WO2020098141A1 - 基于造影图像计算造影血流储备分数和静息态压力比值的方法 - Google Patents
基于造影图像计算造影血流储备分数和静息态压力比值的方法 Download PDFInfo
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T17/00—Three dimensional [3D] modelling, e.g. data description of 3D objects
- G06T17/20—Finite element generation, e.g. wire-frame surface description, tesselation
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
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Definitions
- the invention relates to the field of coronary artery imaging evaluation, and in particular to a method for calculating contrast blood flow reserve fraction (cFFR) and resting state pressure ratio (resting Pd / Pa) based on contrast image.
- cFFR contrast blood flow reserve fraction
- resting Pd / Pa resting state pressure ratio
- the blood flow reserve fraction can indicate the influence of coronary stenosis on the distal blood flow, and the diagnosis of myocardial ischemia has become a recognized index for the functional evaluation of coronary stenosis.
- the FFR When determining FFR, it is necessary to calculate the FFR based on the average blood pressure of the myocardial hyperemia and the average pressure of the coronary aorta at the distal coronary artery through different means.
- the maximum congestion of the myocardium requires intracoronary or intravenous injection of adenosine or ATP. Injection of adenosine or ATP will cause aortic pressure drop and have certain side effects such as atrioventricular block, sinus remission, sinus arrest, etc., contraindications Including 2 degree or 3 degree atrioventricular block, sinus disease, tracheal or bronchial asthma, and adenosine allergy.
- Contrast blood flow reserve fraction is the ratio of the mean pressure in the coronary artery at the distal end of the stenosis to the mean pressure in the coronary aorta at rest; the resting pressure ratio (resting Pd / Pa) is in the normal physiological state The ratio of the average pressure in the distal coronary artery of the lower stenosis to the average pressure of the coronary aorta.
- the contrast flow reserve fraction is considered to be closer to the flow reserve fraction (FFR).
- the existing methods for calculating the contrast blood flow reserve fraction (cFFR) and resting pressure ratio (resting Pd / Pa) are mainly as follows: the pressure guide wire measures the pressure at the distal end of coronary stenosis in the contrast state and resting state Pd to determine FFR. It needs to rely on the pressure guide wire for measurement. The pressure guide wire needs to be inserted into the end of the blood vessel, which increases the difficulty and risk of surgery. At the same time, the expensive price of the pressure guide wire also limits its large-scale application.
- the object of the present invention is to provide a method for calculating the contrast blood flow reserve fraction and resting state pressure ratio based on contrast images to detect myocardial ischemia by conventional coronary angiography surgery for patients with coronary heart disease, That is, there is no need to use vasodilators (that is, no maximum myocardial hyperemia and no adenosine or ATP). From the conventional contrast image, aortic pressure and blood flow, the contrast blood flow reserve fraction (cFFR) and resting pressure ratio (resting P d / P a ) were calculated.
- cFFR contrast blood flow reserve fraction
- resting pressure ratio resting P d / P a
- a method for calculating contrast blood flow reserve score based on contrast image includes the following steps:
- S02 Obtain the two-dimensional tube diameter and length of the blood vessel through the contrast image, and generate the three-dimensional blood vessel grid model from the two contrast images at an angle of more than 30 ° and obtain the three-dimensional tube diameter and length of the blood vessel;
- the step S01 includes connecting the pressure tube of the blood pressure sensor to the multi-way tee, and then connecting the coronary ostium of the heart through a contrast catheter, filling the pressure tube of the blood pressure sensor with saline, and maintaining the blood pressure sensor position at the same level with the heart, the blood pressure sensor measures a pressure value is the pressure of the coronary port P a.
- the method for generating a three-dimensional blood vessel grid model in step S02 includes the following steps:
- S21 Perform 3D reconstruction on the 2D structure data of two segmented blood vessels with a mapping relationship on two X-ray coronary angiography images at an angle of more than 30 ° to obtain 3D structure data of the segmented blood vessel;
- step S22 Repeat step S21 until the three-dimensional reconstruction of all segmented blood vessels is completed, and then merge the reconstructed segmented blood vessels to obtain a complete three-dimensional blood vessel grid model.
- the specific method for calculating the blood flow velocity V 1 in step S03 includes the following steps:
- S31 Obtain the specified patient's heart rate H times / minute, and obtain the image frequency from the contrast image information as S frames / second.
- S32 According to the number of frames traveled by an image in a cardiac cycle, obtain the start point and end point of a cardiac cycle on the images corresponding to the two-dimensional start frame and the end frame, and then pass the start point and the end point in the three-dimensional blood vessel In the grid model, the blood vessel length of one cardiac cycle is intercepted;
- V 1 L ⁇ P
- L the blood vessel length
- P the time taken for one cardiac cycle
- P X ⁇ S.
