WO2020098704A1 - 基于造影图像获取血管评定参数的方法、装置及系统 - Google Patents

基于造影图像获取血管评定参数的方法、装置及系统 Download PDF

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WO2020098704A1
WO2020098704A1 PCT/CN2019/118053 CN2019118053W WO2020098704A1 WO 2020098704 A1 WO2020098704 A1 WO 2020098704A1 CN 2019118053 W CN2019118053 W CN 2019118053W WO 2020098704 A1 WO2020098704 A1 WO 2020098704A1
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pressure
waveform
coronary
coronary artery
blood vessel
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PCT/CN2019/118053
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English (en)
French (fr)
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霍云飞
刘广志
吴星云
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苏州润迈德医疗科技有限公司
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Priority claimed from CN201811344060.XA external-priority patent/CN111166315B/zh
Priority claimed from CN201811344281.7A external-priority patent/CN111166317B/zh
Priority claimed from CN201811344074.1A external-priority patent/CN111166316B/zh
Application filed by 苏州润迈德医疗科技有限公司 filed Critical 苏州润迈德医疗科技有限公司
Priority to EP19885173.5A priority Critical patent/EP3881758A4/en
Priority to CN201980040404.4A priority patent/CN112384136A/zh
Priority to JP2021523637A priority patent/JP7162934B2/ja
Publication of WO2020098704A1 publication Critical patent/WO2020098704A1/zh
Priority to US17/237,662 priority patent/US20210236000A1/en

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Definitions

  • the invention relates to the technical field of coronary arteries, in particular to a method, a device, a coronary artery analysis system and a computer storage medium for acquiring coronary artery blood vessel evaluation parameters based on contrast images.
  • cardiovascular disease has become the "number one killer" of human health.
  • hemodynamics to analyze the physiological and pathological behavior of cardiovascular diseases has also become a very important means of cardiovascular disease diagnosis.
  • 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.
  • the instantaneous waveform-free ratio can provide a method for measuring coronary pressure similar to the fractional flow reserve (FFR). iFR does not require vasodilators, is simple to operate, and will be more used in coronary interventional therapy.
  • the existing measurement methods of coronary artery vascular assessment parameters are mainly: (1) pressure guide wire measurement, which is expensive, difficult to operate, and high risk; (2) coronary artery two-dimensional angiography image measurement, by obtaining real-time pressure and aortic blood flow velocity v P a measured full-cycle, resulting in coronary arteries can only get full cycle of evaluation parameters can not be obtained vascular parameters assessed in contrast diastolic state; and no aortic pressure P a Screening with blood flow velocity v leads to the problem of inaccurate vascular assessment parameters obtained.
  • the present invention provides a method, device and system for acquiring blood vessel evaluation parameters based on contrast images.
  • acquiring Pa- t pressure waves and vt velocity waveforms in the time domain it is possible to solve the problem of obtaining diastolic blood vessel evaluation parameters and measuring The problem of inaccurate vascular assessment parameters.
  • the present application provides a method for obtaining coronary artery vascular assessment parameters based on contrast image, including:
  • the blood flow velocity v and pressure P a Fourier transform, to obtain the velocity waveform v'-t in the frequency domain and P a '-t pressure waveform;
  • the P a -t pressure waveform in the time domain, ⁇ P-t pressure drop waveform, obtaining the coronary angiography vascular parameters assessed state.
  • the vascular assessment parameters includes: instantaneous waveform-free ratio caiFR in contrast state, first diastolic pressure ratio cadPR in contrast state and less than average in contrast state Pressure diastolic ratio caDFR;
  • the first diastolic pressure ratio cadPR, through the average pressure of the first aorta in the full diastolic period Mean pressure distal to the first coronary artery stenosis obtain;
  • the instantaneous waveform-free ratio caiFR, through the mean pressure of the third aorta within the waveform-free period Mean distal pressure with third coronary stenosis obtain.
  • the calculation formulas of the instantaneous waveform-free ratio caiFR, the first diastolic pressure ratio cadPR, and the caDFR less than the average pressure diastolic ratio are:
  • the blood vessel evaluation parameters further includes: blood flow reserve fraction caFFR;
  • the blood flow reserve fraction caFFR is calculated by the average pressure of the fourth aorta within the whole cardiac cycle Mean pressure distal to fourth coronary artery stenosis Obtained, namely:
  • coronary artery evaluation parameter acquired based on the contrast image of the above method the contrast of the acquisition state of real-time pressure inlet coronary P a, P a -t method of obtaining pressure waveforms in the time domain comprising: blood collection conduit means communicating with the real time measurement of the contrast coronary inlet pressure P a, plotted versus time to give the pressure P a -t time domain waveform.
  • the above method for obtaining coronary artery vascular assessment parameters based on contrast images the three-dimensional modeling of the vessel segment of interest in the two-dimensional coronary artery contrast images of the contrast state to obtain a three-dimensional blood vessel grid model includes :
  • the method for acquiring the real-time blood flow velocity v of the three-dimensional blood vessel grid model to obtain the vt velocity waveform in the time domain includes: time domain Vt diastolic velocity waveform under;
  • the number of frames that the coronary angiography image traverses during a diastole is the difference in the length of the blood vessel in the adjacent two frames of the contrast agent flowing in the blood vessel, and the contrast agent velocity of each frame of the coronary angiography image is The real-time diastolic blood flow velocity v of the three-dimensional vascular grid model is as follows:
  • ⁇ L represents the difference in the length of the blood vessel in which the contrast agent flows in the two adjacent frames of the image
  • H represents the patient's heart rate in units of times / min
  • y represents the number of frames of coronary angiography images in the diastolic period
  • t represents Time of diastole in Pa- t pressure waveform
  • T represents the time of whole heartbeat cycle in Pa- t pressure waveform
  • the blood flow velocity v is plotted against time to obtain the v-t diastolic velocity waveform in the time domain.
  • the method for acquiring the real-time blood flow velocity v of the three-dimensional blood vessel grid model to obtain the vt velocity waveform in the time domain includes: time domain Vt full heart cycle velocity waveform under;
  • the number of frames that the coronary angiography image traverses in a certain cardiac cycle the difference in the length of the blood vessel in the adjacent two frames of the contrast agent flowing in the blood vessel, and the contrast agent velocity of each frame of the coronary angiography image
  • the real-time whole-heart cycle blood flow velocity v of the three-dimensional vascular grid model is as follows:
  • ⁇ L represents the difference in the length of the blood vessel in which the contrast agent flows in the two adjacent frames of the image
  • H represents the heart rate of the patient in units of times / min
  • x represents the number of frames of coronary angiography images located in the cardiac cycle
  • the blood flow velocity v is plotted against time to obtain the v-t cardiac cycle velocity waveform in the time domain.
  • the above method for acquiring coronary artery blood vessel assessment parameters based on contrast images the method for acquiring the real-time blood flow velocity v of the three-dimensional blood vessel grid model includes:
  • ⁇ L represents the difference in the length of the blood vessels in which the contrast agent flows in the blood vessels of two adjacent frames
  • fps represents the number of frames transmitted per second in the picture.
  • the contrast image acquisition method parameters based on assessment of coronary artery according to the above-described velocity waveform v'-t domain and P a '-t pressure waveform of the frequency, acquiring the inlet to the coronary artery stenosis
  • the method of the ⁇ P'-t pressure drop waveform in the remote frequency domain includes:
  • the numerical method is used to solve the continuity and Navier-Stokes equations.
  • the inlet boundary condition is the blood flow velocity v 'in the frequency domain, and the outlet boundary condition is the out-flow boundary condition.
