flow velocity of the blood vessel;
and S203, performing congestion correction on the flow velocity of each blood vessel to obtain the blood vessel flow velocity of each blood vessel in the coronary three-dimensional model.
In steps S201 to S203, the flow velocity of the blood vessel is specifically calculated by combining the calculated length of the central line of the blood vessel with the calculated length of the central line of the blood vessel and using the length L/t of the central line of the blood vessel where the contrast agent arrives, and performing congestion correction on the flow velocity of each branch by using a congestion correction formula, so as to obtain a flow velocity after congestion correction, namely, a blood vessel flow velocity of each blood vessel in the coronary three-dimensional model.
S103, acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient;
in the step, based on invasive pressure measurement consumable materials, specific pressure of a patient is measured, and the specific aortic pressure Pa of the patient is obtained through calculation; here, the invasive pressure measurement consumable typically comprises a catheter inserted through a blood vessel into the vascular system of the patient and a sensor located inside the catheter, which can measure the pressure of the blood flowing through the catheter.
As an example, a patient needs to be placed in an operating room or other suitable environment and receive a placement procedure of an invasive pressure measurement consumable, insert a catheter into an artery of the patient, typically the femoral or radial artery, confirm if the catheter is positioned correctly, if the catheter is positioned incorrectly, it is necessary to reposition the catheter, connect a pressure sensor to the end of the catheter and connect the sensor to a data collector, record the arterial pressure of the patient by the data collector, and import the data into a computer, process and analyze the data using computer software, including determining the highest and lowest pressures, and calculate an average arterial pressure, calculate patient-specific aortic pressure Pa using formulas from patient-specific data, such as height, weight, gender and age.
S104, determining boundary conditions for a plurality of blood vessels in the coronary three-dimensional model based on the blood vessel flow rate and the aortic pressure of each blood vessel;
in this step, unlike conventional single vessel, multiple vessel simulation calculations require accurate assessment of patient-specific boundary conditions, including inlet flow boundary conditions and outlet resistance boundary conditions.
It should be noted that, the inlet flow boundary conditions for a plurality of blood vessels in the coronary three-dimensional model are determined by:
s10411, obtaining the average area of each blood vessel from the coronary three-dimensional model of the target patient;
s10412, determining the product of the blood vessel flow rate of each blood vessel and the average area of the blood vessel as the flow of the blood vessel;
s10413, determining the inlet flow obtained by adding the flow of each blood vessel as the inlet flow boundary condition for a plurality of blood vessels in the coronary three-dimensional model.
In steps S10411 to S10413, the mean area S of the main and each branch of the coronary artery is obtained from the three-dimensional model of the coronary artery i Blood vessel flow velocity v after hyperemia correction through coronary main and each branch i And an average area S i Calculate the flow rate Q of each branch i ＝v i *S i Inlet flow Q a For the sum of the individual branch flows, i.e.
Wherein n is the number of coronary outlets.
It should be noted that, the outlet resistance boundary conditions for a plurality of blood vessels in the coronary three-dimensional model are determined by:
s10421, determining the quotient of the aortic pressure and the inlet flow as the total resistance of a plurality of blood vessels in the coronary three-dimensional model;
s10422, distributing the total resistance by using a Muller shunt law of the area of the blood vessels to obtain the outlet resistance of each blood vessel, and determining the outlet resistance of each blood vessel as an outlet resistance boundary condition aiming at a plurality of blood vessels in the coronary three-dimensional model.
In steps S10421 to S10422, the total resistance is calculated using the inlet flow and the patient-specific aortic pressure Pa
The outlet resistance distribution adopts a Mueller split law based on the area of blood vessels, the average diameter of the outlet is obtained according to the sectional area of the outlet, and then the total resistance is distributed according to a mass conservation law, wherein the specific formula is as follows:
wherein alpha is a flow distribution index (the value range can be 1.5<α<3.5 For example, 2.6, d i The mean radius of the blood vessel section of the ith coronary artery outlet is n, the number of the coronary artery outlets is R i Is the resistance of the ith coronary outlet.
