WO2021042477A1 - 测量冠状动脉血管评定参数的简化方法、装置及系统 - Google Patents

测量冠状动脉血管评定参数的简化方法、装置及系统 Download PDF

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WO2021042477A1
WO2021042477A1 PCT/CN2019/115027 CN2019115027W WO2021042477A1 WO 2021042477 A1 WO2021042477 A1 WO 2021042477A1 CN 2019115027 W CN2019115027 W CN 2019115027W WO 2021042477 A1 WO2021042477 A1 WO 2021042477A1
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coronary
coronary artery
image
measuring
angiography
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PCT/CN2019/115027
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English (en)
French (fr)
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刘广志
王之元
冯亮
李泽华
霍勇
龚艳君
李建平
易铁慈
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苏州润迈德医疗科技有限公司
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Priority claimed from CN201910834871.6A external-priority patent/CN110522439A/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 EP19943973.8A priority Critical patent/EP4026491A4/en
Priority to JP2022513657A priority patent/JP7457105B2/ja
Publication of WO2021042477A1 publication Critical patent/WO2021042477A1/zh
Priority to US17/683,490 priority patent/US20220183643A1/en

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Definitions

  • the present invention relates to the technical field of coronary artery medicine, in particular to a simplified method, device, coronary artery analysis system and computer storage medium for measuring coronary artery vascular evaluation parameters.
  • the heart is a high energy-consuming organ. In the resting state, the oxygen uptake of myocardial metabolism can reach 60% to 80% of the blood oxygen content. Therefore, under stress conditions such as exercise, it is difficult for the heart to meet the increased demand for myocardial hypoxia by increasing the oxygen uptake capacity of the tissue, and most of it is to increase the myocardial blood flow to ensure the oxygen demand for myocardial metabolism.
  • Myocardial microcirculation occupies 95% of the coronary circulation. It plays a role in regulating myocardial blood flow through various factors such as local metabolites, endothelium, neuroendocrine, and myogenic origin. Studies have shown that abnormal coronary microcirculation is an important predictor of poor long-term prognosis in patients with coronary heart disease.
  • Coronary artery microvascular function is accomplished by detecting the response of microvessels to vasodilators.
  • the changes in these two aspects of the guidelines also indicate the importance of coronary microvascular function tests.
  • the measurement index used for coronary microvascular function refers to the maximum expansion of coronary microvessels, that is, Coronary Flow Reserve (CFR).
  • the vasodilators used mainly include endothelium-independent vasodilators that act on vascular smooth muscle and their effects An endothelium-dependent vasodilator for vascular endothelial cells, including adenosine and acetylcholine.
  • the current examination methods mainly include the coronary artery blood flow reserve (FFR) and the microcirculation resistance index (IMR).
  • the IMR uses a soft pressure guide wire to simultaneously record the coronary pressure and temperature, and the two temperature sensors on the guide wire detect the temperature.
  • the changing time difference can know the average transit time (transit mean time, Tmn) of the saline from the guide catheter to the temperature sensor at the tip of the guide wire.
  • the IMR value can be obtained.
  • existing inspection methods simplifies the process, improves safety, and optimizes the results. Therefore, the recommended level of the guidelines has been improved compared with the previous ones.
  • non-invasive examinations including transthoracic Doppler ultrasound, radionuclide imaging technology, and nuclear magnetic resonance imaging technology, are valuable in the diagnosis of microcirculation diseases, but they all have varying degrees of deficiencies and have not become microscopic. Recommended method for cyclic function evaluation.
  • Existing CFR measurement methods include: (1) Doppler guide wire measurement method, the Doppler guide wire is sent into the coronary artery (distal to the lesion) to directly measure the blood flow in the coronary artery at rest and maximum congestion. Speed, CFR can be calculated. (2) The thermodilution curve measurement method, through the dual-sensing guide wire with temperature-baroreceptor, can directly sense the changes in the temperature in the coronary arteries, and obtain the thermodilution curve in the coronary arteries at rest and maximum congestion, using blood flow The average conduction time replaces the coronary artery flow velocity to calculate the CFR.
  • the measurement of IMR and CFR by the pressure guide wire sensor has the following problems: (1) The Tmn measured by the pressure guide wire sensor too close to the coronary ostium is too small, resulting in a small IMR result. If the Tmn measured too far is too large, the IMR result will be too large; (2) In the resting state and the maximum hyperemia state, a total of 6 saline injections are required. If the position of the pressure guide wire sensor moves, the result of each measurement will not be available. Comparability, and the measurement process is cumbersome; (3) The Tmn that may be obtained for each injection of saline is quite different.
  • the distance of the pressure guidewire susceptor, the injection speed of saline, the injection volume, and the temperature of the saline will directly affect the measurement results, resulting in inaccurate results and cumbersome measurement process; and continuous injection of dilatation drugs for a long time will have a greater impact on the patient. Severe discomfort.
  • the present invention provides a simplified method, device, coronary artery analysis system and computer storage medium for measuring coronary artery vascular assessment parameters, so as to solve the problem of long-term continuous injection of dilatation drugs when measuring CFR and IMR through pressure guide wires in the prior art. It has a greater impact on the patient, causing serious discomfort, and the pressure guide wire measurement process is cumbersome, and the measurement results are inaccurate.
  • this application provides a simplified method for measuring coronary vascular assessment parameters, including:
  • the coronary vascular evaluation parameters include: coronary blood flow reserve CFR and microcirculation resistance coefficient IMR.
  • the first body position image is a contrast image in a resting state
  • the second body position image is a contrast image in an expanded state
  • the CFR T 1 /T 2 ;
  • the IMR P d ⁇ T 2 .
  • the angle between the first position and the second position is greater than 30°.
  • the aforementioned simplified method for measuring the evaluation parameters of the coronary arteries, before measuring the pressure P d at the distal end of the coronary artery stenosis through the pressure guide wire includes: injecting a dilatation drug into the blood vessel.
  • the above-mentioned simplified method for measuring the evaluation parameters of coronary arteries after the pressure P d at the distal end of the coronary artery stenosis is measured by the pressure guide wire, and before the coronary angiography is performed on the measuring vessel, the method includes: injecting A contrast agent is injected into the blood vessel while expanding the drug.
  • the obtaining a three-dimensional coronary artery vascular model according to the three-dimensional modeling of the first posture angiography image and the second posture angiography image includes:
  • the centerline and diameter of each coronary artery are projected on a three-dimensional space for three-dimensional modeling, and a three-dimensional coronary artery model is obtained.