  • the pressure from the inlet to the downstream points along the center line of the blood vessel is calculated. Drop ⁇ P ';
  • P, ⁇ , ⁇ represent the blood flow velocity, pressure, blood flow density, blood flow viscosity of the coronary artery
  • the present application provides a device for obtaining coronary artery vascular assessment parameters based on contrast images, which is used in the above method for obtaining coronary artery vascular assessment parameters based on contrast images, including: a blood pressure collection device, and sequentially connected three-dimensional building A module unit, a blood flow velocity unit, a pressure drop unit and a coronary artery blood vessel evaluation parameter unit, and the blood pressure collection device is connected to the pressure drop unit;
  • the blood collection device communicating with the outside of the catheter angiography, a contrast for acquiring state, the real-time coronary inlet pressure P a, P a -t pressure to give a time domain waveform;
  • the three-dimensional modeling unit is configured to read an arteriography image in a contrast state, perform three-dimensional modeling on the blood vessel segment of interest in the image, and obtain a three-dimensional blood vessel grid model;
  • a blood flow velocity unit configured to receive the three-dimensional blood vessel grid model sent by the three-dimensional modeling unit, obtain the real-time blood flow velocity v of the vessel segment of interest, and obtain a v-t velocity waveform in the time domain;
  • Vt velocity waveform when the pressure drop in the unit, means for receiving the blood flow velocity, the blood collecting apparatus transmits each domain, -t pressure P a waveform of the blood flow velocity v and pressure P a Fourier transform, v'-t velocity waveforms in the frequency domain and P a '-t pressure waveform; v'-t then according to the velocity waveform in the frequency domain and P a' -t pressure waveform, obtaining The ⁇ P'-t pressure drop waveform in the frequency domain from the entrance of the coronary artery to the distal end of coronary stenosis; through the inverse Fourier transform, the ⁇ P-t pressure drop waveform in the time domain from the entrance of the coronary artery to the distal end of the coronary stenosis ;
  • the coronary artery blood vessel evaluation parameter unit is configured to receive the Pa- t pressure waveform and the ⁇ P-t pressure drop waveform in the time domain sent by the blood pressure collection device and the pressure drop unit to obtain the coronary artery blood vessel evaluation parameter.
  • the coronary artery blood vessel assessment parameter unit further includes: a caiFR module, a cadPR module, a caDFR module, and a caFFR module;
  • the cadPR module is used to pass the average pressure of the first aorta in the period of full diastole Mean pressure distal to the first coronary artery stenosis Obtain the first diastolic pressure ratio cadPR;
  • the caiFR module is used to pass the average pressure of the third aorta in the non-waveform period Mean distal pressure with third coronary stenosis Obtaining the instantaneous waveform-free ratio caiFR;
  • the blood flow reserve fraction caFFR is used to pass the average pressure of the fourth aorta within the whole cardiac cycle Mean pressure distal to fourth coronary artery stenosis
  • the blood flow reserve fraction caFFR is obtained.
  • the present application provides a coronary artery analysis system, including: the above-mentioned device for acquiring coronary artery vascular assessment parameters based on contrast images.
  • the present application provides a computer storage medium.
  • the computer program is executed by a processor, the above method for acquiring coronary artery blood vessel evaluation parameters based on contrast image is realized.
  • the present application provides a method for obtaining coronary artery vascular assessment parameters based on contrast images, by acquiring Pa- t pressure waveforms in contrast state and time domain, and then three-dimensionally constructing two-dimensional coronary artery contrast images in contrast state Mode, the vt velocity waveform in the time domain is obtained, and the diastolic coronary vascular assessment parameters are measured; further, the Fourier transform is used to filter the interference data to improve the accuracy of coronary vascular assessment parameters measurement.
  • FIG. 1 is a flow chart of a method for obtaining coronary artery blood vessel assessment parameters based on contrast images in this application;
  • FIG. 3 is a flowchart of S300 of this application.
  • FIG. 8 is a structural block diagram of an embodiment of an apparatus for acquiring coronary artery blood vessel evaluation parameters based on contrast images in this application;
  • FIG. 9 is a structural block diagram of another embodiment of an apparatus for acquiring coronary artery vascular assessment parameters based on contrast images according to the present application.
  • FIG. 10 is a schematic structural diagram of a blood pressure collection device of the present application.
  • Blood pressure collection device 100 main body 110, first power drive device 120, blood pressure collection unit 130, first control device 140, fixed block 150, second control device 160, infusion device 170, infusion tube 171, three-dimensional modeling unit 200, Blood flow velocity unit 300, pressure drop unit 400, coronary vascular assessment parameter unit 500, Fourier transform module 410, pressure drop calculation module 420, inverse Fourier transform module 430, caiFR module 510, cadPR module 520, caDFR module 530, caFFR module 540.
  • the existing measurement methods of coronary artery vascular assessment parameters are: (1) pressure guide wire measurement, which is expensive, difficult to operate, and high risk; (2) coronary artery two-dimensional angiography image measurement, by obtaining real-time aorta P a pressure and blood flow velocity v is measured full cycle, results in the coronary vasculature can be obtained evaluation parameters of the full cycle, Evaluation parameters can not be obtained under diastole vascular angiography state; and no aortic blood pressure P a and Screening of the flow velocity v leads to the problem that the obtained blood vessel evaluation parameters are inaccurate.
  • a method, device, system and storage medium for obtaining blood flow of the aorta and the aorta In order to solve the above problems, a method, device, system and storage medium for obtaining blood flow of the aorta and the aorta.
  • the present application provides a method for obtaining coronary artery vascular assessment parameters based on contrast images, including:
  • the present application provides a method for obtaining coronary artery vascular assessment parameters based on contrast images, by acquiring Pa- t pressure waveforms in contrast state and time domain, and then three-dimensionally constructing two-dimensional coronary artery contrast images in contrast state Mode, the vt velocity waveform in the time domain is obtained, and the diastolic coronary vascular assessment parameters are measured; further, the Fourier transform is used to filter the interference data to improve the accuracy of coronary vascular assessment parameters measurement.
  • three-dimensional modeling is performed on the blood vessel segment of interest in the two-dimensional coronary angiography image of the coronary artery to obtain a three-dimensional blood vessel grid model, as shown in FIG. 2, including:
  • S210 reading at least two coronary angiography images at different angles; further comprising: denoising the coronary angiography image; the posture shooting angle of the two coronary angiography images is greater than or equal to 30 °;
  • static noise is noise that is static in time, such as ribs in the chest cavity
  • dynamic noise is noise that changes in time, such as part of lung tissue and part of heart tissue
  • Grayscale histogram analysis using threshold to further denoise.
  • S310 Obtain a diastolic start point and an end point on the images corresponding to the two-dimensional start frame and the end frame respectively, and then intercept the diastolic period of interest in the three-dimensional vessel grid model through the start point and the end point L, including: including: removing interference blood vessels, extracting the coronary centerline and diameter of the blood vessel of interest along the extension direction of the coronary artery;
  • the number of frames the coronary angiography image travels during a certain diastole obtain the difference in the length of the blood vessel in the adjacent two frames of the contrast agent flowing in the blood vessel, and obtain the contrast agent velocity of each frame of the coronary angiography image, It is the real-time blood flow velocity v of the three-dimensional vascular grid model.
