WO2017179635A1

WO2017179635A1 - Blood flow analysis system, analysis request accepting system, blood flow analysis method and program

Info

Publication number: WO2017179635A1
Application number: PCT/JP2017/015039
Authority: WO
Inventors: 豊樹古澤; 周一松井; 輝泰西野; 慶一板谷; 翔平宮崎; 匡山本; 進中嶋; 真治後藤
Original assignee: Ｎｅｃソリューションイノベータ株式会社; 株式会社ＣａｒｄｉｏＦｌｏｗＤｅｓｉｇｎ; 社会医療法人北海道循環器病院
Priority date: 2016-04-12
Filing date: 2017-04-12
Publication date: 2017-10-19
Also published as: JP2017189316A; JP6669361B2

Abstract

This blood flow analysis system is provided with: an analysis request receiving unit which receives an analysis request including a two-dimensional tomographic image of a blood flow analysis target via a communication network; an anonymization processing unit which deletes information specifying the subject of the analysis from the analysis request, and assigns a management number to identify the subject of the analysis; a model generating unit which generates a three-dimensional model of the shape of blood vessels on the basis of the two-dimensional tomographic image; a condition setting unit which sets finite volume method conditions to be used in a simulation of the blood flow based on the three-dimensional model; a simulation request processing unit which generates a simulation request including the three-dimensional model, the conditions set by the condition setting unit, and the management number; an analysis execution unit which performs the blood flow simulation using a fluid analysis technique employing said finite volume method, on the basis of the simulation request; an analysis result generating unit which generates an analysis result based on a simulation result obtained by the analysis execution unit; and an analysis result transmitting unit which transmits the analysis result to a requesting party on the basis of the management number.

Description

Blood flow analysis system, analysis request reception system, blood flow analysis method and program

The present invention relates to a blood flow analysis system, an analysis request reception system, a blood flow analysis method, and a program.

One method for analyzing a patient's blood flow is to perform analysis using a three-dimensional model to be analyzed.
For example, Patent Literature 1 describes a method of creating a three-dimensional model representing at least a part of a patient's heart and identifying a coronary flow reserve ratio in the patient's heart based on the created three-dimensional model. ing.

Special table 2013-534154 gazette

In order to analyze the blood flow using the 3D model to be analyzed with high accuracy, advanced analysis technology and a high-performance computer are required. Therefore, it is conceivable that a doctor or the like who needs the analysis result requests an analysis from another person. However, consideration of patient privacy can be a problem when requesting analysis from others.

An object of the present invention is to provide a blood flow analysis system, an analysis request reception system, a blood flow analysis method, and a program that can solve the above-described problems.

According to the first aspect of the present invention, the blood flow analysis system includes an analysis request receiving unit that receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network, and an analysis target from the analysis request. An anonymization processing unit that deletes information for identifying a person and assigns a management number for identifying the analysis subject, a model generation unit that generates a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image, A condition setting unit for setting a finite volume method condition used for blood flow simulation based on a three-dimensional model, a simulation request including the three-dimensional model, the condition set by the condition setting unit, and the management number Based on the simulation request processing unit to be generated and the simulation request, the blood flow simulation is performed by the fluid analysis method using the finite volume method. It comprises a analyzing unit for performing an analysis result generation unit that generates an analysis result based on the simulation result by the analyzing unit, and a analysis result transmitting unit that transmits to the requester on the basis of the management number of the analysis results.

According to the second aspect of the present invention, an analysis request receiving system includes an analysis request receiving unit that receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network, and an analysis target from the analysis request. An anonymization processing unit that deletes information for identifying a person and assigns a management number for identifying the analysis subject, a model generation unit that generates a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image, A condition setting unit for setting a finite volume method condition used for blood flow simulation based on a three-dimensional model, a simulation request including the three-dimensional model, the condition set by the condition setting unit, and the management number A simulation request processing unit to be generated; and a blood flow stain performed by a fluid analysis method using the finite volume method based on the simulation request. Comprising an analysis result generation unit that generates an analysis result based on the result of the translation, and the analysis result transmitting unit that transmits to the request source based on the analysis result to the management number.

According to the third aspect of the present invention, the blood flow analysis method includes an analysis request receiving step for receiving an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network, and an analysis target from the analysis request. Delete the information that identifies the person, a connectable anonymization step that assigns a management number that identifies the analysis subject, a model generation step that generates a three-dimensional model of the blood vessel shape based on the two-dimensional tomographic image, A condition setting step for setting a finite volume method condition used for blood flow simulation based on the three-dimensional model, a simulation request including the three-dimensional model, the condition set by the condition setting step, and the management number And a simulation request processing step for generating a fluid analysis method using the finite volume method based on the simulation request. An analysis execution step for performing simulation of the blood flow, an analysis result generation step for generating an analysis result based on the simulation result by the analysis execution step, and an analysis result for transmitting the analysis result to the request source based on the management number A transmission step.

According to the fourth aspect of the present invention, the program causes the computer to receive an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network, and to analyze the analysis request from the analysis request. Delete the information that identifies the person, a connectable anonymization step that assigns a management number that identifies the analysis subject, a model generation step that generates a three-dimensional model of the blood vessel shape based on the two-dimensional tomographic image, A condition setting step for setting a finite volume method condition used for blood flow simulation based on the three-dimensional model, a simulation request including the three-dimensional model, the condition set by the condition setting step, and the management number And a simulation request processing step for generating the finite volume method based on the simulation request. An analysis result generation step for generating an analysis result based on the result of the blood flow simulation performed by the fluid analysis method, and an analysis result transmission step for transmitting the analysis result to the request source based on the management number. This is a program to be executed.

According to the present invention, blood flow analysis can be requested in consideration of patient privacy.

It is a schematic block diagram which shows the function structure of the user terminal device which concerns on one Embodiment of this invention. It is a schematic block diagram which shows the function structure of the reception server apparatus shown in FIG. It is a schematic block diagram which shows the function structure of the item management server apparatus shown in FIG. It is a flowchart which shows the example of the procedure of the process which the reception server apparatus demonstrated in FIG. 2 performs. It is a flowchart which shows the example of the procedure of the process which the item management server apparatus demonstrated in FIG. 3 performs. It is explanatory drawing which shows the example of the PQ loop in the same embodiment. It is explanatory drawing which shows the example of the internal pressure of the aorta in the same embodiment. It is a graph which shows the example of the boundary condition set in order to obtain | require the value of a proportionality constant in the same embodiment. It is a graph which shows the example of the calculation result of the internal pressure of the aorta when the inlet flow rate of FIG. 8 is set. It is a schematic block diagram which shows the minimum structure of the blood-flow analysis system which concerns on embodiment. It is a schematic block diagram which shows the minimum structure of the analysis request reception system which concerns on embodiment.

Hereinafter, although embodiment of this invention is described, the following embodiment does not limit the invention concerning a claim. In addition, not all the combinations of features described in the embodiments are essential for the solving means of the invention.
FIG. 1 is a schematic block diagram showing a functional configuration of a user terminal device according to an embodiment of the present invention. As shown in the figure, the blood flow analysis system 200 includes an analysis request reception system 210 and an analysis server device 240. The analysis request reception system 210 includes a reception server device 211, an item management server device 212, a user authentication database device 221, a medical data file database device 222, an analysis file database device 223, and an analysis result file database device. 224, an operation terminal device 231, and a diagnostic report creation terminal device 232.
In addition, the reception server device 211 communicates with one or more user terminal devices 100 via the communication network 900.

The user terminal device 100 transmits a blood flow analysis request to the blood flow analysis system 200. Specifically, the user terminal device 100 generates an analysis request file in response to a user operation by a doctor in charge of requesting blood flow analysis, and an image of CT (Computed Tomography) or MRI (Magnetic Resonance Imaging), etc. A two-dimensional tomographic image of the analysis target portion is included in the analysis request and transmitted to the reception server device 211. As the data format of the two-dimensional tomographic image included in the analysis request by the user terminal device 100, a general data format such as DICOM (Digital Imaging and Communication in Medicine) data can be used. The user terminal device 100 is realized using a computer, for example.

The communication network 900 is a communication network that mediates communication between the user terminal device 100 and the reception server device 211. The communication network 900 may be a general-purpose communication network such as the Internet, or may be a dedicated communication network for the blood flow analysis system 200. Hereinafter, a case where the communication network 900 is the Internet will be described as an example.