S105, inputting the coronary three-dimensional model and the boundary condition of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel.
In the step, a hemodynamic simulation model for simulating coronary blood flow is constructed by adopting a numerical calculation method based on a hydrodynamic theory, wherein the hemodynamic simulation model comprises any one model of a reduced-order model and a full-order model, and coronary functional parameters comprise fractional flow reserve and microcirculation resistance indexes.
When the hemodynamic simulation model is a reduced order model, coronary artery functional parameters of each blood vessel are obtained through the following steps:
1) And establishing a 0-dimensional model by adopting a machine learning theory based on the geometric characteristics and boundary conditions of each blood vessel in the coronary three-dimensional model of the target patient to obtain coronary functional parameters of each blood vessel.
Here, the reduced order model based on the hydrodynamic theory comprises a 0-dimensional model established based on the vascular geometric characteristics and boundary conditions, and the simulation result can be obtained rapidly and accurately by adopting the machine learning theory.
When the hemodynamic simulation model is a full-order model, coronary artery functional parameters of each blood vessel are obtained through the following steps:
1) Generating unstructured grids by adopting any one of a Cartesian grid, a quadtree grid and an octree grid to the coronary artery three-dimensional model to obtain a target coronary artery three-dimensional model;
2) And taking boundary conditions of each blood vessel in the target coronary artery three-dimensional model into a fluid control equation by adopting a finite element or finite volume method to solve, so as to obtain coronary artery functional parameters of the blood vessel.
In the above steps 1) to 2), the full-order model based on the hydrodynamic theory is a three-dimensional calculation model established based on the finite element method or the finite volume method by inputting the coronary three-dimensional model and the obtained boundary conditions. Specifically, the input coronary three-dimensional model is generated into unstructured grids by adopting a Cartesian grid or a quadtree-based octree grid generation method, and a fluid control equation is solved by adopting a finite element or finite volume method, wherein the specific formula is as follows:
where u is velocity, t is time, p is pressure, ρ is density, μ is dynamic viscosity, and the method is relatively more accurate, and can also yield more abundant hydrodynamic parameters such as wall shear force (WSS) and plaque stress (APS).
Here, the full-order model is solved by discretizing the control equation in time and space, where the spatial discretization is gridding and the temporal discretization is an iterative solution.
In step S105, the coronary pressure P and the microcirculation resistance index (Index of Microcirculatory Resistance) IMR on the coronary multiple branch vessels of the patient can be obtained by adopting the reduced order model or the full order model based on the hydrodynamics theory, and the ratio of the coronary pressure P to the aortic pressure Pa
Calculating Fractional Flow Reserve (FFR) of corresponding coronary artery and branches thereof, wherein the FFR value is generally considered to be less than 0.8 as an abnormal FFR value, and particularly, a more suitable FFR value point can be selected according to clinical experience of doctors for evaluating coronary artery functional indexes of the patient; in addition, IMR was used to detect microcirculation dysfunction, and clinical studies suggest that IMR is normal<25，IMR>The incidence of 40 clinical practices is more pronounced and can be determined by the formula imr=p t ×T mn Determining and evaluating the microcirculation resistance index IMR of each coronary branch vessel, wherein P t The coronary end pressure in the hyperemic state is the component of the obtained coronary pressure P, T mn Is the blood flow transit time.
It should be noted that, the determining method further includes:
1. Determining coronary artery functional parameters obtained before coronary artery operation of the target patient as preoperative parameters;
2. determining coronary artery functional parameters obtained after coronary artery surgery is performed on the target patient as postoperative parameters;
3. determining a blood vessel corresponding to the preoperative parameter indicating abnormality as a target blood vessel, and determining whether the postoperative parameter of the target blood vessel is indicated to be normal or not in the postoperative parameters;
4. if the coronary artery operation effect of the target patient is abnormal, determining that the coronary artery operation effect of the target patient is failed;
5. if indicated as normal, the effect of the coronary surgery on the target patient is determined to be successful.