  • the specific formula is as follows:
  • ⁇ L represents the difference in the length of the blood vessel in which the contrast agent flows in the two adjacent frames of the image
  • H represents the patient's heart rate in units of times / min
  • y represents the number of frames of coronary angiography images in the diastolic period
  • t represents Time of diastole in Pa- t pressure waveform
  • T represents the time of whole heartbeat cycle in Pa- t pressure waveform
  • ⁇ L represents the difference in the length of the blood vessel in which the contrast agent flows in the two adjacent frames of the image
  • H represents the heart rate of the patient in units of times / min
  • x represents the number of frames of coronary angiography images located in the cardiac cycle
  • the numerical method is used to solve the continuity and Navier-Stokes equations, the inlet boundary condition is the blood flow velocity v 'in the frequency domain, the outlet boundary condition is the out-flow boundary condition, and the points from the inlet to the downstream are calculated along the center line of the blood vessel Pressure drop ⁇ P ';
  • P, ⁇ , ⁇ represent the blood flow velocity, pressure, blood flow density, blood flow viscosity of the coronary artery
  • ⁇ P-t pressure drop waveform acquisition parameters assessed coronary artery angiography state comprising: a lower contrast ratio waveform instantaneous state caiFR, the first diastolic pressure state at a contrast
  • the ratio cadPR, the ratio less than the average pressure diastolic ratio caDFR and the flow reserve fraction caFFR in contrast state are:
  • the first diastolic pressure ratio, cadPR passes through the average pressure of the first aorta located in the diastole bar area of full diastole, that is, in Figure 5 Mean pressure distal to the first coronary artery stenosis Obtained, namely:
  • the instantaneous waveform-free ratio caiFR passes through the average pressure of the third aorta in the waveform-free period, that is, within the WEP bar area in FIG. 7.
  • No waveform is defined as: a period of time during the diastolic phase of the heart, called the no-wave period.
  • the calculation time of the instant non-waveform period is: 25% of the time after the start of the non-waveform period, and the calculation is stopped 5ms before the start of the contraction period;
  • the present application provides a device for obtaining evaluation parameters of coronary arteries based on contrast images.
  • the above method for obtaining evaluation parameters of coronary arteries based on contrast images includes: a blood pressure collection device 100, and sequentially connected 3D modeling unit 200, blood flow velocity unit 300, pressure drop unit 400 and coronary vascular assessment parameter unit 500, blood pressure collection device 100 is connected to the pressure drop unit 400; blood pressure collection device 100 is connected to an external contrast catheter, use contrast to the acquisition state, the real-time pressure inlet coronary P a, P a -t pressure to give a time domain waveform; 3-D modeling unit 200, for reading the image contrast arteriography state interested in the image 3D modeling of the blood vessel segment of the blood vessel segment to obtain a 3D blood vessel grid model; the blood flow velocity unit 300 is used to receive the 3D blood vessel mesh model sent by the 3D modeling unit 200 to obtain the real-time blood flow velocity v of the vessel segment of interest.
  • the pressure drop unit 400 further includes: a Fourier transform module 410, a pressure drop calculation module 420 and an inverse Fourier transform module 430 connected in sequence module 410 for receiving the blood flow velocity means 300, vt velocity waveform in the time domain blood collecting apparatus 100 are transmitted, -t pressure P a waveform of blood flow velocity v and pressure P a Fourier transform, to obtain a frequency v'-t domain and the velocity waveform P a '-t pressure waveform; module 420 then calculates the pressure drop according to v'-t velocity waveform in the frequency domain Fourier transform module 410 and transmitted P a' -t pressure Waveform to obtain the ⁇ P'-t pressure drop waveform in the frequency domain from the entrance of the coronary artery to the distal end of the coronary stenosis; Inverse Fourier Transform to obtain the ⁇ P-t pressure drop waveform from the entrance of the coronary artery to the distal end of coronary stenosis; Inverse Fourier Transform to obtain the ⁇ P-
  • the blood pressure collecting device 100 includes: a main body 110, and a first power driving device 120, a blood pressure collecting unit 130, and a first control device 140 all connected to the main body 110; 110 is used to control whether the first power driving device 120, the blood pressure collecting unit 130, and the first control device 140 start to work; the blood pressure collecting unit 130 is connected to the second control device 160, and the second control device 160 is connected to an external intervention device.
  • the second control device 160 is used to zero-adjust the blood pressure collection unit 130 and to control whether the blood pressure collection unit 130 is connected to an external intervention device;
  • the first power driving device 120 is provided on the main body 110, and the first power driving device 120 is The external infusion device 170 is connected, and the first power driving device 120 is used to drive the liquid flow of the external infusion device 170;
  • the blood pressure collection unit 130 is provided on the main body 110, and the blood pressure collection unit 130 is connected to the first control device 140 and external intervention equipment Connected, the blood pressure collection unit 130 is used to collect invasive arterial pressure;
  • the first control device 140 is fixed to the main body 110 through a fixing block 150 and the like;
  • the first control device 140 is connected to an external infusion device 170 for controlling the infusion device 170
  • the liquid flow direction causes the liquid to flow from the infusion device 170 to the first control device 140.
  • the present application provides a blood pressure collection device.
  • a blood pressure collection device By setting a first power drive device 120, a blood pressure collection unit 130, and a first control device 140 on the main body 110, by opening the first control device 140, the blood pressure collection unit 130 and the external infusion device 170.
  • the atmosphere is connected at the same time, so that the first power driving device 120 drives the liquid flow inside the infusion tube 7100 on the external infusion device 170 to realize automatic exhaust, without manual exhaust, simple and convenient operation; through the second control device 160
  • the setting realizes automatic zero calibration of the blood pressure collection unit 130. Since the height of the operating bed will affect the measurement of invasive arterial pressure, the height of the blood pressure collection device needs to be changed within one operation without repeating zero calibration multiple times. The operation is simple and the measurement is accurate.
  • the present application provides a coronary artery analysis system, including: the above-mentioned device for acquiring coronary artery vascular assessment parameters based on contrast images.
  • the present application provides a computer storage medium.
  • the computer program is executed by a processor, the above method for acquiring coronary artery blood vessel evaluation parameters based on contrast image is realized.
  • aspects of the present invention can be implemented as a system, method, or computer program product. Therefore, various aspects of the present invention may be specifically implemented in the form of: a complete hardware implementation, a complete software implementation (including firmware, resident software, microcode, etc.), or a combination of hardware and software implementation, It can be collectively referred to as "circuit", "module” or “system” here.
  • various aspects of the present invention may also be implemented in the form of a computer program product in one or more computer-readable media that contains computer-readable program code. Implementation of the method and / or system of embodiments of the present invention may involve performing or completing selected tasks manually, automatically, or a combination thereof.
  • a data processor such as a computing platform for executing multiple instructions.
  • the data processor includes a volatile storage for storing instructions and / or data and / or a non-volatile storage for storing instructions and / or data, for example, a magnetic hard disk and / or Removable media.
  • a network connection is also provided.
  • a display and / or user input device such as a keyboard or mouse are also provided.
  • the computer-readable medium may be a computer-readable signal medium or a computer-readable storage medium.
  • the computer-readable storage medium may be, for example, but not limited to, an electrical, magnetic, optical, electromagnetic, infrared, or semiconductor system, device, or device, or any combination of the above.
  • a more specific example of a computer-readable storage medium will include the following:
  • the computer-readable storage medium may be any tangible medium that contains or stores a program, and the program may be used by or in combination with an instruction execution system, apparatus, or device.
  • the computer-readable signal medium may include a data signal that is propagated in baseband or as part of a carrier wave, in which computer-readable program code is carried. This propagated data signal can take many forms, including but not limited to electromagnetic signals, optical signals, or any suitable combination of the foregoing.
  • the computer-readable signal medium may also be any computer-readable medium other than a computer-readable storage medium, and the computer-readable medium may send, propagate, or transmit a program for use by or in combination with an instruction execution system, apparatus, or device. .