  • the times T 1 and T 2 are calculated based on the ratio of the number of frames of the partial area image divided into the heartbeat cycle area and the number of transmitted frames per second.
  • the present application provides a device for measuring coronary artery vascular evaluation parameters, which is used in the above-mentioned simplified method for measuring coronary vascular evaluation parameters, including: pressure guide wire measurement unit, extraction of coronary angiography unit, and three-dimensional modeling A unit and a parameter measurement unit, the extraction coronary angiography unit is connected to a three-dimensional modeling unit, and the parameter measurement unit is connected to the pressure guide wire measurement unit and the three-dimensional modeling unit;
  • the pressure guide wire measuring unit is used to measure the pressure P d at the distal end of the coronary artery stenosis and the coronary artery inlet pressure P a through the pressure guide wire;
  • the extracting coronary angiography unit is used to select the first posture angiography image and the second posture angiography image of the measuring blood vessel;
  • the three-dimensional modeling unit is configured to receive the first posture angiography image and the second posture angiography image delivered by the extracted coronary angiography unit, and obtain a coronary artery three-dimensional vascular model through three-dimensional modeling;
  • the parameter measurement unit is configured to receive the coronary artery three-dimensional blood vessel model transmitted by the three-dimensional modeling unit, obtain the time T 1 that the contrast agent in the first body position contrast image has passed from the entrance to the exit of the blood vessel segment, and obtain the second The elapsed time T 2 for the contrast agent in the body position contrast image from the entrance to the exit of the blood vessel segment ; and receiving the pressure P d transmitted by the pressure guide wire measuring unit, and measuring the coronary artery vascular assessment parameters according to P d , T 1 , and T 2 .
  • the parameter measurement unit includes: a coronary blood flow reserve module, a microcirculation resistance coefficient module, and/or a coronary blood flow reserve fraction module;
  • the blood flow reserve module and the microcirculation resistance coefficient module are both connected to the three-dimensional modeling unit;
  • the microcirculation resistance coefficient module and the coronary blood flow reserve fractional model are both connected to the pressure guide wire measurement unit ;
  • the present application provides a coronary artery analysis system, including: the above-mentioned device for measuring coronary artery vascular evaluation parameters.
  • the present application provides a computer storage medium, and when the computer program is executed by a processor, the simplified method for measuring coronary artery vascular assessment parameters is realized.
  • This application provides a simplified method for measuring the evaluation parameters of coronary arteries. Only when the pressure P d at the distal end of the coronary artery stenosis is tested, the dilatation drug is injected. The angiography process can stop the dilatation drug injection and reduce the dilatation drug injection.
  • FIG. 1 is a flowchart of an embodiment of a simplified method for measuring coronary artery vascular assessment parameters according to this application;
  • FIG. 2 is a flowchart of another embodiment of the simplified method for measuring coronary vascular evaluation parameters of the present application
  • FIG. 3 is a flowchart of step S400 of this application.
  • FIG. 4 is a structural block diagram of the apparatus for measuring coronary artery vascular evaluation parameters according to this application.
  • Fig. 5 is a structural block diagram of the parameter measurement unit of the application.
  • FIG. 6 is a structural block diagram of an embodiment of the three-dimensional modeling unit of this application.
  • FIG. 7 is a structural block diagram of another embodiment of the three-dimensional modeling unit of this application.
  • FIG. 8 is a structural block diagram of the image processing module of this application.
  • Figure 9 is a reference image
  • Figure 10 is a target image to be segmented
  • Figure 11 is another target image to be segmented
  • Figure 12 is an enhanced catheter image
  • Figure 13 is a binarized image of the feature points of the catheter
  • Figure 14 is an enhanced target image
  • Figure 15 is an image of the area where the coronary arteries are located
  • Figure 16 is the result image
  • Figure 17 shows two posture contrast images
  • Figure 18 is a diagram of a three-dimensional coronary artery vascular model generated by combining the body position angle and the centerline of the coronary artery from Figure 17;
  • Pressure guide wire measurement unit 110 extraction coronary angiography unit 120, three-dimensional modeling unit 130, image reading module 131, segmentation module 132, blood vessel length measurement module 133, three-dimensional modeling module 134, image processing module 135, image denoising Module 1350, catheter feature point extraction module 1351, coronary artery extraction module 1352, coronary artery centerline extraction module 136, blood vessel diameter measurement module 137, parameter measurement unit 140, coronary blood flow reserve module 141, microcirculation resistance coefficient module 142, The coronary artery blood flow reserve fraction module 143.
  • this application provides a simplified method for measuring coronary vascular evaluation parameters, including:
  • S600 Measure the coronary vascular assessment parameters according to P d , T 1 and T 2.
  • the coronary vascular assessment parameters in S600 include: coronary blood flow reserve CFR and microcirculation resistance coefficient IMR.
  • This application provides a simplified method for measuring the evaluation parameters of coronary arteries. Only when the pressure P d at the distal end of the coronary artery stenosis is tested, the dilatation drug is injected. The angiography process can stop the dilatation drug injection and reduce the dilatation drug injection.
  • dilatation drugs includes: intravenous or intracoronary injection of dilatation drugs.
  • the infusion methods include: the dilatation drugs can be mixed with contrast media and injected into the vein or coronary artery, or they can be injected in divided intervals. All are protected by this application. Within the scope; as long as the drugs that can play an expansion effect, including adenosine, ATP, etc., are within the protection scope of this application.
  • CFR T 1 /T 2 in S300;
  • IMR P d ⁇ T 2 .
  • the aforementioned times T 1 and T 2 are calculated based on the ratio of the number of frames of the partial area image divided into the heartbeat cycle area and the number of frames transmitted per second; namely:
  • T N/fps
  • N represents the number of frames of the image of the partial area divided into the heartbeat cycle area
  • fps represents the number of frames played per second, in general, refers to the number of animation or video frames
  • T represents the image of a certain body position
  • the CFR is also measured through the three-dimensional coronary vascular model without relying on the pressure guide wire sensor, which overcomes the pressure guide wire sensor in the saline It is easy to move under the impact and the measurement is inaccurate, and when the measurement is based on the contrast image, there is no need to inject saline. Therefore, it avoids the influence of the injection speed, the injection volume, and the temperature of the saline on the CFR measurement results, and improves the accuracy of the measurement.
  • the IMR measurement is based on the pressure guide wire and the angiographic image.