In the step, the operation planning is given by combining the functional parameters such as FFR, IMR and the like obtained in the step with the geometric parameters of the blood vessel of the coronary artery three-dimensional model, the operation planning comprises the steps of calculating the stenosis rate according to the geometric characteristics of the blood vessel, giving a stent size suggestion adapted to a corresponding stenosis area according to the stenosis rate, carrying out post-operation blood vessel prediction and virtual blood vessel three-dimensional model reconstruction reduction according to corresponding stent size information, and carrying out functional evaluation on the virtual stent operation by adopting the constructed numerical calculation model of the coronary artery blood flow according to the reconstructed coronary artery three-dimensional model result.
Here, after the coronary operation is performed, usually, an experienced doctor performs artificial post-operation judgment according to functional parameters of the coronary artery, and the artificial mode is not only low in efficiency, but also easy to misjudge, so that the embodiment can perform three-dimensional reconstruction on a plurality of coronary vessels of a patient after the operation according to the postoperative coronary angiography image, and perform immediate evaluation on the postoperative coronary artery functionality by adopting the constructed hemodynamic simulation model of the coronary blood flow by adopting the functional evaluation method, so that quantitative analysis on the operation effect is achieved.
In summary, the flow condition of blood flow in the coronary artery can be considered more accurately, and compared with the existing technology for mostly calculating only a single coronary artery, the method and the device consider branches of the coronary artery, simplify calculation of flow divided by the branches, and evaluate the flow of the coronary artery fluid more accurately; the patient-specific aortic pressure and vascular flow are calculated through invasive pressure measurement and radiography in a number of frames, accurate evaluation can be carried out on patient-specific coronary artery multiple vascular functions, and corresponding preoperative operation planning and immediate evaluation of postoperative operation effects can be provided, so that a doctor is assisted in stent type selection, operation scheme formulation, medication and the like, and the working efficiency of the doctor is improved.
The embodiment of the application provides a method for determining coronary artery functional parameters, which comprises the following steps: acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient; determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient; acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient; determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition; inputting the coronary three-dimensional model and boundary conditions of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Therefore, by means of the technical scheme, the three-dimensional model of the plurality of blood vessels can be built, the three-dimensional model and the determined boundary conditions are input into the hemodynamic simulation model, coronary artery functional parameters of each blood vessel are obtained, and accuracy of determining the coronary artery functional parameters is improved.
Based on the same application conception, the embodiment of the application further provides a device for determining coronary artery functional parameters, which corresponds to the method for determining coronary artery functional parameters in the embodiment, and because the principle of solving the problem by the device in the embodiment of the application is similar to that of determining coronary artery functional parameters in the embodiment of the application, the implementation of the device can refer to the implementation of the method, and the repetition is omitted.
Referring to fig. 3 and 4, fig. 3 is a first structural diagram of a device for determining coronary artery functional parameters according to an embodiment of the present application, and fig. 4 is a second structural diagram of a device for determining coronary artery functional parameters according to an embodiment of the present application. As shown in fig. 3, the determining means 310 includes:
the first processing module 311 is configured to obtain a coronary angiography image of a target patient, and perform data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
a second processing module 312 for determining a vessel flow rate for each vessel in the three-dimensional coronary model based on the three-dimensional coronary model of the target patient;
a third processing module 313, configured to obtain a blood vessel pressure of the target patient, and perform corresponding processing on the blood vessel pressure to obtain an aortic pressure of the target patient;
A fourth process model 314 for determining boundary conditions for a plurality of vessels in the coronary three-dimensional model based on the vessel flow rate and the aortic pressure for each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition;
a determining module 315, configured to input the three-dimensional coronary model and the boundary condition of the target patient into a hemodynamic simulation model, so as to obtain coronary artery functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Optionally, the second processing module 312 is specifically configured to:
determining the length and time of the central line of the blood vessel reached by the contrast agent in the coronary angiography image in the central line of each blood vessel in the coronary three-dimensional model based on the central line of each blood vessel in the coronary three-dimensional model of the target patient;
for each blood vessel, determining the quotient of the central line length and the time of the blood vessel as the flow rate of the blood vessel;
and performing congestion correction on the flow velocity of each blood vessel to obtain the blood vessel flow velocity of each blood vessel in the coronary three-dimensional model.