  • the program code contained on the computer-readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wired, optical fiber cable, RF, etc., or any suitable combination of the foregoing.
  • any combination of one or more programming languages can be used to write computer program code for performing operations for various aspects of the invention, including object-oriented programming languages such as Java, Smalltalk, C ++, and conventional procedural programming languages, such as "C" programming language or similar programming language.
  • the program code may be executed entirely on the user's computer, partly on the user's computer, as an independent software package, partly on the user's computer and partly on a remote computer, or entirely on the remote computer or server.
  • the remote computer may be connected to the user's computer through any kind of network, including a local area network (LAN) or a wide area network (WAN), or may be connected to an external computer (for example, through an Internet service provider Internet connection).
  • LAN local area network
  • WAN wide area network
  • Internet service provider Internet connection for example, AT&T, MCI, Sprint, EarthLink, MSN, GTE, etc.
  • each block of the flowchart and / or block diagram and a combination of blocks in the flowchart and / or block diagram can be implemented by computer program instructions.
  • These computer program instructions can be provided to the processor of a general-purpose computer, a special-purpose computer, or other programmable data processing device, thereby producing a machine such that these computer program instructions are executed by the processor of the computer or other programmable data processing device A device that implements the functions / actions specified in one or more blocks in the flowchart and / or block diagram is generated.
  • These computer program instructions may also be stored in a computer-readable medium. These instructions cause the computer, other programmable data processing apparatus, or other equipment to work in a specific manner, so that the instructions stored in the computer-readable medium generate Articles of manufacture that implement the instructions of the functions / acts specified in one or more blocks in the flowchart and / or block diagram.
  • Computer program instructions can also be loaded onto a computer (eg, coronary artery analysis system) or other programmable data processing equipment to cause a series of operating steps to be performed on the computer, other programmable data processing equipment, or other equipment to produce a computer-implemented process , So that instructions executed on a computer, other programmable device, or other equipment provide a process for implementing the functions / acts specified in the flowcharts and / or one or more block diagram blocks.
  • a computer eg, coronary artery analysis system
  • other programmable data processing equipment or other equipment to produce a computer-implemented process

Abstract

一种基于造影图像获取血管评定参数的方法、装置及系统。该基于造影图像获取血管评定参数的方法包括：获取造影态下，冠状动脉入口的实时压力Pa，得到时域下的Pa-t压力波形（S100）；对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型（S200）；获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形（S300）；通过傅里叶变换和傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；获取造影态下冠状动脉血管评定参数。该方法和装置实现了舒张期冠状动脉血管评定参数的测量；再通过傅里叶变换对干扰数据进行过滤，提高了冠状动脉血管评定参数测量的准确度。

Description

基于造影图像获取血管评定参数的方法、装置及系统 技术领域
本发明涉及冠状动脉技术领域，特别是涉及一种基于造影图像获取冠状动脉血管评定参数的方法、装置、冠状动脉分析系统及计算机存储介质。
背景技术
世界卫生组织统计，心血管疾病已经成为人类健康的“头号杀手”。近些年，使用血流动力学分析心血管疾病的生理和病理行为也已经成为心血管疾病诊断的一个非常重要的手段。
血流储备分数(FFR)可表明冠脉狭窄病变对远端血流产生的影响，诊断心肌是否缺血，已经成为冠脉狭窄功能性评价的公认指标。FFR定义为狭窄冠状动脉提供给支配区域心肌的最大血流量与同一支冠状动脉正常时提供给心肌的最大血流量的比值。可以简化为心肌最大充血状态下的狭窄远端冠状动脉内平均压(Pd)与冠状动脉口部主动脉平均压(Pa)的比值，即FFR＝Pd/Pa。
确定FFR时候，需要基于心肌最大充血状态下的血流速度和冠状动脉口部主动脉平均压，通过不同的手段获取狭窄远端冠状动脉内平均压来计算FFR。但心肌最大充血需要通过冠脉内或静脉内注射腺苷或ATP，注射腺苷或ATP会造成主动脉压力下降并有一定的副作用比如房室传导阻滞、窦缓、窦停等，禁忌症包括2度或3度房室传到阻滞、窦房结疾病、气管或支气管哮喘、对腺苷过敏。
瞬时无波形比率(iFR)能提供和血流储备分数(FFR)类似的冠状动脉内压力测量方法。iFR不需要血管扩张剂、操作简单，将会更多的应用在冠状动脉介入治疗。
目前，现有的冠状动脉血管评定参数的测量方法主要为：(1)通过压力导丝测量，价格昂贵，手术难度大、风险高；(2)通过冠状动脉二维造影图像测量，通过获得实时主动脉压力P a和测得的全周期的血流速度v，导致只能获得全周期的冠状动脉血管评定参数，无法获得造影态下舒张期的血管评定参数；且没有对主动脉压力P a和血流速度v进行筛选，导致获取的血管评定参数不准确的问题。
发明内容
本发明提供了一种基于造影图像获取血管评定参数的方法、装置及系统，通过获取时域下的P a-t压力波和v-t速度波形，解决了无法获得舒张期的血管评定参数，以及测得血管评定参数不准确的问题。
为实现上述目的，第一方面，本申请提供了一种基于造影图像获取冠状动脉血管评定参数的方法，包括：
获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；
对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；
获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形；
对所述血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；
根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；
通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