The blood flow analysis system 200 performs a simulation for analyzing the blood flow of a patient in response to an analysis request from a doctor, and returns a diagnosis report based on the simulation result. In addition, the patient here is a person to be analyzed, and it is not always necessary to have a medical condition.
Here, in order to grasp the risk to the state of the blood vessel and the necessity of the operation, it is necessary to grasp not only the state of the plaque attached to the blood vessel and the size of the heart but also the state of the blood flow. There is a case.

However, CFD (Computational Fluid Dynamics) used for blood flow analysis (hereinafter referred to as blood flow analysis) requires advanced technology. For this reason, it is not realistic for doctors who want to know the state of blood flow to analyze blood flow using CFD. Further, high-performance CFD software generally has a high license cost. The CFD referred to here is a simulation in which the motion of the fluid is expressed by an equation.

Furthermore, it is necessary to perform complex calculations in CFD, and a high-performance computer is required to perform blood flow analysis quickly. For example, a case where the patient is hospitalized one week before the operation and examined is illustrated. In this case, if an analysis result is obtained in about two days from the examination, the method of surgery can be determined with reference to the obtained result and explained to the patient. On the other hand, when an analysis result is obtained two weeks after the examination, it is not in time for the operation.

Therefore, the blood flow analysis system 200 shown in FIG. 1 receives a diagnosis request from a doctor, performs a simulation by CFD, and returns an analysis result. In particular, the blood flow analysis system 200 performs a blood flow analysis in a short period of about 1 or 2 days using a high-performance computer and returns the analysis result. As a result, the doctor who requested the diagnosis can obtain the analysis results without burdens such as acquiring CFD technology, obtaining a CFD software license, and securing a high-performance computer.

The blood flow analysis system 200 performs blood flow analysis on various parts related to blood flow, such as coronary arteries (coronary arteries), aorta, cerebral arteries, and heart. For example, the blood flow analysis system 200 performs coronary blood flow analysis for angina pectoris. In addition, the blood flow analysis system 200 performs blood flow analysis of the aorta for aortic aneurysm and aortic dissection. In addition, the blood flow analysis system 200 performs blood flow analysis of the cerebral artery for cerebral aneurysm and subarachnoid hemorrhage. In addition, the blood flow analysis system 200 performs blood flow analysis of the blood circulation including the heart for heart deformities such as congenital heart diseases.

The blood flow analysis system 200 also predicts information for evaluating the current state of the blood flow, information for predicting the future state of the blood flow, and the state of the blood flow after surgery when performing surgery. Providing information.
Here, information for evaluating the current state of blood flow will be described.
As information for evaluating the current state of the blood flow, the blood flow analysis system 200 evaluates the current state of the blood flow, for example, an evaluation index value of the severity of blood vessel stenosis and an evaluation index value indicating the risk of aneurysm rupture. To calculate various evaluation index values.

Further, for example, the blood flow analysis system 200 includes a WSS (Wall Shear Stress) indicating the strength of the force exerted on the blood vessel wall, a blood flow energy loss indicating energy efficiency for circulating the blood flow, and the like. The hemodynamic evaluation index value is calculated.
WSS is an index value for evaluating the risk of stenosis and rupture of blood vessels. In a portion where WSS is large, a large load is applied to the blood vessel. On the other hand, there is a possibility that plaque is likely to accumulate in a portion where WSS is small.

The blood flow energy loss is an index value for evaluating the burden on the heart. The greater the blood flow energy loss, the greater the burden on the heart.
In addition, blood flow analysis system 200 calculates blood flow by simulation, so that blood pressure and blood flow information can be obtained even for portions that are not actually measured. Thereby, the frequency | count of measurement of a blood pressure and a blood flow can be reduced, and a patient's burden can be eased.
Hereinafter, the current evaluation of blood flow is referred to as preoperative evaluation.

Next, information for predicting the future situation of blood flow will be described.
In addition, in order to provide information for predicting the future state of the blood flow, the blood flow analysis system 200 includes case data (a three-dimensional model such as a tomographic image, a blood vessel, etc. Analysis result data etc. are accumulated for each patient. Thereby, the blood flow analysis system 200 can obtain statistical data corresponding to the temporal change of the blood flow situation. Note that the three-dimensional model such as a blood vessel here is a three-dimensional model of a portion to be subjected to blood flow analysis, such as a blood vessel and a heart.

Here, for example, even if there is a stenosis of a blood vessel, depending on the degree, it is not always necessary to perform an operation immediately, and measures such as follow-up may be taken. In addition, for example, when a plaque is found in a coronary artery in a medical examination and it is followed up, it may be anxious because the person being examined cannot know how much risk there is. However, it may be difficult to determine the risk of myocardial infarction or the like based only on the shape of the blood vessel or heart. For example, even if the stenosis rate is the same, there may be a difference in whether the variation pattern of the shear stress varies locally between the inside and outside of the curve of the blood vessel. This difference can greatly change future risks. However, at present, the relationship between the blood flow situation and future risks has not been clarified in detail.

Therefore, the blood flow analysis system 200 acquires statistical data on the temporal change in blood flow as described above. Thereby, the blood flow analysis system 200 can provide the prediction data of the future risk with respect to the current state of the blood flow. The doctor in charge can determine the necessity of treatment such as medication or surgery based on the prediction data provided by the blood flow analysis system 200, and explain the future risk to the examinee. Medical examinees can reduce their anxiety by receiving explanations of future risks.
Hereinafter, prediction of the future state of blood flow is referred to as prediction diagnosis.

Next, information for predicting the postoperative blood flow situation when performing surgery will be described.
As information for predicting the state of blood flow after surgery, for example, the blood flow analysis system 200 calculates blood flow after surgery by simulation. Thereby, the attending physician can confirm in advance whether or not the planned operation is appropriate. For example, when a plurality of bypass methods for a patient having a stenosis in a coronary artery can be considered, the blood flow analysis system 200 calculates postoperative blood flow by simulation for each bypass method. Accordingly, the attending physician can examine which bypass method is better before the operation, and can select any bypass method. The blood flow analysis system 200 also simulates blood flow for each of a plurality of lengths with respect to the length of the bypassed blood vessel. This allows the attending physician to consider which length is better before surgery.
Hereinafter, the simulation of the blood flow situation after surgery is referred to as virtual surgery.

Returning to FIG. 1, the analysis request receiving system 210 receives a blood flow analysis request from the user terminal device 100, generates CFD data (data used for CFD), and performs a CFD calculation on the analysis server device 240. Ask. The operator of the analysis request receiving system 210 and the operator of the analysis server device 240 may be the same or different.
Here, as described above, a high-performance computer is required as the analysis server device 240 in order to quickly perform blood flow analysis. On the other hand, the analysis server device 240 need not be a computer dedicated to blood flow analysis, and may be a general-purpose computer as long as it can perform CFD calculations. Therefore, a mode in which the operator of the analysis request receiving system 210 entrusts the CFD calculation to the operator of the analysis server device 240 is conceivable. Thereby, the operator of the analysis request receiving system 210 does not need to have a high-performance computer, and the operator of the analysis server device 240 does not need to have expertise in blood flow analysis. . Thereby, realization of blood flow analysis system 200 becomes comparatively easy. Hereinafter, a case where the operator of the analysis request receiving system 210 and the operator of the analysis server device 240 are different will be described as an example.

The reception server device 211 illustrated in FIG. 1 receives a blood flow analysis request from the user terminal device 100 and transmits (replies) the analysis result. The reception server device 211 is configured using a computer, for example.
As described above, the communication network 900 is the Internet, and the reception server device 211 receives a blood flow analysis request via the Internet and answers the analysis result. As described above, the blood flow analysis system 200 provides a blood flow analysis cloud service to the user terminal device 100.

Here, if a blood flow analysis request is received by mail, it takes time for mailing, and there is a possibility that the answer of the analysis result in a short period may be hindered. In addition, a postage for sending a request for analysis is required. Further, when the analysis result is also mailed, the time required from the transmission of the analysis request to the reception of the analysis result is further increased, and the postage burden is also increased.
In contrast, the blood flow analysis system 200 provides a blood flow analysis cloud service, so that the user terminal device 100 can communicate with the reception server device 211 to transmit an analysis request and receive an analysis result. . Thereby, compared with the case where at least any one of an analysis request and an analysis result is exchanged by mail, time burden and money burden (especially burden of a mailing cost) can be reduced.