Optionally, the first processing module 311 is specifically configured to:
Acquiring a coronary angiography image of a target patient, and extracting a lumen from the coronary angiography image through filtering or deep neural network processing to obtain a vascular lumen of each blood vessel;
processing the vessel lumen of each vessel through Gaussian difference or deep neural network to obtain the contour and the central line of each vessel;
and carrying out three-dimensional reconstruction on each blood vessel through the contour and the central line of each blood vessel to obtain the coronary three-dimensional model of the target patient.
Optionally, the hemodynamic simulation model includes any one of a reduced order model and a full order model.
Optionally, as shown in fig. 4, the determining apparatus 310 further includes an application module 316, where the application module 316 is configured to:
determining coronary artery functional parameters obtained before coronary artery operation of the target patient as preoperative parameters;
determining coronary artery functional parameters obtained after coronary artery surgery is performed on the target patient as postoperative parameters;
determining a blood vessel corresponding to the preoperative parameter indicating abnormality as a target blood vessel, and determining whether the postoperative parameter of the target blood vessel is indicated to be normal or not in the postoperative parameters;
if the coronary artery operation effect of the target patient is abnormal, determining that the coronary artery operation effect of the target patient is failed;
If indicated as normal, the effect of the coronary surgery on the target patient is determined to be successful.
Optionally, when the fourth processing model 314 is used to determine the boundary conditions of the inlet flow for the plurality of vessels in the three-dimensional coronary model, the fourth processing model 314 is specifically configured to:
obtaining the average area of each blood vessel from the coronary three-dimensional model of the target patient;
determining, for each blood vessel, a product of a blood vessel flow rate of the blood vessel and an average area of the blood vessel as a flow rate of the blood vessel;
and determining the inlet flow obtained by adding the flow of each blood vessel as an inlet flow boundary condition for a plurality of blood vessels in the coronary three-dimensional model.
Optionally, when the fourth processing model 314 is used to determine the boundary conditions of the outlet resistance for the plurality of vessels in the three-dimensional coronary model, the fourth processing model 314 is specifically configured to:
determining the quotient of the aortic pressure and the inlet flow as the total resistance of a plurality of blood vessels in the coronary three-dimensional model;
and distributing the total resistance by adopting a Mueller shunt law of the area of the blood vessel to obtain the outlet resistance of each blood vessel, and determining the outlet resistance of each blood vessel as an outlet resistance boundary condition aiming at a plurality of blood vessels in the coronary three-dimensional model.
The embodiment of the application provides a device for determining coronary artery functional parameters, which comprises: the first processing module is used for acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient; a second processing module for determining a vessel flow rate of each vessel in the three-dimensional coronary model based on the three-dimensional coronary model of the target patient; the third processing module is used for acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient; a fourth processing model for determining boundary conditions for a plurality of vessels in the coronary three-dimensional model based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition; the determining module is used for inputting the coronary three-dimensional model and the boundary condition of the target patient into the hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
Therefore, by means of the technical scheme, the three-dimensional model of the plurality of blood vessels can be built, the three-dimensional model and the determined boundary conditions are input into the hemodynamic simulation model, coronary artery functional parameters of each blood vessel are obtained, and accuracy of determining the coronary artery functional parameters is improved.
Referring to fig. 5, fig. 5 is a schematic structural diagram of an electronic device according to an embodiment of the present application. As shown in fig. 5, the electronic device 500 includes a processor 510, a memory 520, and a bus 530.