根据时域下的P a-t压力波形、ΔP-t压力降波形，获取造影态下冠状动脉血管评定参数。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述血管评定参数包括：造影态下瞬时无波形比率caiFR、造影态下第一舒张期压力比率cadPR和造影态下小于平均压舒张期比率 caDFR；
所述第一舒张期压力比率cadPR，通过位于全舒张期内的第一主动脉平均压
Figure PCTCN2019118053-appb-000001
与第一冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000002
获得；
所述小于平均压舒张期比率caDFR，通过从
Figure PCTCN2019118053-appb-000003
开始至主动脉压P n＝P min区间内，第二主动脉平均压
Figure PCTCN2019118053-appb-000004
与第二冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000005
获得，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力，P min表示主动脉压的最小值；
所述瞬时无波形比率caiFR，通过位于无波形期内的第三主动脉平均压
Figure PCTCN2019118053-appb-000006
与第三冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000007
获得。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述瞬时无波形比率caiFR、第一舒张期压力比率cadPR和小于平均压舒张期比率caDFR的计算公式分别为：
Figure PCTCN2019118053-appb-000008
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述血管评定参数还包括：血流储备分数caFFR；
所述血流储备分数caFFR，通过位于全心动周期内的第四主动脉平均压
Figure PCTCN2019118053-appb-000009
与第四冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000010
获得，即：
Figure PCTCN2019118053-appb-000011
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形的方法包括：通过与造影导管连通的血压采集装置实时测量冠状动脉入口的压力P a，与时间绘制曲线，得到时域下的P a-t压力波形。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型的方法包括：
读取至少两个不同夹角的冠脉造影图像；
通过2D结构数据，对具有映射关系的两个所述冠脉造影图像上的某一分段血管进行三维重建，得到所述分段血管的3D模型及3D数据；
重复上述步骤，直到所有分段血管三维重建完成，再将重建后的所有分段血管合并，得到完整的三维血管网格模型。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形的方法，包括：时域下的v-t舒张期速度波形；
通过在二维起始帧和结束帧对应的图像上分别取得一个舒张期的起始点和结束点，然后通过起始点和结束点在所述三维血管网格模型中截取舒张期的血管长度L；
根据患者心率，某舒张期内冠脉造影图像走过的帧数，获取相邻两帧图像中造影剂在血管内流动的血管长度差，获取每帧冠脉造影图像的造影剂速度，即为三维血管网格模型的实时舒张期血流速度v，具体公式如下：
Figure PCTCN2019118053-appb-000012
K＝t/T；
其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，y表示位于舒张期内的冠脉造影图像的帧数，其中t表示P a-t压力波形中舒张期的时间，T表示P a-t压力波形中全心跳周期的时间；
将血流速度v与时间绘制曲线，得到时域下的v-t舒张期速度波形。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形的方法，包括：时域下的v-t全心动周期速度波形；
通过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所述三维血管网格模型中截取心动周期的血管长度L；
根据患者心率，某心动周期内冠脉造影图像走过的帧数，获取相邻两帧图像中造影剂在血管内流动的血管长度差，获取每帧冠脉造影图像的造影剂速度，即为三维血管网格模型的实时全心动周期血流速度v，具体公式如下：
Figure PCTCN2019118053-appb-000013
其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，x表示位于心动周期内的冠脉造影图像的帧数；
将血流速度v与时间绘制曲线，得到时域下的v-t心动周期速度波形。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述获取所述三维血管网格模型的实时血流速度v的方法包括：
v＝ΔL/fps；
其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，fps表示画面每秒传输帧数。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的方法，所述根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形的方法，包括：
采用数值法求解连续性和Navier-Stokes方程，入口边界条件为频域下的血流速度v’，出口边界条件为out-flow边界条件，计算沿着血管中心线从入口到下游各点的压力降ΔP’；
其中，连续性和Navier-Stokes方程为：
Figure PCTCN2019118053-appb-000014
Figure PCTCN2019118053-appb-000015
Figure PCTCN2019118053-appb-000016
P、ρ、μ分别表示冠状动脉的血流速度、压力、血流密度、血流粘性；
将压力降ΔP’与时间绘制曲线，得到频域下的ΔP’-t压力降波形；
第二方面，本申请提供了一种基于造影图像获取冠状动脉血管评定参数的装置，用于上述的基于造影图像获取冠状动脉血管评定参数的方法，包括：血压采集装置，以及依次连接的三维建模单元、血流速度单元、压力降单元和冠状动脉血管评定参数单元，所述血压采集装置与所述压力降单元连接；
所述血压采集装置，与外部的造影导管连通，用于获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；
所述三维建模单元，用于读取造影态下的动脉造影图像，对所述图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；
血流速度单元，用于接收所述三维建模单元发送的三维血管网格模型，获取所述感兴趣的血管段的实时血流速度v，得到时域下的v-t速度波形；
所述压力降单元，用于接收所述血流速度单元、所述血压采集装置分别发送的时域下的v-t速度波形、P a-t压力波形，对所述血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；再根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
所述冠状动脉血管评定参数单元，用于接收所述血压采集装置、所述压力降单元发送的时域下的P a-t压力波形和ΔP-t压力降波形，获取冠状动脉血管评定参数。
可选地，上述的基于造影图像获取冠状动脉血管评定参数的装置，所述冠状动脉血管评定参数单元还包括：caiFR模块、cadPR模块、caDFR模块和caFFR模块；
所述cadPR模块，用于通过位于全舒张期内的第一主动脉平均压
Figure PCTCN2019118053-appb-000017
与第一冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000018
获得第一舒张期压力比率cadPR；
所述caDFR模块，用于通过从
Figure PCTCN2019118053-appb-000019
开始至主动脉压P n＝P min区间内，第二主动脉平均压
Figure PCTCN2019118053-appb-000020
与第二冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000021
获得小于平均压舒张期比率caDFR，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力，P min表示主动脉压的最小值；
所述caiFR模块，用于通过位于无波形期内的第三主动脉平均压
Figure PCTCN2019118053-appb-000022
与第三冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000023
获得所述瞬时无波形比率caiFR；
所述血流储备分数caFFR，用于通过位于全心动周期内的第四主动脉平均压
Figure PCTCN2019118053-appb-000024
与第四冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000025
获得所述血流储备分数caFFR。
第三方面，本申请提供了一种冠状动脉分析系统，包括：上述的基于造影图像获取冠状动脉血管评定参数的装置。
第四方面，本申请提供了一种计算机存储介质，计算机程序被处理器执行时实现上述的基于造影图像获取冠状动脉血管评定参数的方法。
本申请实施例提供的方案带来的有益效果至少包括：
本申请提供了一种基于造影图像获取冠状动脉血管评定参数的方法，通过获取造影态下、时域下的P a-t压力波形，再通过对造影态下冠状动脉二维造影图像进行三维建模，得到时域下的v-t速度波形，实现了舒张期冠状动脉血管评定参数的测量；进一步地，再通过傅里叶变换对干扰数据进行过滤，提高了冠状动脉血管评定参数测量的准确度。
附图说明
此处所说明的附图用来提供对本发明的进一步理解，构成本发明的一部分，本发明的示意性实施例及其说明用于解释本发明，并不构成对本发明的不当限定。在附图中：
图1为本申请的基于造影图像获取冠状动脉血管评定参数的方法的流程图；
图2为本申请的S200的流程图；
图3为本申请的S300的流程图；
图4为本申请的S500的流程图；
图5为本申请的第一舒张期压力比率cadPR的压力波形图；