  • the pressure P d at the distal end of the coronary artery stenosis measured by the pressure guide wire is more accurate, and then the time T 2 is measured based on the angiographic image, which reduces the injection time of the expansion drug and reduces
  • the number of injections of saline is reduced, the influence of saline on the test results is reduced, and the accuracy of IMR measurement results is improved, and the test process is simple.
  • the angle between the first body position selected in the first body position image in S300 and the second body position selected in the second body position image is greater than 30°.
  • Fig. 2 in an embodiment of the present application, before S100, it includes: S110, injecting a contrast agent into the blood vessel while injecting the dilatation drug. It should be noted that the injection of dilatation drugs can be stopped after the angiography is completed, which reduces the injection volume and number of injections of dilatation drugs, making it safer and more reliable.
  • S400 includes:
  • Denoise the coronary angiography image including: static noise and dynamic noise;
  • the target image is subtracted from the reference image, and the characteristic point O of the catheter is extracted.
  • the specific method is: subtracting the target image from the reference image; denoising, including: static noise and dynamic noise; Image enhancement is performed on the denoised image; binarization is performed on the enhanced catheter image to obtain a binarized image with a set of catheter feature points O;
  • the reference image is subtracted from the target image to extract the regional image of the position of the coronary artery.
  • the specific method is: subtracting the reference image from the target image; denoising, including: static noise and dynamic noise Image enhancement is performed on the denoised image; according to the positional relationship between each region in the enhanced target image and the feature point of the catheter, the region of the coronary artery is determined and extracted, that is, the coronary artery is located Regional image of location;
  • the regional image uses the characteristic points of the catheter as seed points to dynamically grow to obtain the result image.
  • the specific method is: binarize the regional image of the position of the coronary artery to obtain a binary coronary Artery image; performing morphological operations on the binarized coronary artery image, using feature points of the catheter as seed points, and the binarized coronary artery image undergoes dynamic region growth according to the location of the seed point to obtain The result image;
  • S430 Project the centerline and diameter of each coronary artery on a three-dimensional space to perform three-dimensional modeling to obtain a three-dimensional coronary artery model.
  • the specific method is as follows:
  • the center line of each coronary artery is combined with the posture shooting angle to be projected on a three-dimensional space, and the projection is performed to generate a three-dimensional coronary artery model.
  • the present application provides a device for measuring coronary artery vascular evaluation parameters.
  • the simplified method for measuring coronary artery vascular evaluation parameters includes: a pressure guide wire measuring unit 110 and an extraction coronary angiography unit 120 1.
  • the three-dimensional modeling unit 130 and the parameter measurement unit 140, the extraction coronary angiography unit 120 is connected to the three-dimensional modeling unit 130, and the parameter measurement unit 140 is connected to the pressure guidewire measurement unit 110 and the three-dimensional modeling unit 130; the pressure guidewire measurement unit 110.
  • the extraction coronary angiography unit 120 is used to select the first posture angiography image and the second posture angiography of the measurement blood vessel Image; three-dimensional modeling unit 130, for receiving and extracting the first posture angiography image and second posture angiography image delivered by the coronary angiography unit, three-dimensional modeling to obtain a coronary three-dimensional blood vessel model; parameter measurement unit 140 for receiving three-dimensional The three-dimensional coronary artery model transmitted by the modeling unit obtains the elapsed time T 1 for the contrast agent in the first body position contrast image from the entrance to the exit of the blood vessel segment, and obtains the contrast agent in the second body position contrast image from the entrance to the blood vessel segment The elapsed time T 2 of the outlet; and receiving the pressure P d transmitted by the pressure guide wire measuring unit, and measure the coronary vascular assessment parameters according to P d
  • the parameter measurement unit 140 includes: a coronary blood flow reserve module 141, a microcirculation resistance coefficient module 142, and/or a coronary blood flow reserve fraction module 143, and a coronary blood flow reserve module 143.
  • the flow reserve module 141 and the microcirculation resistance coefficient module 142 are all connected to the three-dimensional modeling unit 130; the microcirculation resistance coefficient module 142 and the coronary artery blood flow reserve fraction module 143 are all connected to the pressure guide wire measurement unit 110; the coronary blood flow reserve
  • the parameter measurement unit 140 further includes: a T 1 measurement module, a T 2 measurement module, and a CFR measurement module, all of which are connected to the three-dimensional modeling unit 130, and the T 1 measurement module and T 2 measurement module are all connected to the CFR measurement module.
  • the three-dimensional modeling unit 130 includes an image reading module 131, a segmentation module 132, a blood vessel length measurement module 133, and a three-dimensional modeling module 134, the segmentation module 132 and the image reading module 131.
  • the blood vessel length measurement module 133 and the three-dimensional modeling module 134 are connected; the image reading module 131 is used to read the angiographic image; the segmentation module 132 is used to select a heartbeat cycle region of the coronary angiography image; the blood vessel length measurement module 133 is used to Measure the length L of the blood vessel in the heartbeat cycle area, and pass the length L of the blood vessel to the segmentation module 132; the three-dimensional modeling module 134 is used to perform three-dimensional modeling according to the coronary angiography image selected by the segmentation module 132 to obtain the three-dimensional coronary artery model.
  • the three-dimensional modeling unit 130 further includes: an image processing module 135, a coronary artery centerline extraction module 136, and a blood vessel diameter measurement module 137.
  • the image processing module 135 and the coronary artery centerline The extraction module 136 is connected, and the three-dimensional modeling module 134 is connected with the coronary artery centerline extraction module 136 and the blood vessel diameter measurement module 137.
  • the image processing module 135 is used to receive the coronary angiography images of at least two positions transmitted by the segmentation module 132, and remove the interfering blood vessels of the coronary angiography images to obtain the result image as shown in FIG.
  • the coronary artery centerline extraction module 136 uses To extract the coronary artery centerline of each result image as shown in FIG. 17 along the extension direction of the coronary arteries; the blood vessel diameter measuring module 137 is used to measure the blood vessel diameter D; the three-dimensional modeling module 134 is used to integrate each coronary artery The centerline and diameter are projected on the three-dimensional space for three-dimensional modeling, and a three-dimensional coronary artery model is obtained.
  • This application realizes the synthesis of a three-dimensional coronary artery vascular model based on coronary angiography images, which fills up the gap in the industry, and has a positive effect on the field of medical technology.
  • an image denoising module 1350 is provided inside the image processing module 135 to denoise the coronary angiography image, including static noise and dynamic noise.
  • the denoising module 1350 removes the interference factors in the coronary angiography image and improves the quality of image processing.