The memory 520 stores machine-readable instructions executable by the processor 510, and when the electronic device 500 is running, the processor 510 communicates with the memory 520 through the bus 530, and when the machine-readable instructions are executed by the processor 510, the steps of the method for determining coronary artery functional parameters in the method embodiments shown in fig. 1 and fig. 2 can be executed, and detailed description thereof will be omitted.
The embodiment of the present application further provides a computer readable storage medium, where a computer program is stored on the computer readable storage medium, and when the computer program is executed by a processor, the steps of the method for determining coronary artery functional parameters in the method embodiments shown in fig. 1 and fig. 2 may be executed, and detailed implementation manner may refer to the method embodiments and will not be repeated herein.
It will be clear to those skilled in the art that, for convenience and brevity of description, specific working procedures of the above-described systems, apparatuses and units may refer to corresponding procedures in the foregoing method embodiments, and are not repeated herein.
In the several embodiments provided in this application, it should be understood that the disclosed systems, devices, and methods may be implemented in other manners. The above-described apparatus embodiments are merely illustrative, for example, the division of the units is merely a logical function division, and there may be other manners of division in actual implementation, and for example, multiple units or components may be combined or integrated into another system, or some features may be omitted, or not performed. Alternatively, the coupling or direct coupling or communication connection shown or discussed with each other may be through some communication interface, device or unit indirect coupling or communication connection, which may be in electrical, mechanical or other form.
The units described as separate units may or may not be physically separate, and units shown as units may or may not be physical units, may be located in one place, or may be distributed on a plurality of network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the solution of this embodiment.
In addition, each functional unit in each embodiment of the present application may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit.
The functions, if implemented in the form of software functional units and sold or used as a stand-alone product, may be stored in a non-volatile computer readable storage medium executable by a processor. Based on such understanding, the technical solution of the present application may be embodied essentially or in a part contributing to the prior art or in a part of the technical solution, in the form of a software product stored in a storage medium, including several instructions for causing a computer device (which may be a personal computer, a server, or a network device, etc.) to perform all or part of the steps of the methods described in the embodiments of the present application. And the aforementioned storage medium includes: a U-disk, a removable hard disk, a Read-Only Memory (ROM), a random access Memory (Random Access Memory, RAM), a magnetic disk, or an optical disk, or other various media capable of storing program codes.
Finally, it should be noted that: the foregoing examples are merely specific embodiments of the present application, and are not intended to limit the scope of the present application, but the present application is not limited thereto, and those skilled in the art will appreciate that while the foregoing examples are described in detail, the present application is not limited thereto. Any person skilled in the art may modify or easily conceive of the technical solution described in the foregoing embodiments, or make equivalent substitutions for some of the technical features within the technical scope of the disclosure of the present application; such modifications, changes or substitutions do not depart from the spirit and scope of the technical solutions of the embodiments of the present application, and are intended to be included in the scope of the present application. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.
Claims (10)
1. A method of determining coronary functioning parameters, the method comprising:
acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient;
acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient;
determining boundary conditions for a plurality of vessels in the three-dimensional model of coronary artery based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition;
inputting the coronary three-dimensional model and boundary conditions of the target patient into a hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
2. The method of determining according to claim 1, wherein the step of determining a blood vessel flow rate of each blood vessel in the coronary three-dimensional model based on the coronary three-dimensional model of the target patient includes:
Determining the length and time of the central line of the blood vessel reached by the contrast agent in the coronary angiography image in the central line of each blood vessel in the coronary three-dimensional model based on the central line of each blood vessel in the coronary three-dimensional model of the target patient;
for each blood vessel, determining the quotient of the central line length and the time of the blood vessel as the flow rate of the blood vessel;
and performing congestion correction on the flow velocity of each blood vessel to obtain the blood vessel flow velocity of each blood vessel in the coronary three-dimensional model.