The reception server device 211 deletes information that can identify an individual such as a patient's name from the analysis request received from the user terminal device 100. Hereinafter, information that can identify an individual is referred to as personal identification information. Moreover, the process which deletes personal identification information is called anonymization. Since the reception server device 211 anonymizes the analysis request, even if information included in the analysis request such as information on a medical condition leaks, the leaked information is not linked to an individual.

In this respect, privacy infringement can be avoided. In addition, since privacy infringement at the time of information leakage can be avoided in this way, the information included in the analysis request and the analysis result information by the blood flow analysis system 200 are accumulated for statistical use as described above. The management of these information becomes relatively easy. In the following, information for each individual patient such as an analysis request and analysis result information is referred to as patient information.

In addition, the reception server device 211 gives a management number to the anonymized analysis request. The management number here is an identification number for identifying a patient. This management number is used to anonymize the analysis request and analysis result information.
Here, when the reception server device 211 simply anonymizes the information, even if the blood flow analysis system 200 (medical data file database device 222) stores the information of the analysis request and the analysis result, It is difficult to classify by patient. In this case, it is difficult to track how the condition of the same patient has changed over time.

Therefore, the reception server device 211 issues a management number for each patient, and the blood flow analysis system 200 classifies and accumulates patient information for each patient according to the management number. Thereby, in the blood flow analysis system 200, it becomes possible to track how the medical condition of the same patient has changed over time. As described above, the blood flow analysis system 200 can obtain statistical data indicating changes in the medical condition over time.
The blood flow analysis system 200 can associate multiple types of information using management information, such as associating an analysis request and an analysis result with the same management number.

The item management server device 212 shown in FIG. 1 generates CFD data based on the analysis request anonymously accepted by the reception server device 211 and requests the analysis server device 240 to perform CFD calculation. The item management server device 212 is configured using, for example, a computer.
In particular, the item management server device 212 generates a three-dimensional model such as a blood vessel from a two-dimensional tomographic image included in the analysis request. In addition, the item management server device 212 generates setting condition information for the finite volume method, such as a boundary condition for performing CFD calculation by the finite volume method.
Then, the item management server device 212 transmits a CFD calculation request (finite volume method calculation request) including the generated three-dimensional model and setting condition information to the analysis server device 240. Based on the information that the accepting server device 211 is anonymizable to be connectable (anonymization and assignment of a management number), the item management server device 212 generates CFD data that is anonymized to be connectable.

Here, there are cases where information including personal identification information is exchanged between medical institutions, such as sharing of medical information, second opinion, or patient inquiry. Therefore, it is relatively easy to transmit information including personal identification information to a medical institution.
On the other hand, the operator of the analysis server device 240 may be an organization other than a medical institution such as an IT (Information Technology) company. Even in such a case, the item management server device 212 generates anonymized CFD data, so that the barrier regarding personal privacy can be kept relatively low. For this reason, the reception server device 211 can request the calculation of CFD by transmitting CFD data to the analysis server device 240.

The user authentication database device 221 shown in FIG. 1 stores user authentication information for the reception server device 211 to perform user authentication. For example, a user who requests blood flow analysis from the blood flow analysis system 200 (for example, a doctor in charge of a patient to be analyzed) logs in to the blood flow analysis system 200 in order to request blood flow analysis. Therefore, the reception server device 211 performs user authentication by password authentication. In this case, the user authentication database device 221 stores user authentication information in which a user name and a password are associated with each other. Alternatively, the user terminal device 100 may transmit an analysis request including authentication information such as a user name and a password by e-mail. In this case, the user terminal device 100 reads out the authentication information from the e-mail, performs user authentication, and performs the requested analysis when the user authentication is successful.

The medical data file database device 222 shown in FIG. 1 stores (accumulates) information related to the patient state included in the analysis request, such as a two-dimensional tomographic image included in the analysis request, under the control of the item management server device 212. In particular, the medical data file database device 222 stores information related to the patient's state in an anonymized state. The medical data file database device 222 may store the analysis request itself, or may store only a part of the analysis request.

The analysis file database apparatus 223 shown in FIG. 1 stores (accumulates) the CFD data generated by the item management server apparatus 212 according to the control of the item management server apparatus 212. In particular, the analysis file database device 223 stores the CFD data generated by the item management server device 212 in a connectable and anonymized state. The analysis file database apparatus 223 may store the CFD calculation request itself to the analysis server apparatus 240 or may store only a part of the calculation request.

The analysis result file database device 224 shown in FIG. 1 stores (accumulates) the analysis result by the analysis server device 240 in accordance with the control of the item management server device 212. In particular, the analysis result file database device 224 stores the analysis result in an anonymized state that can be connected. The analysis result file database device 224 may store the analysis result itself, or may store only a part of the analysis result.

An operation terminal device 231 illustrated in FIG. 1 is an operator terminal device that assists the item management server device 212 in generating a CFD calculation request to the analysis server device 240.
For example, by operating the operation terminal device 231, the operator cuts (deletes) branch and vein blood vessels that are not necessary for analysis from a three-dimensional model such as blood vessels generated by the item management server device 212. Thereby, the calculation amount of the analysis server apparatus 240 can be reduced.

In addition, for a three-dimensional model such as a blood vessel generated by the item management server device 212, the shape of the model may be inaccurate, such as a convex portion that should not originally exist due to the influence of the resolution of the original tomographic image, etc. . Therefore, the operator operates the operation terminal device 231 to shape (smooth) the three-dimensional model. Thereby, the accuracy of the three-dimensional model is improved and the accuracy of blood flow analysis is improved.
In addition, the operator may use the operation terminal device 231 to extract blood vessels, hearts, and the like from the two-dimensional tomographic image. Alternatively, the item management server device 212 may automatically extract blood vessels, hearts, and the like from the two-dimensional tomographic image.

The diagnostic report creation terminal device 232 shown in FIG. 1 is a terminal device for a dedicated doctor of the analysis request reception system 210 to create a diagnostic report based on the simulation result (calculation result of CFD) by the analysis server device 240. . The dedicated doctor of the analysis request reception system 210 adds additional information to the simulation result, such as findings when viewing the simulation result, and summarizes it as a diagnostic report.
However, the diagnostic report creation terminal device 232 is not essential for the analysis request receiving system 210. That is, the analysis request reception system 210 may be configured not to include the diagnostic report creation terminal device 232.

The analysis server device 240 shown in FIG. 1 is configured using a computer, performs CFD calculation in response to a request from the item management server device 212, and transmits (replies) the calculation result to the item management server device 212.
For example, the item management server device 212 and the analysis server device 240 are communicatively connected via the Internet, and the analysis server device 240 provides the item management server device 212 with computation by a high-performance computer through a cloud service.
The analysis server device 240 corresponds to an example of an analysis execution unit.

In CFD based on the finite volume method, a blood vessel space is finely divided into, for example, a region of about 1 million to 2 million, for example, with a tetrahedral mesh. In addition, a blood pressure is set at the entrance of the three-dimensional model, and a resistance value for blood flow is set at the exit. The inlet and outlet referred to here are the inlet and outlet of blood flow in the three-dimensional model, respectively. Both the entrance and the exit correspond to the boundary of the 3D model. In CFD based on the finite volume method, equations based on physical laws such as a flow rate conservation law and a momentum conservation law are set. In the blood flow analysis system 200, the item management server device 212 performs mesh division of the blood space and sets these equations and conditions.
The analysis server device 240 calculates a blood flow that satisfies the set equation and the set condition. For example, the analysis server device 240 repeats the calculation of the blood flow velocity and blood pressure for each mesh until an error with respect to a given condition becomes equal to or less than a predetermined error.

Thereby, the pattern of the blood flow in each mesh is obtained. As a result, for example, where the blood flow is accelerating, how much flow is flowing in each branch of the blood vessel, or how much the difference in blood pressure is before and after stenosis, it is precise It becomes possible to grasp.
Note that the analysis server device 240 may execute a simulation of blood flow analysis in real time, and the user terminal device 100 may display a moving image of the simulation result in real time.