  • the image processing module 135 is internally provided with a catheter feature point extraction module 1351 and a coronary artery extraction module 1352, which are all connected to the coronary artery centerline extraction module 136, and the catheter feature point extraction module 1351 Connected to the coronary artery extraction module 1352 and the image denoising module 1350; the catheter feature point extraction module 1351 is used to define the first segmented image where the catheter appears as a reference image as shown in FIG. 9, and there will be a complete coronary artery.
  • the k-th frame segmented image is defined as the target image shown in Figure 10 and Figure 11, and k is a positive integer greater than 1.
  • the target image shown in Figures 10 and 11 is enhanced to obtain the target image shown in Figures 12 and 14.
  • the target image shown in Figure 10 and Figure 11 is subtracted from the reference image shown in Figure 9, and the positional relationship between each region and the catheter feature point in the enhanced target image shown in Figure 14 is determined and extracted
  • the area of the coronary artery is the image of the area where the coronary artery is located as shown in FIG. 15; the area image shown in FIG. 15 uses the characteristic points of the catheter as shown in FIG. 13 as seed points for dynamic growth to obtain Figure 16 shows the resulting image.
  • the image processing module 135 is also provided with a binarization processing module, which is used to perform binarization processing on the image to obtain a three-dimensional coronary artery vessel model.
  • the coronary angiography images of two positions taken by a patient the left picture shows the angiographic images with the right anterior oblique RAO: 25° and the head CRA: 23°; the right picture shows the posture angle: Right anterior oblique RAO: 3° and head position CRA: 30° contrast images;
  • Comparative Example 1 and Example 1 are both the same coronary angiography image taken by the same patient;
  • the catheter Place the pressure guidewire sensor on the distal end of the patient's coronary artery (>5cm from the opening of the guiding catheter), and inject 3ml of saline into the blood vessel through the catheter. If the blood temperature is detected to return to the normal value, the catheter will be injected into the blood vessel again Inject 3ml of normal saline, repeat the above process 3 times, and then record T 1 , T 1 is 1.6s; pass the dilatation drug into the blood vessel to make the blood vessel reach and maintain the expansion state (make sure that the pressure guide wire sensor before and after the dilatation drug is in the same Position), inject 3ml of saline into the blood vessel through the catheter.
  • Example 1 From the comparison between Example 1 and Comparative Example 1, the difference is within 0.5. It can be seen that the IMR measurement results are basically the same. Therefore, the measurement results of Example 1 are accurate, and the example of this application uses a pressure guide wire to measure the pressure at the distal end, but Without using physiological saline, T 1 and T 2 are measured by a three-dimensional blood vessel model; and the IMR measurement is realized through the contrast image, which makes up for the blank in the industry, and the operation is simpler. It also realizes the FFR measurement without the need to use physiological saline. It solves the problem that the pressure guide wire sensor is difficult to control the position of the pressure guide wire under the impulse of the physiological saline, and solves the problem of inaccurate measurement of the distal end pressure.
  • the present application provides a coronary artery analysis system, including: the above-mentioned device for measuring coronary artery vascular evaluation parameters.
  • the present application provides a computer storage medium, and when the computer program is executed by a processor, the simplified method for measuring the evaluation parameters of coronary arteries is realized.
  • aspects of the present invention can be implemented as a system, a method, or a computer program product. Therefore, various aspects of the present invention can be specifically implemented in the following forms, namely: complete hardware implementation, complete software implementation (including firmware, resident software, microcode, etc.), or a combination of hardware and software implementations, Here can be collectively referred to as "circuit", "module” or "system”.
  • 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, and the computer-readable medium contains computer-readable program code.
  • the implementation of the method and/or system of the embodiments of the present invention may involve performing or completing selected tasks manually, automatically, or in a combination thereof.
  • a data processor such as a computing platform for executing a plurality of instructions.
  • the data processor includes a volatile memory for storing instructions and/or data and/or a non-volatile memory for storing instructions and/or data, for example, a magnetic hard disk and/or a Move the media.
  • a network connection is also provided.
  • a display and/or user input device such as a keyboard or mouse, is 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 a combination of any of the above. More specific examples (non-exhaustive list) of computer-readable storage media would include the following:
  • the computer-readable storage medium can be any tangible medium that contains or stores a program, and the program can be used by or in combination with an instruction execution system, apparatus, or device.
  • the computer-readable signal medium may include a data signal propagated in baseband or as a part of a carrier wave, and computer-readable program code is carried therein. 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 the computer-readable storage medium.
  • the computer-readable medium may send, propagate, or transmit the program for use by or in combination with the instruction execution system, apparatus, or device .
  • the program code contained on the computer-readable medium can be transmitted by any suitable medium, including (but not limited to) wireless, wired, optical cable, RF, etc., or any suitable combination of the above.
  • any combination of one or more programming languages can be used to write computer program codes for performing operations for various aspects of the present invention, including object-oriented programming languages such as Java, Smalltalk, C++, and conventional process programming languages, such as "C" programming language or similar programming language.
  • the program code can be executed entirely on the user's computer, partly on the user's computer, executed as an independent software package, partly on the user's computer and partly executed on a remote computer, or entirely executed on the remote computer or server.
  • the remote computer can 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 it can be connected to an external computer (for example, using an Internet service provider to pass Internet connection).
  • LAN local area network
  • WAN wide area network
  • each block of the flowchart and/or block diagram and the combination of each block in the flowchart and/or block diagram can be implemented by computer program instructions.
  • These computer program instructions can be provided to the processors of general-purpose computers, special-purpose computers, or other programmable data processing devices, thereby producing a machine that makes these computer program instructions when executed by the processors of the computer or other programmable data processing devices , A device that implements the functions/actions specified in one or more blocks in the flowcharts and/or block diagrams is produced.
  • These computer program instructions can also be stored in a computer-readable medium. These instructions make computers, other programmable data processing devices, or other devices work in a specific manner, so that the instructions stored in the computer-readable medium generate An article of manufacture that implements instructions for the functions/actions specified in one or more blocks in the flowchart and/or block diagram.
  • Computer program instructions can also be loaded onto a computer (for example, a coronary artery analysis system) or other programmable data processing equipment to cause a series of operation steps to be executed on the computer, other programmable data processing equipment or other equipment to produce a computer-implemented process , Causing instructions executed on a computer, other programmable device or other equipment to provide a process for implementing the functions/actions specified in the flowchart and/or one or more block diagrams.