- the specific method for calculating the pressure drop ⁇ P 1 from the entrance of the coronary artery to the distal end of the coronary stenosis in the step S04 is as follows:
- P, ⁇ , ⁇ are flow velocity, pressure, blood flow density, blood flow viscosity
- the inlet boundary condition is the blood flow velocity
- the outlet boundary condition is the out-flow boundary condition
- the invention also discloses a method for calculating the resting pressure ratio based on the contrast image, including the following steps:
- S12 Obtain the two-dimensional diameter and length of the blood vessel from the contrast image, and generate the three-dimensional vessel mesh model from the two contrast images with an angle of more than 30 ° and obtain the three-dimensional diameter and length of the blood vessel;
- V 2 0.43 * V 1 +35;
- V 1 200mm / s
- V 2 0.35 * V 1 +55
- the step S11 includes connecting the pressure tube of the blood pressure sensor to the multi-way tee, and then connecting it to the coronary ostium of the heart through a contrast catheter, filling the pressure tube of the blood pressure sensor with saline, and maintaining the blood pressure sensor position at the same level with the heart, the blood pressure sensor measures a pressure value is the pressure of the coronary port P a.
- the method for generating a three-dimensional blood vessel grid model in step S12 includes the following steps:
- S21 Perform 3D reconstruction on the 2D structure data of two segmented blood vessels with a mapping relationship on two X-ray coronary angiography images at an angle of more than 30 ° to obtain 3D structure data of the segmented blood vessel;
- step S22 Repeat step S21 until the three-dimensional reconstruction of all segmented blood vessels is completed, and then merge the reconstructed segmented blood vessels to obtain a complete three-dimensional blood vessel grid model.
- the specific method for calculating the blood flow velocity V 1 in step S13 includes the following steps:
- S31 Obtain the specified patient's heart rate H times / minute, and obtain the image frequency from the contrast image information as S frames / second.
- S32 According to the number of frames traveled by an image in a cardiac cycle, obtain the start point and end point of a cardiac cycle on the images corresponding to the two-dimensional start frame and the end frame, and then pass the start point and the end point in the three-dimensional blood vessel In the grid model, the blood vessel length of one cardiac cycle is intercepted;
- V 1 L ⁇ P
- L the blood vessel length
- P the time taken for one cardiac cycle
- P X ⁇ S.
- the specific method for calculating the pressure drop ⁇ P 2 from the entrance of the coronary artery to the distal end of the coronary stenosis in step S15 is as follows:
- P, ⁇ , ⁇ are flow velocity, pressure, blood flow density, blood flow viscosity
- the inlet boundary condition is the blood flow velocity
- the outlet boundary condition is the out-flow boundary condition
- FIG. 1 is a flowchart of the method of the present invention
- Figure 2 is the reference image
- Fig. 31 is an image of the position-contrast agent flowing to the catheter port
- Fig. 32 is an image of a position-contrast agent flowing to the distal end of a blood vessel
- Figure 33 is an image of the second position of the contrast agent flowing to the catheter port
- Figure 34 is an image of the second position of the contrast agent flowing to the distal end of the blood vessel
- Figure 4 is a screenshot of the cross section of the grid
- Figure 5 is a screenshot of the grid's longitudinal section.
- the method for calculating contrast blood flow reserve fraction and resting state pressure ratio based on contrast images of the present invention includes the following steps.
- Step S1 The pressure P a of the coronary ostium of the heart is measured by the blood pressure sensor.
- the specific method is as follows:
- the pressure tube using the blood pressure sensor is connected to the multi-way tee, and then connected to the coronary ostium of the heart through the contrast catheter.
- the pressure tube of the blood pressure sensor is filled with saline and keeping the blood pressure sensor and the heart at the same horizontal position.
- coronary heart pressure value is the pressure port P a.
- Step S2 Obtain the two-dimensional diameter and length of the blood vessel from the contrast image, and generate the three-dimensional blood vessel mesh model from the two contrast images at an angle of 30 ° or more and obtain the three-dimensional diameter and length of the blood vessel, as shown in FIG. ;
- the specific method of the three-dimensional blood vessel grid model is as follows:
- Step S3 As shown in FIGS. 31-34, measure the time taken by the blood (including contrast agent) from the start point (31, 33) to the end point (32, 34) of a specified blood vessel (including a possible criminal blood vessel), and The blood flow velocity V 1 is calculated according to the time and the three-dimensional length of the blood vessel, and the specific method is as follows:
- the images corresponding to the two-dimensional start frame and the end frame are obtained as shown in Figure 31 and Figure 32 or Figure 33 and Figure 34, respectively.
- Point and then intercept the blood vessel length of a cardiac cycle in the three-dimensional synthetic data through the starting point and the ending point;
- V 1 L ⁇ P.