FIG. 2 is a schematic block diagram showing a functional configuration of the reception server device 211 shown in FIG. As illustrated in FIG. 2, the reception server device 211 includes a first communication unit 310, a first storage unit 380, and a first control unit 390. The first control unit 390 includes a user authentication unit 391 and an anonymization processing unit 392.

The first communication unit 310 communicates with other devices. In particular, the first communication unit 310 communicates with the user terminal device 100 via the communication network 900 and receives an analysis request (a blood flow analysis request) from the user terminal device 100. The first communication unit 310 corresponds to an example of an analysis request receiving unit.
In addition, the first communication unit 310 transmits a diagnostic report of an answer to the analysis request to the user terminal device 100 that is the request source. The first communication unit 310 communicates with the user authentication database device 221 to register and read information for user authentication. In addition, the first communication unit 310 communicates with the item management server device 212 and transmits the connection request anonymized analysis request to the item management server device 212. Further, the first communication unit 310 receives a diagnostic report of an answer to the analysis request from the item management server device 212.

The first storage unit 380 is configured using a storage device provided in the reception server device 211 and stores various types of information. For example, the first storage unit 380 stores patient identification information and a management number in association with each other. Accordingly, when the first communication unit 310 receives an analysis request of a patient that has been analyzed by the blood flow analysis system 200 in the past, the reception server device 211 (anonymization processing unit 392) The same management number as in the above can be assigned to the analysis request. Thereby, the reception server device 211 can realize connectable anonymization.

The 1st control part 390 controls each part of the reception server apparatus 211, and performs various functions. The first control unit 390 is realized by, for example, a CPU (Central Processing Unit) provided in the reception server device 211 reading and executing a program from the first storage unit 380.
The user authentication unit 391 performs user authentication when receiving a blood flow analysis request from the user terminal device 100. For example, the user authentication unit 391 performs password authentication based on the user name and password included in the analysis request (blood flow analysis request) and the user authentication information stored in the user authentication database device 221. Perform user authentication.

The anonymization processing unit 392 anonymizes the analysis request received by the first communication unit 310. Specifically, the anonymization processing unit 392 deletes the personal identification information from the analysis request.
Moreover, the anonymization processing unit 392 gives the above-described management number to the anonymized analysis request. Thereby, the reception server device 211 can anonymize the analysis request to be connectable.

FIG. 3 is a schematic block diagram showing a functional configuration of the item management server device 212 shown in FIG. As illustrated in FIG. 3, the item management server device 212 includes a second communication unit 410, a second storage unit 480, and a second control unit 490. The second control unit 490 includes a model generation unit 491, a preprocessing unit 492, a simulation request processing unit 493, and a diagnosis report processing unit 494.

The second communication unit 410 communicates with other devices. In particular, the second communication unit 410 communicates with the reception server device 211 and receives the connection request anonymized analysis request from the reception server device 211. In addition, the second communication unit 410 transmits a diagnostic report of a response to the analysis request to the reception server device 211.
Further, the second communication unit 410 communicates with the medical data file database device 222 and stores (accumulates) the analysis request from the user terminal device 100 in the medical data file database device 222. The second communication unit 410 communicates with the analysis file database device 223 to store (accumulate) the CFD data in the analysis file database device 223. Further, the second communication unit 410 communicates with the analysis result file database device 224 and stores (accumulates) the analysis result by the analysis server device 240 in the analysis result file database device 224.
In addition, the second communication unit 410 communicates with the operation terminal device 231, and displays information indicating user operations (operations by an operator) for generating CFD calculation requests such as assistance for generating a three-dimensional model such as a blood vessel. Receive.

The 2nd memory | storage part 480 is comprised using the storage device with which the item management server apparatus 212 is provided, and memorize | stores various information. For example, the second storage unit 480 functions as a working memory of the second control unit 490, and temporarily stores a two-dimensional tomographic image included in the analysis request and a three-dimensional model such as a blood vessel.
The second control unit 490 realizes various functions by controlling each unit of the item management server device 212. The second control unit 490 is realized by, for example, a CPU included in the item management server device 212 reading and executing a program from the second storage unit 480.

The model generation unit 491 generates a three-dimensional model such as a blood vessel. As described above, the model generation unit 491 may automatically generate a three-dimensional model, or based on the extraction result of blood vessels or the like from a two-dimensional tomographic image by an operator who operates the operation terminal device 231. May be generated.
In addition, the model generation unit 491 corrects the three-dimensional model in accordance with the operator's operation on the operation terminal device 231. For example, the model generation unit 491 cuts branches and veins that are not necessary for the above-described analysis. The model generation unit 491 performs the above-described shaping (smoothing) of the three-dimensional model.

The preprocessing unit 492 performs various settings for CFD by the finite volume method. The preprocessing unit 492 corresponds to an example of a condition setting unit.
In particular, the preprocessing unit 492 extends the inlet and outlet (blood vessels) of the three-dimensional model. This is to reduce the influence of blood flow at the inlet and outlet of the model and stabilize the flow rate ratio.
Here, the flow rate ratio changes depending on the amount of extension of the inlet and outlet of the three-dimensional model. Further, as the inlet and outlet are lengthened, the number of meshes in the finite volume method increases and the amount of calculation increases.

On the other hand, as a result of experiments, it was found that a simulation result close to actual measurement data can be obtained by extending the diameter of the blood vessel by about 50 times. Therefore, the preprocessing unit 492 extends the inlet and outlet blood vessels of the three-dimensional model by 50 times the diameter of the blood vessels. However, the blood vessel extension performed by the preprocessing unit 492 is not necessarily strictly 50 times the diameter of the blood vessel. For example, the preprocessing unit 492 may extend the blood vessel in the range of 40 to 60 times the diameter of the blood vessel.
In the following, extending the inlet and outlet of the three-dimensional model is referred to as mesh extension.

Also, the preprocessing unit 492 sets boundary conditions in the finite volume method. The boundary conditions set by the preprocessing unit 492 will be described later.

The simulation request processing unit 493 requests the analysis server device 240 for blood flow simulation (blood flow analysis by CFD using a finite volume method). Specifically, the simulation request processing unit 493 generates an analysis request (simulation request) including a three-dimensional model such as a blood vessel generated by the model generation unit 491 and information indicating the conditions set by the preprocessing unit 492. And transmitted to the analysis server device 240 via the second communication unit 410.

The diagnostic report processing unit 494 creates a diagnostic report. Specifically, the diagnostic report processing unit 494 creates a diagnostic report based on a specialist's operation on the diagnostic report creation terminal device 232.
The diagnosis report created by the diagnosis report processing unit 494 includes various information according to the analysis request from the user terminal device 100. For example, the diagnostic report processing unit 494 may create a diagnostic report including a hemodynamic evaluation index value such as WSS or blood flow energy loss. Or the diagnostic report process part 494 may produce the diagnostic report containing the statistical data regarding the time change of the condition of a blood flow. Alternatively, the diagnostic report processing unit 494 may create a diagnostic report including the result of virtual surgery.
For example, the user terminal device 100 transmits an analysis request including information indicating necessary items as an analysis result. Then, the diagnosis report processing unit 494 generates a diagnosis report including information on items required for the analysis request.
The diagnosis report processing unit 494 corresponds to an example of an analysis result generation unit. The diagnosis report corresponds to an example of the analysis result. Moreover, the 1st communication part 310 of the reception server apparatus 211 which transmits a diagnostic report to the user terminal device 100 corresponds to the example of an analysis result transmission part.

Next, the operation of the blood flow analysis system 200 will be described with reference to FIGS.
FIG. 4 is a flowchart illustrating an example of a procedure of processing performed by the reception server device 211 described in FIG. When receiving the analysis request from the user terminal device 100, the reception server device 211 starts the process of FIG.
In the process of FIG. 4, the user authentication unit 391 performs user authentication based on the user information received from the user terminal device 100 by the first communication unit 310 (step S101). For example, the first communication unit 310 receives user information including a user name and a password from the user terminal device 100. Then, the user authentication unit 391 performs password authentication using the user name and password received by the first communication unit 310.
Then, the user authentication unit 391 determines whether or not the user authentication is successful in step S101 (step S102).