  • a computer for example, a coronary artery analysis system
  • other programmable data processing equipment or other equipment to produce a computer-implemented process
  • Causing instructions executed on a computer, other programmable device or other equipment to provide a process for implementing the functions/actions specified in the flowchart and/or one or more block diagrams.

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Abstract

一种测量冠状动脉血管评定参数的简化方法、装置及系统，测量方法包括：对测量血管进行冠脉造影（S100）；通过压力导丝测量冠状动脉狭窄远端的压力P d（S200）；选取测量血管的第一体位造影图像和第二体位造影图像（S300）；根据第一体位造影图像和第二体位造影图像三维建模获得冠状动脉三维血管模型（S400）；根据冠状动脉三维血管模型，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2（S500）；根据P d、T 1、T 2测量冠状动脉血管评定参数（S600）。该方法降低了扩张药物的注射时间，基于冠脉造影图像测量IMR、CFR等冠状动脉血管评定参数，测量过程简单，测试结果准确。

Description

测量冠状动脉血管评定参数的简化方法、装置及系统
本申请要求在2019年9月5日提交中国专利局、申请号为201910834871.6、申请名称为“测量冠状动脉血管评定参数的简化方法、装置及系统”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本发明涉及冠状动脉医学技术领域，特别是涉及一种测量冠状动脉血管评定参数的简化方法、装置、冠状动脉分析系统及计算机存储介质。
背景技术
心脏属于高耗能器官。静息状态下，心肌代谢的摄氧量即可达血液氧含量的60％～80％。因此，在运动等应激状态下，心脏难以通过提高组织的摄氧能力来满足心肌缺氧量增加的需求，而绝大部分是通过增加心肌血流量来保证心肌代谢的氧需要量。心肌微循环占冠状动脉循环组成的95％，通过局部代谢产物、内皮、神经内分泌、肌源性等各种因素发挥调控心肌血流量的作用。研究显示，冠状动脉微循环功能异常是冠心病患者远期预后不良的重要预测因素。
在2013年指南进行了变迁，指出“对于怀疑存在微血管性心绞痛的患者，如果冠脉造影未见明显异常，可以考虑在造影期间腔内注射乙酰胆碱或腺苷进行多普勒测量，计算内皮依赖或非内皮以来的CFR，明确是否存在微循环/心外膜血管的痉挛”，并将此列为IIB类的推荐。
2019年指南增加了1个IIA类推荐和2个IIB类推荐。提出“对于持续存在症状的患者但冠脉造影正常或中等狭窄且iwfr/FFR值保留的患者，应当考虑使用基于导丝测量的CFR和/或微循环阻力测量”，并列为IIA类的推荐。
冠状动脉微血管功能是通过检测微血管对于血管扩张剂的反应来完成的。指南这两个方面的变迁，也提示冠状动脉微血管功能检查的重要性。冠状动脉微血管功能采用的测量指标是指冠状动脉微血管最大扩张程度即冠脉血流储备(Coronary Flow Reserve)CFR，所使用血管扩张剂主要包括作用于血管平滑肌的非内皮依赖性血管扩张剂以及作用于血管内皮细胞的内皮依赖性血管扩张剂，其中包括腺苷和乙酰胆碱。
对于冠状造影未见明显狭窄，但怀疑冠心病(CAD)的患者，我们既往的检查手段是注射腺苷和乙酰胆碱，来检测微血管对于血管扩张剂的反应。现在的检查方法主要包括冠状动脉血流储备分数(FFR)和微循环阻力指数(IMR)，IMR通过软压力导丝同步记录冠脉压力和温度，导丝杆上的两个温度感受器探测到温度变化的时间差就可知道盐水从指引导管到达导丝头端温度感受器运行的平均传导时间(transit mean time，Tmn)，根据定义冠脉远端的压力Pd与Tmn的乘积就可得出IMR值。但是总体来说现在评估微循环的方法并不多。现有的检查手段简化了流程、提高了安全性，对结果也进行了优化，所以指南的推荐级别较以前有所提升。除此之外，无创检查包括经胸多普勒超声、放射性核素显像技术、 核磁共振成像技术等手段在微循环疾病的诊断中具有价值，但是都有不同程度的不足，未能成为微循环功能评估的推荐方法。
现有的CFR测量方法包括：(1)多普勒导丝测量方法，将多普勒导丝送入冠状动脉血管内(病变远端)直接测量静息和最大充血状态下冠状动脉内血流速度，即可计算出CFR。(2)热稀释曲线测量方法，通过双重感应导丝崁有温度-压力感受器，能直接感受冠状动脉内温度的变化，可获得静息和最大充血状态下的冠状动脉内热稀释曲线，采用血流平均传导时间替代冠状动脉流量速度来计算CFR。
通过压力导丝传感器测量IMR和CFR存在如下问题：(1)压力导丝传感器离冠脉口太近测量的Tmn太小导致IMR结果偏小。太远测量的Tmn太大导致IMR结果偏大；(2)在静息态和最大充血态时共要注射6次生理盐水，压力导丝传感器位置如果有移动会导致每次测量的结果不具备可比性，且测量过程繁琐；(3)每次注射盐水可能得到的Tmn差异较大，如果某次数值与其他2个数值相差超过30％，需要再次注射盐水测量，增加盐水注射次数；(4)压力导丝感受器测量注射盐水温度下降不够迅速会导致无法记录数值，要提高注射速度，提高注射量，用更低温度的盐水。影响因素太多；(5)注射后温度没有足够快恢复原始值也会出错，从开始注射，到温度恢复正常时间太长(>0.6秒)；可能是注射太慢，注射速度不均匀，注射量太大等。因此，压力导丝感受器的距离、注射盐水速度、注射量、盐水的温度均会直接影响测量结果，导致结果不准确，测量过程繁琐；且长时间持续注射扩张药物，对病人有较大影响产生严重的不适感。
发明内容
本发明提供了一种测量冠状动脉血管评定参数的简化方法、装置、冠状动脉分析系统及计算机存储介质，以解决现有技术中通过压力导丝测量CFR和IMR时存在长时间持续注射扩张药物，对病人有较大影响产生严重的不适感，以及压力导丝测量过程繁琐，测量结果不准确的问题。
为实现上述目的，第一方面，本申请提供了一种测量冠状动脉血管评定参数的简化方法，包括：
对测量血管进行冠脉造影；