3. The method according to claim 1, wherein the step of acquiring a coronary angiography image of a target patient and performing data processing on the coronary angiography image to obtain a three-dimensional model of the coronary of the target patient comprises:
acquiring a coronary angiography image of a target patient, and extracting a lumen from the coronary angiography image through filtering or deep neural network processing to obtain a vascular lumen of each blood vessel;
processing the vessel lumen of each vessel through Gaussian difference or deep neural network to obtain the contour and the central line of each vessel;
and carrying out three-dimensional reconstruction on each blood vessel through the contour and the central line of each blood vessel to obtain the coronary three-dimensional model of the target patient.
4. The method of determining according to claim 1, wherein the hemodynamic simulation model includes any one of a reduced order model and a full order model.
5. The determination method according to claim 1, characterized in that the determination method further comprises:
determining coronary artery functional parameters obtained before coronary artery operation of the target patient as preoperative parameters;
determining coronary artery functional parameters obtained after coronary artery surgery is performed on the target patient as postoperative parameters;
determining a blood vessel corresponding to the preoperative parameter indicating abnormality as a target blood vessel, and determining whether the postoperative parameter of the target blood vessel is indicated to be normal or not in the postoperative parameters;
if the coronary artery operation effect of the target patient is abnormal, determining that the coronary artery operation effect of the target patient is failed;
if indicated as normal, the effect of the coronary surgery on the target patient is determined to be successful.
6. The method of determining according to claim 1, wherein the inlet flow boundary conditions for a plurality of vessels in the coronary three-dimensional model are determined by:
obtaining the average area of each blood vessel from the coronary three-dimensional model of the target patient;
Determining, for each blood vessel, a product of a blood vessel flow rate of the blood vessel and an average area of the blood vessel as a flow rate of the blood vessel;
and determining the inlet flow obtained by adding the flow of each blood vessel as an inlet flow boundary condition for a plurality of blood vessels in the coronary three-dimensional model.
7. The method of determining according to claim 6, wherein the outlet resistance boundary conditions for a plurality of vessels in the coronary three-dimensional model are determined by:
determining the quotient of the aortic pressure and the inlet flow as the total resistance of a plurality of blood vessels in the coronary three-dimensional model;
and distributing the total resistance by adopting a Mueller shunt law of the area of the blood vessel to obtain the outlet resistance of each blood vessel, and determining the outlet resistance of each blood vessel as an outlet resistance boundary condition aiming at a plurality of blood vessels in the coronary three-dimensional model.
8. A device for determining coronary functioning parameters, the device comprising:
the first processing module is used for acquiring a coronary angiography image of a target patient, and performing data processing on the coronary angiography image to obtain a coronary three-dimensional model of the target patient;
A second processing module for determining a vessel flow rate of each vessel in the three-dimensional coronary model based on the three-dimensional coronary model of the target patient;
the third processing module is used for acquiring the blood vessel pressure of the target patient, and correspondingly processing the blood vessel pressure to obtain the aortic pressure of the target patient;
a fourth processing model for determining boundary conditions for a plurality of vessels in the coronary three-dimensional model based on the vessel flow rate and the aortic pressure of each vessel; wherein the boundary conditions include an inlet flow boundary condition and an outlet resistance boundary condition;
the determining module is used for inputting the coronary three-dimensional model and the boundary condition of the target patient into the hemodynamic simulation model to obtain coronary functional parameters of each blood vessel; wherein the coronary functional parameter comprises fractional flow reserve and a microcirculation resistance index.
9. An electronic device, comprising: a processor, a memory and a bus, said memory storing machine readable instructions executable by said processor, said processor and said memory communicating via said bus when the electronic device is running, said machine readable instructions when executed by said processor performing the steps of the method of determining coronary functional parameters according to any one of claims 1 to 7.
10. A computer-readable storage medium, characterized in that the computer-readable storage medium has stored thereon a computer program which, when executed by a processor, performs the steps of the method of determining coronary functional parameters according to any of claims 1 to 7.
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| CN202310325773.6A CN116344059A (en) | 2023-03-23 | 2023-03-23 | Method and device for determining coronary artery functional parameters, electronic equipment and storage medium |
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