When it determines with having succeeded in authentication (step S102: YES), the anonymization process part 392 performs the anonymization process which deletes personal identification information (information which can identify individuals, such as a name) from patient information (step S111). ).
Next, the anonymization processing unit 392 gives a management number to the anonymized patient information (step S112). The management number here is an identification number for identifying a patient. This management number is used to anonymize patient information.
Here, when the patient information is simply anonymized, it is difficult to classify the stored patient information for each patient even if the medical data file database device 222 stores the patient information. For this reason, it is difficult to track how the same patient's medical condition has changed over time.

On the other hand, when the medical data file database device 222 stores (accumulates) patient information and management numbers in association with each other, the accumulated patient information can be classified for each patient. Therefore, it becomes possible to track how the medical condition of the same patient has changed over time. As described above, the anonymization processing unit 392 assigns the management number to the patient information and anonymizes the information so that statistical data indicating changes in the medical condition with time can be obtained.
Further, patient information stored in the medical data file database device 222, information on the three-dimensional model of blood vessels stored in the analysis file database device 223, and analysis result information stored in the analysis result file database device 224 are stored for each patient. Can be associated. In this way, a plurality of types of information can be associated using management information.

The medical data file database device 222, the analysis file database device 223, and the analysis result file database device 224 are all at least of the information included in the analysis request, the simulation result, and the information included in the analysis result based on the simulation result. One of them is stored for each person to be analyzed based on the management number. The medical data file database device 222, the analysis file database device 223, and the analysis result file database device 224 all correspond to examples of the time information storage unit.
The diagnosis report processing unit 494 indicates the prediction of the blood flow situation such as the future risk of aneurysm rupture based on the analysis result stored (accumulated) in time series by the analysis result file database device 224, for example. Generate diagnostic reports with information.

In order to anonymize patient information, the anonymization processing unit 392 assigns a management number to each patient. Specifically, when the first communication unit 310 receives patient information, the anonymization processing unit 392 determines whether the first communication unit 310 has received patient information of the same patient in the past. judge. When it is determined that the patient information of the same patient has been received in the past, the anonymization processing unit 392 assigns the same management number as the management number issued to the patient to the current patient information (first communication unit 310). To the patient information received this time).
On the other hand, when it is determined that the patient information of the same patient has not been received in the past, the anonymization processing unit 392 issues a new management number, and uses the issued new management number as the current patient information. Give.

In order to determine whether the first communication unit 310 has received patient information of the same patient in the past, the analysis request reception system 210 (for example, the first storage unit 380) A management number may be stored in association with each other. For example, when the anonymization processing unit 392 issues a new management number in step S112, the issued management number and the personal identification information deleted in step S111 are associated with each other and stored in the first storage unit 380. Then, when the first communication unit 310 receives the patient information, the anonymization processing unit 392 extracts the personal identification information from the patient information in step S111, and deletes the extracted personal identification information from the patient information. Then, the anonymization processing unit 392 determines whether or not the personal identification information extracted in step S111 is already stored in association with the management number, so that the first communication unit 310 has the same patient in the past. It is determined whether or not patient information has been received.

After step S112, the first control unit 390 transmits the information of the anonymized patient connectable in step S112 to the item management server device 212 via the first communication unit 310 (step S113).
On the other hand, if it is determined in step S102 that the user authentication has failed (step S102: NO), the user authentication unit 391 notifies the user of the request source via the first communication unit 310 that the user authentication has failed. It transmits to the terminal device 100 (step S121).
After step S121, the process of FIG. 4 ends.

FIG. 5 is a flowchart illustrating an example of a procedure of processing performed by the item management server apparatus 212 described with reference to FIG. The item management server device 212 starts the process of FIG. 5 when the second communication unit 410 receives the patient information transmitted by the reception server device 211 in step S113 of FIG.
In the process of FIG. 5, the second control unit 490 stores the patient information received by the second communication unit 410 in the medical data file database device 222 (step S201). Specifically, the second control unit 490 transmits an instruction to store patient information and patient information to be stored (patient information received by the second communication unit 410) via the second communication unit 410. Transmit to the file database device 222.

Next, the model generation unit 491 generates a three-dimensional model of the blood vessel based on the tomographic image (CT image or MRI image) included in the patient information (step S202).
Next, the preprocessing unit 492 performs preprocessing such as setting of analysis conditions (step S203).
The model generation unit 491 stores the three-dimensional blood vessel model generated in step S202 in the analysis file database device 223 (step S204). Specifically, the model generation unit 491 sends an instruction to store the three-dimensional model and a file of the three-dimensional model to be stored (data file indicating the three-dimensional model of the blood vessel generated in step S202) to the second communication unit. The data is transmitted to the analysis file database apparatus 223 via 410.

Next, the simulation request processing unit 493 transmits a blood flow analysis request to the analysis server device 240 (step S205). Specifically, the simulation request processing unit 493 analyzes the blood flow based on the three-dimensional model of the blood vessel generated by the model generation unit 491 in step S202, the file indicating the analysis conditions set in step S203, and the information to be transmitted. Is transmitted to the analysis server device 240 via the second communication unit 410.

The analysis server device 240 performs blood flow analysis (blood flow simulation) using the finite volume method based on the obtained information.
Specifically, the space is divided into regular tetrahedral meshes. Then, an equation indicating the relationship between meshes is established using a law such as a flow rate conservation law, and the calculation is repeated until the boundary condition is met (until the magnitude of the error falls below a predetermined allowable value). As described above, the item management server device 212 performs space mesh division and simultaneous equations and boundary condition setting. And the analysis server apparatus 240 performs a calculation.

When the second communication unit 410 receives the analysis result from the analysis server device 240 (step S206), the simulation request processing unit 493 stores the analysis result in the analysis result file database device 224 (step S207). Specifically, the simulation request processing unit 493 sends an instruction to store the analysis result and the analysis result to be stored (the analysis result received by the second communication unit 410 in step S206) via the second communication unit 410. To the analysis result file database device 224.

In addition, the simulation request processing unit 493 creates a diagnostic report based on a user operation on the diagnostic report creation terminal device 232 (step S208).
Then, the simulation request processing unit 493 transmits the created diagnostic report to the requesting user terminal device 100 (step S209). Specifically, the simulation request processing unit 493 transmits the diagnostic report created in step S208 to the reception server device 211 via the second communication unit 410. Then, the reception server device 211 transmits (transfers) the received diagnostic report to the requesting user terminal device 100.
After step S209, the process of FIG.

Next, setting of boundary conditions by the preprocessing unit 492 will be described.
As described above, when the blood vessel at the entrance / exit of the three-dimensional model is extended, the measurement value at the original entrance / exit cannot be applied to the extended entrance / exit.
Therefore, for example, when there is no stenosis in the blood vessel to be analyzed such as a coronary artery, the preprocessing unit 492 sets a boundary condition based on the reflected wave.
Here, blood pressure is classified into incident waves and reflected waves as shown in Equation (1).

Here, the value P indicates a blood pressure measurement value (measurement pressure). The value P _for indicates the incident wave. The value P _ref indicates the reflected wave. The incident wave P _for simulates the pressure due to the energy of pulsation. On the other hand, the reflected wave _Pref simulates pressure return (reflection) from peripheral blood vessels and the like.
Here, the incident wave P _for is defined as shown in Equation (2).

Here, the value Q indicates the blood flow rate. Further, the value Z ₀ indicates impedance. The impedance here is a value obtained by dividing blood pressure by blood flow. Impedance quantitatively indicates the difficulty of blood flow (the magnitude of resistance to blood flow).
Also, the reflected wave _Pref is defined as shown in Equation (3).

Impedance _{Z 0} is determined according to PQ loop.
FIG. 6 is an explanatory diagram showing an example of a PQ loop. The horizontal axis of the graph shown in the figure indicates the blood flow volume passing through the aorta. The vertical axis indicates the pressure at that portion.
As indicated by the line L11, the pressure increases and the flow rate increases early in the systole of the heart. In the early part of this systole, the reflected wave does not return again. The inclination “dP / dQ” in the early stage of the systole of the heart is used as the impedance Z ₀ . This inclination is indicated by the inclination of the line L12.

By using this reflected wave, it is possible to simulate blood pressure fluctuations associated with heartbeats, and the blood pressure at the outlet of the three-dimensional model with the blood vessels extended can be set with higher accuracy. In particular, it is possible to set boundary conditions that reproduce the elasticity and peripheral resistance of the blood vessels inherent to the patient.
The impedance obtained here may be used as a resistance value in a ramped parameter method for simulating blood flow with an electric circuit.