通过压力导丝测量冠状动脉狭窄远端的压力P d；
选取所述测量血管的静息态下的第一体位造影图像和扩张状态下的第二体位造影图像；
选取从冠脉狭窄病变近端到远端的一段血管，根据所述第一体位造影图像和所述第二体位造影图像三维建模获得冠状动脉三维血管模型；
注射造影剂，根据所述造影剂在所述冠状动脉三维血管模型内的流动，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；
根据P d、T 1、T 2测量冠状动脉血管评定参数。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述冠状动脉血管评定参数包括：冠脉血流储备CFR、微循环阻力系数IMR。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述第一体位图像为静息态下的造影图像， 所述第二体位图像为扩张态下的造影图像，即：
所述CFR＝T 1/T 2；和/或
所述IMR＝P d×T 2。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述冠状动脉血管评定参数包括：冠状动脉血流储备分数FFR，通过所述压力导丝测量冠状动脉入口压力P a，所述FFR＝P d/P a。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述第一体位与所述第二体位的夹角大于30°。
可选地，上述的测量冠状动脉血管评定参数的简化方法，在所述通过压力导丝测量冠状动脉狭窄远端的压力P d之前，包括：向血管内注射扩张药物。
可选地，上述的测量冠状动脉血管评定参数的简化方法，在所述通过压力导丝测量冠状动脉狭窄远端的压力P d之后，所述对测量血管进行冠脉造影之前，包括：在注射扩张药物的同时向所述血管内注射造影剂。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述根据所述第一体位造影图像和所述第二体位造影图像三维建模获得冠状动脉三维血管模型包括：
去除第一体位造影图像和所述第二体位造影图像的干扰血管，得到结果图像；
沿着所述冠状动脉的延伸方向，提取每幅所述结果图像的冠脉中心线和直径；
将每根所述冠脉中心线和直径均投射于三维空间上进行三维建模，获得冠状动脉三维血管模型。
可选地，上述的测量冠状动脉血管评定参数的简化方法，所述时间T 1和T 2根据心跳周期区域被分成的局部区域图像的帧数与每秒传输帧数的比值计算。
第二方面，本申请提供了一种测量冠状动脉血管评定参数的装置，用于上述的测量冠状动脉血管评定参数的简化方法，包括：压力导丝测量单元、提取冠脉造影单元、三维建模单元和参数测量单元，所述提取冠脉造影单元与三维建模单元连接，所述参数测量单元与所述压力导丝测量单元、所述三维建模单元连接；
所述压力导丝测量单元，用于通过压力导丝测量冠状动脉狭窄远端的压力P d和冠状动脉入口压力P a；
所述提取冠脉造影单元，用于选取所述测量血管的第一体位造影图像和第二体位造影图像；
所述三维建模单元，用于接收所述提取冠脉造影单元传递的第一体位造影图像和所述第二体位造影图像，三维建模获得冠状动脉三维血管模型；
所述参数测量单元，用于接收所述三维建模单元传递的冠状动脉三维血管模型，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；以及接收所述压力导丝测量单元传递的压力P d，根据P d、T 1、T 2测量冠状动 脉血管评定参数。
可选地，上述的测量冠状动脉血管评定参数的装置，所述参数测量单元包括：冠脉血流储备模块、微循环阻力系数模块，和/或冠状动脉血流储备分数模块；所述冠脉血流储备模块、所述微循环阻力系数模块均与所述三维建模单元连接；所述微循环阻力系数模块、所述冠状动脉血流储备分数模均与所述压力导丝测量单元连接；
所述冠脉血流储备模块，用于测量冠脉血流储备CFR，CFR＝T 1/T 2；
所述微循环阻力系数模块，用于测量微循环阻力系数IMR，IMR＝P d×T 2；
所述冠状动脉血流储备分数模块，用于测量冠状动脉血流储备分数FFR，FFR＝P d/P a。
第三方面，本申请提供了一种冠状动脉分析系统，包括：上述的测量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测量冠状动脉血管评定参数的简化方法。
本申请实施例提供的方案带来的有益效果至少包括：
本申请提供了测量冠状动脉血管评定参数的简化方法，只在测试冠状动脉狭窄远端的压力P d时，注射扩张药物，造影过程只需几秒钟即可停止扩张药物注射，降低扩张药物的注射时间，然后通过冠脉造影图像进行三维建模，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；根据P d、T 1、T 2测量IMR、CFR等冠状动脉血管评定参数，测量过程简单，测试结果准确，克服了全部使用压力导丝测量IMR、CFR等冠状动脉血管评定参数时的问题。
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为本申请的测量冠状动脉血管评定参数的简化方法的一个实施例的流程图；
图2为本申请的测量冠状动脉血管评定参数的简化方法的另一实施例的流程图；
图3为本申请的步骤S400的流程图；
图4为本申请的测量冠状动脉血管评定参数的装置的结构框图；
图5为本申请的参数测量单元的结构框图；
图6为本申请的三维建模单元的一个实施例的结构框图；
图7为本申请的三维建模单元的另一实施例的结构框图；
图8为本申请的图像处理模块的结构框图；
图9为参考图像；
图10为待分割的一目标图像；
图11为待分割的另一目标图像；
图12为增强后的导管图像；
图13为导管特征点的二值化图像；
图14为增强后的目标图像；
图15为冠状动脉所处位置的区域图像；
图16为结果图像；
图17为两个体位造影图像；
图18为由图17结合体位角度以及冠脉中心线生成的冠状动脉三维血管模型图；
下面对附图标记进行说明：
压力导丝测量单元110，提取冠脉造影单元120，三维建模单元130，图像读取模块131，分割模块132，血管长度测量模块133，三维建模模块134，图像处理模块135，图像去噪模块1350，导管特征点提取模块1351，冠状动脉提取模块1352，冠脉中心线提取模块136，血管直径测量模块137，参数测量单元140，冠脉血流储备模块141，微循环阻力系数模块142，冠状动脉血流储备分数模块143。
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。