- Step S4 Calculate the blood flow velocity V 2 in the resting state
- V 1 100 millimeters per second (mm / s)
- V 2 0.53 * V 1 +20;
- V 2 0.43 * V 1 +35;
- V 1 200mm / s
- V 2 0.35 * V 1 +55
- P, ⁇ , ⁇ are flow velocity, pressure, blood flow density, blood flow viscosity
- the inlet boundary condition is the blood flow velocity
- the outlet boundary condition is the out-flow boundary condition
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Abstract
Description
Claims (10)
- 一种基于造影图像计算造影血流储备分数的方法,其特征在于,包括以下步骤:S01:通过血压传感器测量心脏冠脉口的压力P a;S02:通过造影图像获取血管的二维管径及长度,并通过两个呈30°以上夹角的造影图像生成三维血管网格模型并获得血管的三维管径及长度;S03:测量包含造影剂的血液从一段指定血管的起始点到结束点所用的时间,并根据该时间和血管三维长度计算血流速度V 1;S04:将步骤S03计算得到的造影状态下的血流速度V 1作为冠脉入口流速,计算冠脉入口到冠脉狭窄远端的压力降ΔP 1,狭窄远端冠状动脉内平均压P d1=P a-ΔP 1,通过造影血流储备分数计算公式cFFR=P d1/P a计算得到造影血流储备分数。
- 根据权利要求1所述的基于造影图像计算造影血流储备分数的方法,其特征在于,所述步骤S01包括,使用血压传感器的压力管连接到多联三通,然后通过造影导管与心脏冠脉口部相连,在血压传感器的压力管内充满盐水,并保持血压传感器与心脏在同一水平位置,该血压传感器测量的压力值即为心脏冠脉口的压力P a。
- 根据权利要求1所述的基于造影图像计算造影血流储备分数的方法,其特征在于,所述步骤S02中生成三维血管网格模型的方法包括以下步骤:S21:将两个呈30°以上夹角的X射线冠脉造影图像上,具有映射关系的两分段血管的2D结构数据进行三维重建,得到该分段血管的3D结构数据;S22:重复步骤S21,直到所有分段血管三维重建完成,再将重建后的分段血管合并,得到完整的三维血管网格模型。
- 根据权利要求1所述的基于造影图像计算造影血流储备分数的方法,其特征在于,步骤S03中计算血流速度V 1的具体方法包括以下步骤:S31:获取指定的病人心率为H次/分钟,从造影图像信息中获取图像频率为S帧/秒,其帧数X的计算公式如下:X=(1÷(H÷60))×S;S32:通过一个心动周期内图像所走过的帧数,在二维起始帧和结束帧对应的图像上分别取得一个心动周期的起始点和结束点,然后通过起始点和结束点在三维血管网格模型中截取一个心动周期的血管长度;S33:通过公式V 1=L÷P,计算得到血液流动速度V 1,L为血管长度,P为一个心动周期所用的时间,P=X÷S。
- 一种基于造影图像计算静息态压力比值的方法,其特征在于,包括以下步骤:S11:通过血压传感器测量心脏冠脉口的压力P a;S12:通过造影图像获取血管的二维管径及长度,并通过两个呈30°以上夹角的造影图像生成三维血管网格模型并获得血管的三维管径及长度;S13:测量包含造影剂的血液从一段指定血管的起始点到结束点所用的时间,并根据该时间和血管三维长度计算血流速度V 1;S14:根据以下计算公式,计算得到静息态下的血流速度V 2,计算公式为:当V 1≤100mm/s时,V 2=0.53*V 1+20;当100mm/s<V 1≤200mm/s时,V 2=0.43*V 1+35;当V 1>200mm/s时,V 2=0.35*V 1+55;S15:将步骤S14计算得到的静息态下的血流速度V 2作为冠脉入口流速,计算冠脉入口到冠脉狭窄远端的压力降ΔP 2,狭窄远端冠状动脉内平均压P d2=P a-ΔP 2,通过公式resting P d/P a=P d2/P a计算得到静息态压力比值。
- 根据权利要求6所述的基于造影图像计算静息态压力比值的方法,其特征在于,所述步骤S11包括,使用血压传感器的压力管连接到多联三通, 然后通过造影导管与心脏冠脉口部相连,在血压传感器的压力管内充满盐水,并保持血压传感器与心脏在同一水平位置,该血压传感器测量的压力值即为心脏冠脉口的压力P a。
- 根据权利要求6所述的基于造影图像计算静息态压力比值的方法,其特征在于,所述步骤S12中生成三维血管网格模型的方法包括以下步骤:S21:将两个呈30°以上夹角的X射线冠脉造影图像上,具有映射关系的两分段血管的2D结构数据进行三维重建,得到该分段血管的3D结构数据;S22:重复步骤S21,直到所有分段血管三维重建完成,再将重建后的分段血管合并,得到完整的三维血管网格模型。
- 根据权利要求6所述的基于造影图像计算静息态压力比值的方法,其特征在于,步骤S13中计算血流速度V 1的具体方法包括以下步骤:S31:获取指定的病人心率为H次/分钟,从造影图像信息中获取图像频率为S帧/秒,其帧数X的计算公式如下:X=(1÷(H÷60))×S;S32:通过一个心动周期内图像所走过的帧数,在二维起始帧和结束帧对应的图像上分别取得一个心动周期的起始点和结束点,然后通过起始点和结束点在三维血管网格模型中截取一个心动周期的血管长度;S33:通过公式V 1=L÷P,计算得到血液流动速度V 1,L为血管长度,P为一个心动周期所用的时间,P=X÷S。
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CN116188336A (zh) * | 2023-04-17 | 2023-05-30 | 柏意慧心(杭州)网络科技有限公司 | 基于血管造影的心肌病形态学计算方法、装置及存储介质 |
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