The boundary conditions based on the reflected wave when there is no stenosis in the blood vessel to be analyzed have been described.
On the other hand, when there is a stenosis of the blood vessel, the reflected wave as described above does not return. Therefore, when there is a stenosis of the blood vessel in the analysis of the coronary artery, the preprocessing unit 492 sets a variable impedance based on the actual measurement. The fluctuation impedance here is an impedance whose value fluctuates with time (specifically, an impedance whose value fluctuates in accordance with the heartbeat phase).
Specifically, the preprocessing unit 492 sets the impedance Z (t) according to Expression (4).

Here, the value P (t) indicates the measured pressure waveform (blood pressure at each time). The value Q (t) indicates a flow waveform (blood flow volume at each time). The steady venous pressure is a blood pressure in the venous portion. In equation (4), a pressure difference obtained by subtracting the steady venous pressure from the pressure waveform is used in order to accurately obtain the pressure difference of the capillaries.

Here, the value “P (t) −steady venous pressure” indicates the pressure applied to the capillary portion. In order to allow blood flow to flow through the capillaries, a pressure of this value “P (t) −steady venous pressure” is required. In the equation (4), the resistance in the capillary is obtained by dividing the value “P (t) −steady venous pressure” by the flow rate.
By using this variable impedance (impedance Z (t)), a patient-specific variable impedance can be set.

Also, the preprocessing unit 492 sets a variable impedance in consideration of myocardial viability and myocardial perfusion. Here, the viability of the myocardium is the rate at which myocardial cells are alive. When cardiomyocytes die, the amount of capillary passage is reduced and the resistance of blood flow changes. Therefore, the preprocessing unit 492 obtains a variable impedance based on the perfusion region of the myocardium for each coronary artery and the viability of the myocardium in the perfusion region.

Specifically, the preprocessing unit 492 estimates a perfusion area from the CT image. The preprocessing unit 492 divides the myocardial region into the nearest perfusion region for each coronary artery. Then, the preprocessing unit 492 calculates the volume of the myocardium in the perfusion region, and obtains the impedance to the blood flow based on the obtained volume and the viability of the myocardium. For example, the preprocessing unit 492 modifies the fluctuation width and average value of the fluctuation impedance based on the myocardial volume and viability, and obtains the impedance for each branch of the coronary artery.
Thereby, it becomes possible to obtain | require the distribution of the blood flow for every myocardium, and can set the impedance according to the distribution of the blood flow.

The preprocessing unit 492 sets the exit boundary condition according to the presence or absence of stenosis of the blood vessel in the three-dimensional model and the influence of the stenosis on the blood flow.
Specifically, the preprocessing unit 492 or the operator (user of the operation terminal device 231) determines whether or not there is stenosis and whether or not the influence of stenosis on the blood flow can be ignored.

When the preprocessing unit 492 automatically performs the above determination, for example, the determination is performed based on image analysis on a two-dimensional tomographic image to be analyzed for blood flow.
Specifically, the preprocessing unit 492 has a region in the blood vessel having a predetermined length or less (for example, 1 centimeter or less), and the diameter of the narrowest part is equal to the diameter of any end of the region. When an area of a predetermined first ratio or less (for example, 90% or less) is detected, it is determined that the detected area has stenosis.
In addition, the preprocessing unit 492 locally performs a blood flow analysis on, for example, a region determined to have stenosis. When the preprocessing unit 492 calculates that the pressure behind the stenosis is a predetermined second ratio or less (for example, 80% or less) with respect to the pressure before the stenosis, the influence of the stenosis on the blood flow cannot be ignored. Is determined.

When the preprocessing unit 492 or the operator determines that there is no stenosis, the preprocessing unit 492 calculates the outlet pressure including the reflected wave by the above method and sets it as the outlet boundary condition. The same applies when the preprocessing unit 492 or the operator determines that the influence of stenosis can be ignored.
On the other hand, when the preprocessing unit 492 or the operator determines that the influence of the stenosis cannot be ignored, the preprocessing unit 492 calculates the fluctuation impedance on the external side of the model viewed from the exit boundary by the above method, and the exit boundary condition Set as.

In the case of analysis of the aorta, the preprocessing unit 492 performs correction for a rapid change in blood pressure.
Here, when the CFD calculation was performed with the outlet pressure as the value “0”, rapid increase and decrease in blood pressure (overshoot and undershoot) that could not occur in the living body were observed in the internal pressure of the aorta.
FIG. 7 is an explanatory diagram showing an example of the internal pressure of the aorta. The horizontal axis of the graph shown in the figure represents time, and the vertical axis represents pressure. In the area A11, the pressure overshoots. On the other hand, in the area A12, the pressure undershoots.

This large change in blood pressure is considered to be a simulation error caused by simulating a blood vessel wall, which is an elastic body, with a rigid body wall.
Here, when the inlet flow rate was differentiated, a waveform similar to this sudden change in pressure was obtained. Based on the differential of the inlet flow rate, if an abrupt change in pressure is predicted from the inlet flow rate and the waveforms of opposite phases can be superimposed, the abnormal pressure change can be canceled out.
Although the pressure waveform can be estimated from the inlet flow rate waveform, the relationship between the inlet flow rate and the pressure is unknown. Therefore, assuming that the equation is as shown in Equation (5), a proportionality constant is obtained according to an experiment.

Here, the value k indicates a proportionality constant. The value _{P a} indicates the pressure.
In order to obtain the value of the proportionality constant k, a boundary condition is set such that the flow rate increases linearly and the flow rate decreases linearly.
FIG. 8 is a graph showing an example of boundary conditions set for obtaining the value of the proportionality constant k. The horizontal axis of the graph shown in the figure represents time, and the vertical axis represents flow rate. According to line L21 in FIG. 8, the flow rate increases at a constant rate and then decreases at a constant rate.

FIG. 9 is a graph showing an example of the calculation result of the internal pressure of the aorta when the inlet flow rate of FIG. 8 is set. The horizontal axis of the graph shown in FIG. 9 indicates time, and the vertical axis indicates pressure.
In the graph shown in FIG. 9, the pressure P11 is offset when the inlet flow rate is increased. This pressure P11 is considered to be a pressure due to the value dQ / dt. On the other hand, the pressure P12 is considered to be a pressure due to the flow rate Q. Therefore, the pressure P12 is assigned to _{P a} of formula (5), the slope of the flow rate Q is substituted into the value dQ / dt of the formula (5). As a result, the value of the proportionality constant k can be obtained.

The preprocessing unit 492 sets the outlet pressure as shown in Expression (6) using the obtained proportionality constant k.

Here, the value _Pout indicates the outlet pressure. The value P _ref is a term of the reflected wave shown in Expression (3). The term “−k × (dQ / dt)” is a term for canceling the rapid increase and decrease in blood pressure described above. The value “k × (dQ / dt)” corresponds to an example of a value proportional to the derivative of the blood inlet flow rate.
By using this outlet pressure, a blood pressure close to the actual blood pressure can be set as the outlet pressure.

The preprocessing unit 492 sets boundary conditions corresponding to blood flow adjustment by the autonomic nerve.
Here, the blood flow amount flowing through the upper body and the lower body is adjusted by the autonomic nerve. For example, the autonomic nerve causes blood flow to flow toward the head by closing the muscles of the blood vessels and controlling the flow rate so that blood does not flow too much in the lower body.
On the other hand, the preprocessing unit 492 sets the outlet pressure represented by Expression (7) in order to simulate the adjustment of blood flow by the autonomic nerve.

Here, the value _Pout indicates the outlet pressure. Further, the value _{P INER,} outlet pressure _{P out} of the equation (6) is substituted. H represents a snake site function. When the value of the term “Q _out −Q _in ” is positive, the value of the heavy site function H (Q _out −Q _in ) is “1”. When the value of the term “Q _out −Q _in ” is zero, the value of the heavy site function H (Q _out −Q _in ) is “½”. Further, when the value of the term “Q _out −Q _in ” is negative, the value of the heavy site function H (Q _out −Q _in ) is “0”.

The values Q _out and Q _in indicate the outlet flow rate and the inlet flow rate, respectively. The value K is a constant. The value of the constant K is set empirically, for example.
In the equation (7), when the value of the term “Q _out −Q _in ” is positive, it indicates that the value Q _out is larger than the value Q _in , which means that the blood flow is flowing backward. Therefore, the pressure is increased by the amount of backflow according to the equation (7). Thereby, adjustment of blood flow by the autonomic nerve is simulated. The snake site function H may be offset.