如图1所示，本申请提供了一种测量冠状动脉血管评定参数的简化方法，包括：
S100，对测量血管进行冠脉造影；
S200，通过压力导丝测量冠状动脉狭窄远端的压力P d；
S300，选取所述测量血管的静息态下的第一体位造影图像和扩张状态下的第二体位造影图像；
S400，选取从冠脉狭窄病变近端到远端的一段血管，根据第一体位造影图像和第二体位造影图像三维建模获得冠状动脉三维血管模型；
S500，注射造影剂，根据所述造影剂在所述冠状动脉三维血管模型内的流动，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；
S600，根据P d、T 1、T 2测量冠状动脉血管评定参数。
本申请的一个实施例中，S600中的冠状动脉血管评定参数包括：冠脉血流储备CFR、微循环阻力系数IMR。
本申请提供了测量冠状动脉血管评定参数的简化方法，只在测试冠状动脉狭窄远端的压力P d时，注射扩张药物，造影过程只需几秒钟即可停止扩张药物注射，降低扩张药物的注射时间，然后通过冠脉造影图像进行三维建模，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；根据P d、T 1、T 2测量IMR、CFR等冠状动脉血管评定参数，测量过程简单，测试结果准确，克服了全部使用压力导丝测量IMR、CFR等冠状动脉血管评定参数时的问题。
需要注意的是：注射扩张药物包括：静脉或者冠脉内注射扩张药物，打入方式包括：扩张药物可以与造影剂混合注射进入静脉或者冠脉，也可以分次间隔注射均在本申请的保护范围内；只要能够起到扩张作用的药物包括腺苷、ATP等均在本申请的保护范围内。
本申请的一个实施例中，S300中CFR＝T 1/T 2；和/或
IMR＝P d×T 2。
本申请的一个实施例中，上述的时间T 1和T 2根据心跳周期区域被分成的局部区域图像的帧数与每秒传输帧数的比值计算；即：
T＝N/fps，N表示心跳周期区域被分成的局部区域图像的帧数，fps表示画面每秒播放帧数，通俗来讲就是指动画或视频的画面数，T表示某一体位造影图像中的造影剂从血管段入口到出口所经过的时间T，因此T 1和T 2可以根据上述公式计算得出。本申请的一个实施例中，fps＝10～30；优选地，fps＝15。
由于T 1和T 2均是基于造影图像获得的冠状动脉三维血管模型测得，因此CFR也是通过冠状动脉三维血管模型测得，无需依赖于压力导丝传感器，因此克服了压力导丝传感器在盐水的冲击下容易移动，测量不准确的问题，且测量基于造影图像时无需注射盐水，因此避免了注射盐水速度、注射量、盐水的温度对CFR测量结果的影响，提高了测量的准确率。
IMR的测量是基于压力导丝和造影图像的，由于压力导丝测量的冠状动脉狭窄远端的压力P d更加准确，然后再基于造影图像测量时间T 2，减少了扩张药物的注射时间，降低了盐水的注射次数，降低了盐水对测试结果的影响，进而提高了IMR测量结果的准确率，测试过程简单。
本申请的一个实施例中，S600中的冠状动脉血管评定参数包括：冠状动脉血流储备分数FFR，通过S200中的压力导丝测量冠状动脉入口压力P a，FFR＝P d/P a。
本申请的一个实施例中，S300中的第一体位图像中选取的第一体位与第二体位图像中选取的第二体位的夹角大于30°。
如图2所示，本申请的一个实施例中，在S100之后，S200之前，包括：S000，向血管内注射扩张药物。
如图2所示，本申请的一个实施例中，在S100之前，包括：S110，在注射扩张药物的同时向血管 内注射造影剂。需要注意的是：在造影结束后即可停止注射扩张药物，降低了扩张药物的注射量和注射次数，更加安全、可靠。
如图3所示，本申请的一个实施例中，S400包括：
S410，去除第一体位造影图像和第二体位造影图像的干扰血管，得到结果图像，具体为：
去除第一体位造影图像和第二体位造影图像的干扰血管；
对冠脉造影图像去噪，包括：静态噪声和动态噪声；
将有导管出现的第一帧分割图像定义为参考图像，将有完整冠状动脉出现的第k帧所述分割图像定义为目标图像，k为大于1的正整数；
将所述参考图像减去所述目标图像，提取所述导管的特征点O，具体方法为：将所述参考图像减去所述目标图像；去噪，包括：静态噪声和动态噪声；对所述去噪后的图像进行图像增强；对增强后的导管图像进行二值化处理，得到具有一组导管特征点O的二值化图像；
将所述目标图像减去所述参考图像，提取所述冠状动脉所处位置的区域图像，具体方法为：将所述目标图像减去所述参考图像；去噪，包括：静态噪声和动态噪声；对去噪后的所述图像进行图像增强；根据增强后的所述目标图像中各区域与所述导管特征点的位置关系，确定并提取冠状动脉的区域，即为所述冠状动脉所处位置的区域图像；
所述区域图像以所述导管的特征点作为种子点进行动态生长，获得所述结果图像，具体方法为：对所述冠状动脉所处位置的区域图像进行二值化处理，获得二值化冠状动脉图像；对所述二值化冠状动脉图像进行形态学运算，以所述导管的特征点作为种子点，所述二值化冠状动脉图像依据所述种子点所处位置进行动态区域生长，获得所述结果图像；
S420，沿着冠状动脉的延伸方向，提取每幅结果图像的冠脉中心线和直径；
S430，将每根冠脉中心线和直径均投射于三维空间上进行三维建模，获得冠状动脉三维血管模型，具体方法为：
获取每幅冠脉造影图像的体位拍摄角度；
将每根所述冠脉中心线结合体位拍摄角度投射于三维空间上，进行投影，生成冠状动脉三维血管模型。
如图4所示，本申请提供了一种测量冠状动脉血管评定参数的装置，用于上述的测量冠状动脉血管评定参数的简化方法，包括：压力导丝测量单元110、提取冠脉造影单元120、三维建模单元130和参数测量单元140，提取冠脉造影单元120与三维建模单元130连接，参数测量单元140与压力导丝测量单元110、三维建模单元130连接；压力导丝测量单元110，用于通过压力导丝测量冠状动脉狭窄远端的压力P d和冠状动脉入口压力P a；提取冠脉造影单元120，用于选取测量血管的第一体位造影图像和第二体位造影图像；三维建模单元130，用于接收提取冠脉造影单元传递的第一体位造影图像和第二体位造影图像，三维建模获得冠状动脉三维血管模型；参数测量单元140，用于接收三维建模单元传递的冠状动脉三维血管模型，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；以及接收压力导丝测量单元传递的压力 P d，根据P d、T 1、T 2测量冠状动脉血管评定参数。