图6为本申请的小于平均压舒张期比率caDFR的压力波形图；
图7为本申请的瞬时无波型比率caiFR的压力波形图；
图8为本申请的基于造影图像获取冠状动脉血管评定参数的装置的一个实施例的结构框图；
图9为本申请的基于造影图像获取冠状动脉血管评定参数的装置的另一实施例的结构框图；
图10为本申请的血压采集装置的结构示意图；
下面对附图标记进行说明：
血压采集装置100，主体110，第一动力驱动装置120，血压采集单元130，第一控制装置140，固定块150，第二控制装置160，输液装置170，输液管171，三维建模单元200，血流速度单元300，压力降单元400，冠状动脉血管评定参数单元500，傅里叶变换模块410，压力降计算模块420，傅里叶变换逆模块430，caiFR模块510，cadPR模块520，caDFR模块530，caFFR模块540。
具体实施方式
为使本发明的目的、技术方案和优点更加清楚，下面将结合本发明具体实施例及相应的附图对本发明技术方案进行清楚、完整地描述。显然，所描述的实施例仅是本发明一部分实施例，而不是全部的实施例。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
以下将以图式揭露本发明的多个实施方式，为明确说明起见，许多实务上的细节将在以下叙述中一并说明。然而，应了解到，这些实务上的细节不应用以限制本发明。也就是说，在本发明的部分实施方式中，这些实务上的细节是非必要的。此外，为简化图式起见，一些习知惯用的结构与组件在图式中将以简单的示意的方式绘示之。
现有的冠状动脉血管评定参数的测量方法主要为：(1)通过压力导丝测量，价格昂贵，手术难度大、风险高；(2)通过冠状动脉二维造影图像测量，通过获得实时主动脉压力P a和测得的全周期的血流速度v，导致只能获得全周期的冠状动脉血管评定参数，无法获得造影态下舒张期的血管评定参数；且没有对主动脉压力P a和血流速度v进行筛选，导致获取的血管评定参数不准确的问题。
为了解决上述问题，获取大动脉心表大动脉的血流量的方法、装置、系统及存储介质。
实施例1：
如图1所示，本申请提供了一种基于造影图像获取冠状动脉血管评定参数的方法，包括：
S100，获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；
S200，对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；
S300，获取三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形；
S400，对血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；
S500，根据频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；
S600，通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
S700，根据时域下的P a-t压力波形、ΔP-t压力降波形，获取造影态下冠状动脉血管评定参数。
本申请提供了一种基于造影图像获取冠状动脉血管评定参数的方法，通过获取造影态下、时域下的P a-t压力波形，再通过对造影态下冠状动脉二维造影图像进行三维建模，得到时域下的v-t速度波形，实现了舒张期冠状动脉血管评定参数的测量；进一步地，再通过傅里叶变换对干扰数据进行过滤，提高了冠状动脉血管评定参数测量的准确度。
实施例2：
S100，获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形，包括：
通过与造影导管连通的血压采集装置实时测量冠状动脉入口的压力P a，与时间绘制曲线，得到时域下的P a-t压力波形；
S200，对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型，如图2所示，包括：
S210，读取至少两个不同夹角的冠脉造影图像；还包括：对冠脉造影图像去噪；两幅冠脉造影图像的体位拍摄角度大于等于30°；
包括：静态噪声和动态噪声；静态噪声为在时间中静止不变的噪声，如胸腔中的肋骨；动态噪声为在时间中变化的噪声，如部分肺部组织、部分心脏组织；以及包括：通过灰度直方图分析，利用阈值进一步去噪。
S220，通过2D结构数据，对具有映射关系的两个冠脉造影图像上的某一分段血管进行三维重建，得到分段血管的3D模型及3D数据；
S230，重复上述步骤，直到所有分段血管三维重建完成，再将重建后的所有分段血管合并，得到完整的三维血管网格模型；
S300，获取三维血管网格模型的感兴趣的血管的实时血流速度v，得到时域下的v-t速度波形，如图3所示，包括：
S310，在二维起始帧和结束帧对应的图像上分别取得一个舒张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舒张期的感兴趣的血管长度L，包括：包括：去除干扰血管，沿着冠状动脉的延伸方向，提取感兴趣血管的冠脉中心线和直径；
S320，根据患者心率，某舒张期内冠脉造影图像走过的帧数，获取相邻两帧图像中造影剂在血管内流动的血管长度差，获取每帧冠脉造影图像的造影剂速度，即为三维血管网格模型的实时血流速度v，具体公式如下：
(1)如果实时血流速度v为舒张期血流速度，则
Figure PCTCN2019118053-appb-000026
K＝t/T；
其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，y表示位于舒张期内的冠脉造影图像的帧数，其中t表示P a-t压力波形中舒张期的时间，T表示P a-t压力波形中全心跳周期的时间；
(2)如果实时血流速度v为全心动周期血流速度，则：
Figure PCTCN2019118053-appb-000027
其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，x表示位于心动周期内的冠脉造影图像的帧数；
S330，将血流速度v与时间绘制曲线，得到时域下的v-t速度波形；
S400，对血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；
S500，根据频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形，如图4所示，包括：
S510，采用数值法求解连续性和Navier-Stokes方程，入口边界条件为频域下的血流速度v’，出口边界条件为out-flow边界条件，计算沿着血管中心线从入口到下游各点的压力降ΔP’；
其中，连续性和Navier-Stokes方程为：
Figure PCTCN2019118053-appb-000028
Figure PCTCN2019118053-appb-000029
Figure PCTCN2019118053-appb-000030
P、ρ、μ分别表示冠状动脉的血流速度、压力、血流密度、血流粘性；
S520，将压力降ΔP’与时间绘制曲线，得到频域下的ΔP’-t压力降波形；
S600，通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
S700，根据时域下的P a-t压力波形、ΔP-t压力降波形，获取造影态下冠状动脉血管评定参数，包括：造影态下瞬时无波形比率caiFR、造影态下第一舒张期压力比率cadPR、造影态下小于平均压舒张期比率caDFR和血流储备分数caFFR，则：
(1)如图5所示，第一舒张期压力比率cadPR，通过位于全舒张期即图5中Diastole条形区域内的第一主动脉平均压
Figure PCTCN2019118053-appb-000031
与第一冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000032
获得，即：
Figure PCTCN2019118053-appb-000033
(2)如图6所示，小于平均压舒张期比率caDFR，通过从
Figure PCTCN2019118053-appb-000034
开始至主动脉压P n＝P min区间，即图6条形区域内的第二主动脉平均压
Figure PCTCN2019118053-appb-000035
与第二冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000036
获得，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力，即：
Figure PCTCN2019118053-appb-000037
P min表示主动脉压的最小值；
(3)如图7所示，瞬时无波形比率caiFR，通过位于无波形期即图7中WEP条形区域内的第三主动脉平均压
Figure PCTCN2019118053-appb-000038
与第三冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000039
获得，即：
Figure PCTCN2019118053-appb-000040
无波形定义为：心脏舒张期的某段时间，称之为无波形期。
瞬时无波形时期的运算时间为：无波形期开始后25％的时间，到收缩期开始前5ms的时间停止计算；
(4)血流储备分数caFFR，通过位于全心动周期内的第四主动脉平均压
Figure PCTCN2019118053-appb-000041
与第四冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000042
获得，即：
Figure PCTCN2019118053-appb-000043
本申请的另一个实施例中，S300中血流速度v通过v＝ΔL/fps计算，其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，fps表示画面每秒传输帧数。
实施例3：