In order to facilitate condition setting in CFD, the reception server device 211 provides an input screen to the user terminal device 100. For example, it is not realistic for the user (the doctor in charge who requests the analysis) to appropriately set the size of the mesh and the length of the boundary region. Therefore, the reception server device 211 (first control unit 390) provides an input screen in which default values are input to these input items. By using this default value without changing it, the user can request blood flow analysis without having to set complicated numerical values.
In addition, the reception server device 211 (first control unit 390) provides an input screen for each pattern of blood flow analysis such as coronary artery or aortic stenosis. Thereby, the reception server device 211 can provide an appropriate default value for each pattern of blood flow analysis. In addition, the user can grasp necessary input items according to the pattern of blood flow analysis.

Further, the preprocessing unit 492 sets either the inlet flow rate or the inlet pressure as the inlet boundary condition based on whether the inlet flow rate is known. The preprocessing unit 492 may automatically determine whether the inlet flow rate is known or may be determined by an operator (user of the operation terminal device 231).

When automatically determining whether the inlet flow rate is known, the preprocessing unit 492 determines, for example, whether the analysis request from the user terminal device 100 includes blood flow information corresponding to the inlet flow rate. By determining, it is determined whether or not the inlet flow rate is known. When it is determined that the inlet flow rate is known (that is, when it is determined that blood flow information corresponding to the inlet flow rate is included in the analysis request), the preprocessing unit 492 sets the blood flow rate as the inlet flow rate. To do.
On the other hand, when it is determined that the inlet flow rate is unknown (that is, when it is determined that blood flow information corresponding to the inlet flow rate is not included in the analysis request), the preprocessing unit 492 displays the blood pressure corresponding to the inlet pressure. Is read from the analysis request and set as the inlet pressure.

Thus, the preprocessing unit 492 sets the inlet flow rate as the inlet boundary condition when the inlet flow rate is known. On the other hand, when the inlet flow rate is unknown, the preprocessing unit 492 sets the inlet pressure as the inlet boundary condition.
Thereby, the blood flow analysis system 200 can perform blood flow analysis even when the inlet flow rate is unknown. Therefore, according to the blood flow analysis system 200, blood flow analysis can be performed even when an additional test for obtaining the inlet flow rate is not performed.

As described above, the first communication unit 310 of the reception server device 211 receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow from the user terminal device 100 via the communication network 900. Then, the anonymization processing unit 392 deletes information specifying the analysis target person from the analysis request, and assigns a management number for identifying the analysis target person. The analysis server device 240 generates a three-dimensional model of the blood vessel shape based on the two-dimensional tomographic image. Then, the preprocessing unit 492 performs finite volume method condition setting for blood flow simulation based on the three-dimensional model. The simulation request processing unit 493 generates a simulation request (a blood flow analysis request) including the conditions set by the 3D model and the preprocessing unit 492 and the management number. The analysis server device 240 performs blood flow simulation by a fluid analysis method using a finite volume method based on the simulation request. The diagnosis report processing unit 494 generates an analysis result based on the simulation result by the simulation request processing unit 493. Then, the first communication unit 310 transmits the analysis result to the request source based on the management number.

As described above, the anonymization processing unit 392 deletes information for identifying the analysis target person from the analysis request, and assigns a management number for each analysis countermeasure, so that information included in the analysis request such as information on a medical condition is leaked. Even if you do, the leaked information is not tied to the individual.
In this regard, according to the blood flow analysis system 200, blood flow analysis can be requested in consideration of patient privacy.

The database group of the medical data file database device 222, the analysis file database device 223, and the analysis result file database device 224 includes information included in the analysis request, simulation results, and information included in the analysis results based on the simulation results. At least one of them is stored for each person to be analyzed based on the management number. Then, the diagnosis report processing unit 494 generates an analysis result including information indicating the prediction of the blood flow state based on the information stored in the database group.
As described above, the database group stores information for each person to be analyzed based on the management number, so that statistical data can be obtained regarding the temporal change in the blood flow state.

Moreover, the 1st communication part 310 receives the analysis request containing the information which shows the content of the operation regarding blood flow. Then, the diagnosis report processing unit 494 generates an analysis result including information indicating a blood flow state when an operation is performed with the content of the operation.
Thereby, a user (for example, a doctor in charge performing an operation) can confirm in advance whether or not the planned operation is appropriate.

The preprocessing unit 492 extends at least one of the inlet and outlet blood vessels in the three-dimensional model.
Thereby, the preprocessing unit 492 can reduce the influence of blood flow at the entrance and exit of the three-dimensional model, and can improve the accuracy of blood flow analysis.

Further, the preprocessing unit 492 sets an outlet pressure including a reflected wave of blood pressure.
Accordingly, even when at least one of the inlet and outlet blood vessels in the three-dimensional model is extended, the preprocessing unit 492 can set an appropriate boundary condition. Thereby, the preprocessing unit 492 can improve the accuracy of blood flow analysis.

In addition, when the preprocessing unit 492 determines that there is no stenosis in the blood vessel in the three-dimensional model in the analysis of the coronary artery and determines that the influence of the stenosis on the blood flow can be ignored, Set the pressure. On the other hand, when it is determined that the influence of stenosis on the blood flow cannot be ignored, the preprocessing unit 492 sets a variable impedance (impedance whose value varies with time) at the exit boundary of the three-dimensional model.
Thereby, the preprocessing unit 492 can perform blood flow analysis more accurately regardless of the presence or absence of stenosis of blood vessels.

The preprocessing unit 492 performs correction to subtract a value proportional to the derivative of the inlet flow rate of the blood flow from the outlet pressure.
Thereby, the preprocessing unit 492 can simulate the elasticity of the blood vessel wall, and in this respect, the accuracy of blood flow analysis can be improved.

Also, the preprocessing unit 492 sets an outlet pressure simulating blood flow adjustment by the autonomic nerve using a snake sight function. The preprocessing unit 492 can improve the accuracy of blood flow analysis by simulating blood flow adjustment by the autonomic nerve.

Further, when the preprocessing unit 492 determines that the flow rate at the inlet boundary of the three-dimensional model is known, the preprocessing unit 492 sets the inlet flow rate of the blood flow as the inlet boundary condition. On the other hand, when determining that the flow rate at the inlet boundary is unknown, the preprocessing unit 492 sets the inlet pressure of the blood flow as the inlet boundary condition.
Thereby, the preprocessing unit 492 can perform blood flow analysis more accurately regardless of whether or not the flow rate at the inlet boundary is known.

Next, the minimum configuration of the embodiment will be described with reference to FIGS.
FIG. 10 is a schematic block diagram showing the minimum configuration of the blood flow analysis system according to the embodiment. As shown in the figure, the blood flow analysis system 10 includes an analysis request receiving unit 11, an anonymization processing unit 12, a model generation unit 13, a condition setting unit 14, a simulation request processing unit 15, and an analysis execution unit. 16, an analysis result generation unit 17, and an analysis result transmission unit 18.

10, the analysis request receiving unit 11 receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network. The anonymization processing unit 12 deletes information for specifying the analysis target person from the analysis request and assigns a management number for identifying the analysis target person. The model generation unit 13 generates a three-dimensional model of the blood vessel shape based on the two-dimensional tomographic image. The condition setting unit 14 sets conditions for a finite volume method for blood flow simulation based on a three-dimensional model. The simulation request processing unit 15 generates a simulation request including the conditions set by the three-dimensional model and condition setting unit 14 and a management number. The analysis execution unit 16 performs a blood flow simulation by a fluid analysis method using a finite volume method based on the simulation request. The analysis result generation unit 17 generates an analysis result based on the simulation result by the analysis execution unit 16. The analysis result transmission unit 18 transmits the analysis result to the request source based on the management number.

In this way, the anonymization processing unit 12 deletes information for identifying the person to be analyzed from the analysis request, and assigns a management number for each analysis countermeasure. Thereby, even if information included in the analysis request such as medical condition information is leaked, the leaked information is not linked to an individual.
In this regard, the blood flow analysis system 10 can request blood flow analysis in consideration of patient privacy.