如图8所示，本申请提供了一种基于造影图像获取冠状动脉血管评定参数的装置，用于上述的基于造影图像获取冠状动脉血管评定参数的方法，包括：血压采集装置100，以及依次连接的三维建模单元200、血流速度单元300、压力降单元400和冠状动脉血管评定参数单元500，血压采集装置100与压力降单元400连接；血压采集装置100，与外部的造影导管连通，用于获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；三维建模单元200，用于读取造影态下的动脉造影图像，对图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；血流速度单元300，用于接收三维建模单元200发送的三维血管网格模型，获取感兴趣的血管段的实时血流速度v，得到时域下的v-t速度波 形；压力降单元400，如图6所示还包括：依次连接的傅里叶变换模块410、压力降计算模块420和傅里叶变换逆模块430，傅里叶变换模块410用于接收血流速度单元300、血压采集装置100分别发送的时域下的v-t速度波形、P a-t压力波形，对血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；压力降计算模块420再根据傅里叶变换模块410发送的频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；傅里叶变换逆模块430根据压力降计算模块420发送的ΔP’-t压力降波形，通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；冠状动脉血管评定参数单元500，用于接收血压采集装置100、压力降单元400发送的时域下的P a-t压力波形和ΔP-t压力降波形，获取冠状动脉血管评定参数。
本申请的一个实时例中，如图9所示，冠状动脉血管评定参数单元500还包括：均与傅里叶变换逆模块430连接的caiFR模块510、cadPR模块520、caDFR模块530和caFFR模块540；cadPR模块520用于从压力降单元400发送的时域下的P a-t压力波形和ΔP-t压力降波形中选取全舒张期区域的波形，通过位于全舒张期内的第一主动脉平均压
Figure PCTCN2019118053-appb-000044
与第一冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000045
获得第一舒张期压力比率cadPR；caDFR模块530用于从压力降单元400发送的时域下的P a-t压力波形和ΔP-t压力降波形中选取
Figure PCTCN2019118053-appb-000046
开始至主动脉压P n＝P min的区间波形，通过小于平均压舒张期比率区间内第二主动脉平均压
Figure PCTCN2019118053-appb-000047
与第二冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000048
获得小于平均压舒张期比率caDFR，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力；caiFR模块510，用于从压力降单元400发送的时域下的P a-t压力波形和ΔP-t压力降波形中选取无波形期的波形，通过位于无波形期内的第三主动脉平均压
Figure PCTCN2019118053-appb-000049
与第三冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000050
获得瞬时无波形比率caiFR；血流储备分数caFFR，用于选取压力降单元400发送的时域下的P a-t压力波形和ΔP-t压力降波形的全部数据，作为全心动周期数据，通过位于全心动周期内的第四主动脉平均压
Figure PCTCN2019118053-appb-000051
与第四冠状动脉狭窄远端平均压
Figure PCTCN2019118053-appb-000052
获得血流储备分数caFFR。
本申请的一个实施例中，如图10所示，血压采集装置100，包括：主体110、以及均与主体110连接的第一动力驱动装置120、血压采集单元130和第一控制装置140；主体110用于控制第一动力驱动装置120、血压采集单元130和第一控制装置140是否开始工作；血压采集单元130与第二控制装置160连接，第二控制装置160与外部的介入设备连接，第二控制装置160用于对血压采集单元130进行校零，以及用于控制血压采集单元130与外部的介入设备是否连通；第一动力驱动装置120设置于主体110上，第一动力驱动装置120与外部的输液装置170连接，第一动力驱动装置120用于驱动外部的输液装置170的液体流动；血压采集单元130设置于主体110上，血压采集单元130与第一控制装置140、外部的介入设备连接，血压采集单元130用于采集有创动脉压力；第一控制装置140通过固定块150等固定于主体110上；第一控制装置140与外部的输液装置170连接，用于控制输液装置170的液体流向，使液体从输液装置170流向第一控制装置140。本申请提供了血压采集装置，通过在主体110上设置第一动力驱动装置120、血压采集单元130和第一控制装置140，通过打开第一控制装置140，使血压采集单元130与外部的输液装置170、大气同时连通，使第一动力驱动装置120驱动外部的输液装置170上的输液管7100内部的液体流动，实现自动排气，无需手动排气，操作简单、便捷；通过第二控制装置160的设置实现对血压采集单元130的自动校零，由于手术床的高度变化会影响有创动脉压力的测量，因此在一场手术内，需要变换血压采集装置的高度，无需重复多次校零，操作简单，测量准确。
第三方面，本申请提供了一种冠状动脉分析系统，包括：上述的基于造影图像获取冠状动脉血管评定参数的装置。
第四方面，本申请提供了一种计算机存储介质，计算机程序被处理器执行时实现上述的基于造影图像获取冠状动脉血管评定参数的方法。
所属技术领域的技术人员知道，本发明的各个方面可以实现为系统、方法或计算机程序产品。因此，本发明的各个方面可以具体实现为以下形式，即：完全的硬件实施方式、完全的软件实施方式(包括固件、驻留软件、微代码等)，或硬件和软件方面结合的实施方式，这里可以统称为“电路”、“模块”或“系统”。此外，在一些实施例中，本发明的各个方面还可以实现为在一个或多个计算机可读介质中的计算机程序产品的形式，该计算机可读介质中包含计算机可读的程序代码。本发明的实施例的方法和/或系统的实施方式可以涉及到手动地、自动地或以其组合的方式执行或完成所选任务。
例如，可以将用于执行根据本发明的实施例的所选任务的硬件实现为芯片或电路。作为软件，可以将根据本发明的实施例的所选任务实现为由计算机使用任何适当操作系统执行的多个软件指令。在本发明的示例性实施例中，由数据处理器来执行如本文的根据方法和/或系统的示例性实施例的一个或多个任务，诸如用于执行多个指令的计算平台。可选地，该数据处理器包括用于存储指令和/或数据的易失性储存器和/或用于存储指令和/或数据的非易失性储存器，例如，磁硬盘和/或可移动介质。可选地，也提供了一种网络连接。可选地也提供显示器和/或用户输入设备，诸如键盘或鼠标。
可利用一个或多个计算机可读的任何组合。计算机可读介质可以是计算机可读信号介质或计算机可读存储介质。计算机可读存储介质例如可以是——但不限于——电、磁、光、电磁、红外线、或半导体的系统、装置或器件，或者任意以上的组合。计算机可读存储介质的更具体的例子(非穷举列表)将包括以下各项：
具有一个或多个导线的电连接、便携式计算机盘、硬盘、随机存取存储器(RAM)、只读存储器(ROM)、可擦式可编程只读存储器(EPROM或闪存)、光纤、便携式紧凑盘只读存储器(CD-ROM)、光存储器件、磁存储器件、或者上述的任意合适的组合。在本文件中，计算机可读存储介质可以是任何包含或存储程序的有形介质，该程序可以被指令执行系统、装置或者器件使用或者与其结合使用。
计算机可读的信号介质可以包括在基带中或者作为载波一部分传播的数据信号，其中承载了计算机可读的程序代码。这种传播的数据信号可以采用多种形式，包括但不限于电磁信号、光信号或上述的任意合适的组合。计算机可读的信号介质还可以是计算机可读存储介质以外的任何计算机可读介质，该计算机可读介质可以发送、传播或者传输用于由指令执行系统、装置或者器件使用或者与其结合使用的程序。
计算机可读介质上包含的程序代码可以用任何适当的介质传输，包括(但不限于)无线、有线、光缆、RF等等，或者上述的任意合适的组合。
例如，可用一个或多个编程语言的任何组合来编写用于执行用于本发明的各方面的操作的计算机程序代码，包括诸如Java、Smalltalk、C++等面向对象编程语言和常规过程编程语言，诸如"C"编程语言或类似编程语言。程序代码可以完全地在用户计算机上执行、部分地在用户计算机上执行、作为一个独立的软件包执行、部分在用户计算机上部分在远程计算机上执行、或者完全在远程计算机或服务器上执行。在涉及远程计算机的情形中，远程计算机可以通过任意种类的网络--包括局域网(LAN)或广域网(WAN)-连接到用户计算机，或者，可以连接到外部计算机(例如利用因特网服务提供商来通过因特网连接)。
应当理解，流程图和/或框图的每个方框以及流程图和/或框图中各方框的组合，都可以由计算机程序指令实现。这些计算机程序指令可以提供给通用计算机、专用计算机或其它可编程数据处理装置的处理器，从而生产出一种机器，使得这些计算机程序指令在通过计算机或其它可编程数据处理装置的处理器执行时，产生了实现流程图和/或框图中的一个或多个方框中规定的功能/动作的装置。
也可以把这些计算机程序指令存储在计算机可读介质中，这些指令使得计算机、其它可编程数据处理装置、或其它设备以特定方式工作，从而，存储在计算机可读介质中的指令就产生出包括实现流程图和/或框图中的一个或多个方框中规定的功能/动作的指令的制造品(article of manufacture)。
还可将计算机程序指令加载到计算机(例如，冠状动脉分析系统)或其它可编程数据处理设备上以促使在计算机、其它可编程数据处理设备或其它设备上执行一系列操作步骤以产生计算机实现过程，使得在计算机、其它可编程装置或其它设备上执行的指令提供用于实现在流程图和/或一个或多个框图方框中指定的功能/动作的过程。
本发明的以上的具体实例，对本发明的目的、技术方案和有益效果进行了进一步详细说明，所应理解的是，以上仅为本发明的具体实施例而已，并不用于限制本发明，凡在本发明的精神和原则之内，所做的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。

Claims (14)

  1. 基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，包括：
    获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；
    对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；
    获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形；
    对所述血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；
    根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；
    通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
    根据时域下的P a-t压力波形、ΔP-t压力降波形，获取造影态下冠状动脉血管评定参数。
  2. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述血管评定参数包括：造影态下瞬时无波形比率caiFR、造影态下第一舒张期压力比率cadPR和造影态下小于平均压舒张期比率caDFR；
    所述第一舒张期压力比率cadPR，通过位于全舒张期内的第一主动脉平均压
    Figure PCTCN2019118053-appb-100001
    与第一冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100002
    获得；
    所述小于平均压舒张期比率caDFR，通过从
    Figure PCTCN2019118053-appb-100003
    开始至主动脉压P n＝P min区间内，第二主动脉平均压
    Figure PCTCN2019118053-appb-100004
    与第二冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100005
    获得，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力，P min表示主动脉压的最小值；
    所述瞬时无波形比率caiFR，通过位于无波形期内的第三主动脉平均压
    Figure PCTCN2019118053-appb-100006
    与第三冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100007
    获得。
  3. 根据权利要求2所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述瞬时无波形比率caiFR、第一舒张期压力比率cadPR和小于平均压舒张期比率caDFR的计算公式分别为：
    Figure PCTCN2019118053-appb-100008
  4. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述血管评定参数还包括：血流储备分数caFFR；
    所述血流储备分数caFFR，通过位于全心动周期内的第四主动脉平均压
    Figure PCTCN2019118053-appb-100009
    与第四冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100010
    获得，即：
    Figure PCTCN2019118053-appb-100011
  5. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形的方法包括：通过与造影导管连通的血压采集装置实时测量冠状动脉入口的压力P a，与时间绘制曲线，得到时域下的P a-t压力波形。
  6. 根据权利要求5所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述对造影态下冠状动脉二维造影图像中感兴趣的血管段进行三维建模，得到三维血管网格模型的方法包括：
    读取至少两个不同夹角的冠脉造影图像；
    通过2D结构数据，对具有映射关系的两个所述冠脉造影图像上的某一分段血管进行三维重建，得到所述分段血管的3D模型及3D数据；
    重复上述步骤，直到所有分段血管三维重建完成，再将重建后的所有分段血管合并，得到完整的三维血管网格模型。
  7. 根据权利要求6所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形的方法，包括：时域下的v-t舒张期速度波形；
    通过在二维起始帧和结束帧对应的图像上分别取得一个舒张期的起始点和结束点，然后通过起始点和结束点在所述三维血管网格模型中截取舒张期的血管长度L；
    根据患者心率，某舒张期内冠脉造影图像走过的帧数，获取相邻两帧图像中造影剂在血管内流动的血管长度差，获取每帧冠脉造影图像的造影剂速度，即为三维血管网格模型的实时舒张期血流速度v，具体公式如下：
    Figure PCTCN2019118053-appb-100012
    K＝t/T；
    其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，y表示位于舒张期内的冠脉造影图像的帧数，其中t表示P a-t压力波形中舒张期的时间，T表示P a-t压力波形中全心跳周期的时间；
    将血流速度v与时间绘制曲线，得到时域下的v-t舒张期速度波形。
  8. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述获取所述三维血管网格模型的实时血流速度v，得到时域下的v-t速度波形的方法，包括：时域下的v-t全心动周期速度波形；
    通过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所述三维血管网格模型中截取心动周期的血管长度L；
    根据患者心率，某心动周期内冠脉造影图像走过的帧数，获取相邻两帧图像中造影剂在血管内流动的血管长度差，获取每帧冠脉造影图像的造影剂速度，即为三维血管网格模型的实时全心动周期血流速度v，具体公式如下：
    Figure PCTCN2019118053-appb-100013
    其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，H表示患者的心率，单位为次/分，x表示位于心动周期内的冠脉造影图像的帧数；
    将血流速度v与时间绘制曲线，得到时域下的v-t心动周期速度波形。
  9. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述获取所述三维血管网格模型的实时血流速度v的方法包括：
    v＝ΔL/fps；
    其中，ΔL表示相邻两帧图像造影剂在血管内流动的血管长度差，fps表示画面每秒传输帧数。
  10. 根据权利要求1所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，所述根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形的方法，包括：
    采用数值法求解连续性和Navier-Stokes方程求解冠状动脉入口至冠状动脉狭窄远端的压力降ΔP’；
    通过公式：
    Figure PCTCN2019118053-appb-100014
    其中，
    Figure PCTCN2019118053-appb-100015
    P、ρ、μ分别表示冠状动脉的血流速度、压力、血流密度、血流粘性；
    入口边界条件为频域下的血流速度v’，出口边界条件为out-flow边界条件；
    计算沿着血管中心线从入口到下游各点的压力降ΔP’；
    将压力降ΔP’与时间绘制曲线，得到频域下的ΔP’-t压力降波形。
  11. 一种基于造影图像获取冠状动脉血管评定参数的装置，用于权利要求1-10任一项所述的基于造影图像获取冠状动脉血管评定参数的方法，其特征在于，包括：血压采集装置，以及依次连接的三维建模单元、血流速度单元、压力降单元和冠状动脉血管评定参数单元，所述血压采集装置与所述压力降单元连接；
    所述血压采集装置，与外部的造影导管连通，用于获取造影态下，冠状动脉入口的实时压力P a，得到时域下的P a-t压力波形；
    所述三维建模单元，用于读取造影态下的动脉造影图像，对所述图像中感兴趣的血管段进行三维建模，得到三维血管网格模型；
    血流速度单元，用于接收所述三维建模单元发送的三维血管网格模型，获取所述感兴趣的血管段的实时血流速度v，得到时域下的v-t速度波形；
    所述压力降单元，用于接收所述血流速度单元、所述血压采集装置分别发送的时域下的v-t速度波形、P a-t压力波形，对所述血流速度v和压力P a进行傅里叶变换，得到频域下的v’-t速度波形和P a’-t压力波形；再根据所述频域下的v’-t速度波形和P a’-t压力波形，获取冠脉入口到冠脉狭窄远端的频域下的ΔP’-t压力降波形；通过傅里叶逆变换，获取时域下的冠脉入口到冠脉狭窄远端的ΔP-t压力降波形；
    所述冠状动脉血管评定参数单元，用于接收所述血压采集装置、所述压力降单元发送的时域下的P a-t压力波形和ΔP-t压力降波形，获取冠状动脉血管评定参数。
  12. 根据权利要求11所述的基于造影图像获取冠状动脉血管评定参数的装置，其特征在于，所述冠状动脉血管评定参数单元还包括：caiFR模块、cadPR模块、caDFR模块和caFFR模块；
    所述cadPR模块，用于通过位于全舒张期内的第一主动脉平均压
    Figure PCTCN2019118053-appb-100016
    与第一冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100017
    获得第一舒张期压力比率cadPR；
    所述caDFR模块，用于通过从
    Figure PCTCN2019118053-appb-100018
    开始至主动脉压P n＝P min区间内，第二主动脉平均压
    Figure PCTCN2019118053-appb-100019
    与第二冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100020
    获得小于平均压舒张期比率caDFR，其中，P m、P n分别表示舒张期内的第m和第n个主动脉压力，P min表示主动脉压的最小值；
    所述caiFR模块，用于通过位于无波形期内的第三主动脉平均压
    Figure PCTCN2019118053-appb-100021
    与第三冠状动脉狭窄远端平均压
    Figure PCTCN2019118053-appb-100022
    获得所述瞬时无波形比率caiFR；
    所述血流储备分数caFFR，用于通过位于全心动周期内的第四主动脉平均压
    Figure PCTCN2019118053-appb-100023
    与第四冠状动脉狭 窄远端平均压
    Figure PCTCN2019118053-appb-100024
    获得所述血流储备分数caFFR。
  13. 一种冠状动脉分析系统，其特征在于，包括：权利要求11或12所述的基于造影图像获取冠状动脉血管评定参数的装置。
  14. 一种计算机存储介质，其特征在于，计算机程序被处理器执行时实现权利要求1～10任一项所述的基于造影图像获取冠状动脉血管评定参数的方法。
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