FIG. 11 is a schematic block diagram showing the minimum configuration of the analysis request receiving system according to the embodiment. As shown in the figure, the analysis request receiving system 20 includes an analysis request receiving unit 21, an anonymization processing unit 22, a model generation unit 23, a condition setting unit 24, a simulation request processing unit 25, and an analysis result generation. Unit 26 and an analysis result transmitting unit 27.

In the analysis request receiving system 20 in FIG. 11, the analysis request receiving unit 21 receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network. The anonymization processing unit 22 deletes information for identifying the analysis target person from the analysis request and assigns a management number for identifying the analysis target person. The model generation unit 23 generates a three-dimensional model of the blood vessel shape based on the two-dimensional tomographic image. The condition setting unit 24 sets conditions for the finite volume method for blood flow simulation based on the three-dimensional model. The simulation request processing unit 25 generates a simulation request including the conditions set by the three-dimensional model and condition setting unit 24 and the management number. The analysis result generation unit 26 generates an analysis result based on the result of the blood flow simulation performed by the fluid analysis method using the finite volume method based on the simulation request. The analysis result transmission unit 27 transmits the analysis result to the request source based on the management number.

As described above, the anonymization processing unit 22 deletes information for identifying the person to be analyzed from the analysis request, and assigns a management number for each analysis countermeasure. Thus, even if information included in the analysis request such as medical condition information is leaked, the leaked information is not tied to an individual.
Thereby, according to the analysis request reception system 20, it is possible to request blood flow analysis in consideration of patient privacy.

Note that all or some of the functions of the blood

flow analysis systems

10 and 200 and the analysis request reception system 20 can be realized by the CPU reading and executing the program. In that case, a program for realizing this function may be recorded on a computer-readable recording medium, and the program recorded on this recording medium may be read into a computer system and executed. Here, the “computer system” includes an OS and hardware such as peripheral devices. The “computer-readable recording medium” refers to a storage device such as a flexible medium, a magneto-optical disk, a portable medium such as a ROM or a CD-ROM, and a hard disk incorporated in a computer system.
Further, the program may be a program for realizing a part of the above-described functions, and may be a program capable of realizing the functions described above in combination with a program already recorded in a computer system. You may implement | achieve using programmable logic devices, such as FPGA (Field Programmable Gate Array).

As described above, the embodiment of the present invention has been described in detail with reference to the drawings. However, the specific configuration is not limited to this embodiment, and includes design and the like within the scope not departing from the gist of the present invention.

This application claims priority based on Japanese Patent Application No. 2016-079905 filed in Japan on April 12, 2016, the entire disclosure of which is incorporated herein.

DESCRIPTION OF SYMBOLS 100

User terminal device

10, 200 Blood flow analysis system 11, 21 Analysis

request receiving part

12, 22, 392

Anonymization processing part

13, 23, 491

Model generation part

14, 24

Condition setting part

15, 25, 493 Simulation request process Unit 16

analysis execution unit

17, 26 analysis

result generation unit

18, 27 analysis

result transmission unit

20, 210 analysis request reception system 211 reception server device 310 first communication unit 380 first storage unit 390 first control unit 391 user authentication unit 212 Item management server device 410 Second communication unit 480 Second storage unit 490 Second control unit 492 Preprocessing unit 494 Diagnostic report processing unit 221 User authentication database device 222 Medical data file database device 223 Analysis file database device 224 Analysis result Phi Database system 231 operation terminal 232 diagnostic report creation terminal unit 240 analyzes the server device 900 a communication network

Claims

An analysis request receiving unit that receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network;
Anonymization processing unit that deletes information for identifying an analysis target person from the analysis request and gives a management number for identifying the analysis target person;
A model generation unit that generates a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image;
A condition setting unit for setting conditions of a finite volume method used for simulation of blood flow based on the three-dimensional model;
A simulation request processing unit that generates a simulation request including the three-dimensional model, the condition set by the condition setting unit, and the management number;
Based on the simulation request, an analysis execution unit that simulates the blood flow by a fluid analysis method using the finite volume method;
An analysis result generation unit that generates an analysis result based on a simulation result by the analysis execution unit;
An analysis result transmitter for transmitting the analysis result to the requester based on the management number;
A blood flow analysis system comprising:
A temporal information storage unit that stores at least one of the information included in the analysis request, the simulation result, and the information included in the analysis result for each person to be analyzed based on the management number;
The analysis result generation unit generates the analysis result including information indicating prediction of the blood flow state based on information stored in the time-lapse information storage unit.
The blood flow analysis system according to claim 1.
The analysis request receiving unit receives the analysis request further including information indicating the content of the surgery related to the blood flow,
The analysis result generation unit generates the analysis result including information indicating the state of the blood flow when an operation is performed with the content of the operation.
The blood flow analysis system according to claim 1 or 2.
The condition setting unit sets an extension of at least one of the inlet and outlet blood vessels in the three-dimensional model.
The blood flow analysis system according to any one of claims 1 to 3.
The condition setting unit sets an outlet pressure including a reflected wave of blood pressure.
The blood flow analysis system according to any one of claims 1 to 4.
When the condition setting unit determines that there is no stenosis in the blood vessel in the three-dimensional model in the analysis of the coronary artery, and when it is determined that the influence of the stenosis on the blood flow can be ignored, the reflected wave of blood pressure When the outlet pressure including is determined and it is determined that the influence cannot be ignored, an impedance whose value varies with time at the outlet boundary of the three-dimensional model is set.
The blood flow analysis system according to any one of claims 1 to 4.
The blood flow analysis system according to any one of claims 1 to 6, wherein the condition setting unit performs correction by subtracting a value proportional to the derivative of the inlet flow rate of the blood flow from the outlet pressure.
The blood flow analysis system according to any one of claims 1 to 7, wherein the condition setting unit sets an outlet pressure simulating the adjustment of the blood flow by an autonomic nerve using a snake sight function.
When determining that the flow rate at the inlet boundary of the three-dimensional model is known, the condition setting unit sets the inlet flow rate of the blood flow as the inlet boundary condition, and determines that the flow rate at the inlet boundary is unknown. The inlet pressure of the blood flow is set as the inlet boundary condition,
The blood flow analysis system according to any one of claims 1 to 8.
An analysis request receiving unit that receives an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network;
Anonymization processing unit that deletes information for identifying an analysis target person from the analysis request and gives a management number for identifying the analysis target person;
A model generation unit that generates a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image;
A condition setting unit for setting conditions of a finite volume method used for simulation of blood flow based on the three-dimensional model;
A simulation request processing unit that generates a simulation request including the three-dimensional model, the condition set by the condition setting unit, and the management number;
Based on the simulation request, an analysis result generation unit that generates an analysis result based on a result of the blood flow simulation performed by a fluid analysis method using the finite volume method;
An analysis result transmitter for transmitting the analysis result to the requester based on the management number;
An analysis request reception system comprising:
An analysis request receiving step for receiving an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network;
A connectable anonymization step that deletes information for identifying the analysis target person from the analysis request and gives a management number for identifying the analysis target person;
A model generation step of generating a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image;
A condition setting step for setting conditions of a finite volume method used for simulation of blood flow based on the three-dimensional model;
A simulation request processing step for generating a simulation request including the three-dimensional model, the condition set in the condition setting step, and the management number;
Based on the simulation request, an analysis execution step of simulating the blood flow by a fluid analysis method using the finite volume method;
An analysis result generation step for generating an analysis result based on a simulation result in the analysis execution step;
An analysis result transmission step of transmitting the analysis result to a requester based on the management number;
A blood flow analysis method including:
On the computer,
An analysis request receiving step for receiving an analysis request including a two-dimensional tomographic image to be analyzed for blood flow via a communication network;
A connectable anonymization step that deletes information for identifying the analysis target person from the analysis request and gives a management number for identifying the analysis target person;
A model generation step of generating a three-dimensional model of a blood vessel shape based on the two-dimensional tomographic image;
A condition setting step for setting conditions of a finite volume method used for simulation of blood flow based on the three-dimensional model;
A simulation request processing step for generating a simulation request including the three-dimensional model, the condition set in the condition setting step, and the management number;
Based on the simulation request, an analysis result generating step for generating an analysis result based on a result of the blood flow simulation performed by a fluid analysis method using the finite volume method;
An analysis result transmission step of transmitting the analysis result to a requester based on the management number;
A program for running