如图5所示，本申请的一个实施例中，参数测量单元140包括：冠脉血流储备模块141、微循环阻力系数模块142，和/或冠状动脉血流储备分数模块143，冠脉血流储备模块141、微循环阻力系数模块142均与三维建模单元130连接；微循环阻力系数模块142、冠状动脉血流储备分数模块143均与压力导丝测量单元110连接；冠脉血流储备模块141用于测量冠脉血流储备CFR，CFR＝T 1/T 2；微循环阻力系数模块142用于测量微循环阻力系数IMR，IMR＝P d×T 2；冠状动脉血流储备分数模块143用于测量冠状动脉血流储备分数FFR，FFR＝P d/P a。
参数测量单元140还包括：T 1测量模块、T 2测量模块和CFR测量模块，均与三维建模单元130连接，且T 1测量模块、T 2测量模块均与CFR测量模块连接。
如图6所示，本申请的一个实施例中，三维建模单元130包括图像读取模块131、分割模块132、血管长度测量模块133和三维建模模块134，分割模块132与图像读取模块131、血管长度测量模块133、三维建模模块134连接；图像读取模块131用于读取造影图像；分割模块132用于选取冠状动脉造影图像的一个心跳周期区域；血管长度测量模块133用于测量心跳周期区域内的血管的长度L，并将血管的长度L传递给分割模块132；三维建模模块134用于根据分割模块132选取的冠脉造影图像进行三维建模，获得冠状动脉三维血管模型。
如图7所示，本申请的一个实施例中，三维建模单元130还包括：图像处理模块135、冠脉中心线提取模块136和血管直径测量模块137，图像处理模块135与冠脉中心线提取模块136连接，三维建模模块134与冠脉中心线提取模块136、血管直径测量模块137连接。图像处理模块135用于接收分割模块132传递的至少两个体位的冠脉造影图像，并去除冠脉造影图像的干扰血管，得到如图17所示的结果图像；冠脉中心线提取模块136用于沿着冠状动脉的延伸方向，提取每幅如图17所示的结果图像的冠脉中心线；血管直径测量模块137用于测量血管直径D；三维建模模块134用于将每根冠脉中心线和直径均投射于三维空间上进行三维建模，获得冠状动脉三维血管模型。本申请实现了根据冠脉造影图像合成冠状动脉三维血管模型，弥补了行业内的空白，对于医学技术领域具有积极的作用。
本申请的一个实施例中，图像处理模块135内部设置图像去噪模块1350，用于对冠脉造影图像去噪，包括：静态噪声和动态噪声。通过去噪模块1350去除冠脉造影图像中的干扰因素，提高图像处理的质量。
如图8所示，本申请的一个实施例中，图像处理模块135内部设置均与冠脉中心线提取模块136连接的导管特征点提取模块1351和冠状动脉提取模块1352，导管特征点提取模块1351与冠状动脉提取模块1352、图像去噪模块1350连接；导管特征点提取模块1351用于将有导管出现的第一帧分割图像定义为如图9所示的参考图像，将有完整冠状动脉出现的第k帧分割图像定义为如图10和如图11所示的目标图像，k为大于1的正整数，对如图10和11所示的目标图像进行增强，得到如图12和14所示的增 强后的图像；将如图9所示的参考图像减去如图10和如图11所示的目标图像，提取如图13所示的导管的特征点O；冠状动脉提取模块1352用于将如图10和如图11所示的目标图像减去如图9所示的参考图像，根据如图14所示的增强后的目标图像中各区域与导管特征点的位置关系，确定并提取冠状动脉的区域，即为如图15所示的冠状动脉所处位置的区域图像；如图15所示的区域图像以如图13所示的导管的特征点作为种子点进行动态生长，获得如图16所示的结果图像。
图像处理模块135内部还设置二值化处理模块，用于对图像进行二值化处理，以获得冠状动脉三维血管模型。
下面结合具体实施例对本申请进行具体说明：
实施例1：
如图17所示，为一位患者拍摄的两个体位的冠脉造影图像；左图为体位角度为右前斜RAO：25°和头位CRA：23°的造影图像；右图为体位角度为右前斜RAO：3°和头位CRA：30°的造影图像；
把压力导丝传感器放到患者的冠脉远端(离导引导管开口＞5cm)；在测量FFR时注射扩张药物，通过压力导丝测得P a＝95.2Hg，P d＝85.8mmHg；
冠状动脉三维血管模型的血管长度L值＝120mm；生成的冠状动脉三维血管模型如图18所示；血管直径D值＝2～4mm，T 1＝N 1/fps 1＝26/15＝1.7s；T 2＝N 2/fps 2＝9/15＝0.6s；
CFR＝T 1/T 2＝1.7/0.6＝2.83；
因此IMR＝85.8×0.6＝51.48；
FFR＝85.8/95.2＝0.90。
对比例1：
与实施例1的患者相同，对比例1和实施例1均为同一位患者拍摄的同一张冠脉造影图像；
把压力导丝传感器放到患者的冠脉远端(离导引导管开口＞5cm)，通过导管向血管中注入3ml生理盐水，如果检测到血液温度回复到正常值，则再次通过导管向血管中注入3ml生理盐水，重复上述过程3次，然后记录T 1，T 1为1.6s；向血管通入扩张药物，使血管达到并保持扩张状态(保证通入扩张药物前后的压力导丝传感器处于相同位置)，通过导管向血管中注入3ml生理盐水，如果检测到血液温度回复到正常值，则再次通过导管向血管中注入3ml生理盐水，重复上述过程3次，然后记录T 2，T 2为0.58s，测得冠脉远端的压力P d＝88mmHg，冠脉入口压力P a＝94.8mmHg；
CFR＝1.6/0.58＝2.76；
IMR＝P d×T 2＝88×0.58＝51.04；
FFR＝88/94.8＝0.928。
通过实施例1和对比例1的比较，差值在0.5以内，可知IMR测量结果基本相同，因此实施例1的测量结果准确，且本申请的实施例采用压力导丝测量远端的压力，但是不使用生理盐水，T 1、T 2通过三维血管模型测得；且通过造影图像实现了IMR的测量，弥补了行业内的空白，操作更加简单，还实现了FFR的测量，且无需采用生理盐水，解决了压力导丝传感器在生理盐水的冲力作用下，导致的压力导丝的位置很难控制的问题，解决了远端压力测量不准的问题。
本申请提供了一种冠状动脉分析系统，包括：上述的测量冠状动脉血管评定参数的装置。
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测量冠状动脉血管评定参数的简化方法。
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 (12)

  1. 一种测量冠状动脉血管评定参数的简化方法，其特征在于，包括：
    对测量血管进行冠脉造影；
    通过压力导丝测量冠状动脉狭窄远端的压力P d；
    选取所述测量血管的静息态下的第一体位造影图像和扩张状态下的第二体位造影图像；
    选取从冠脉狭窄病变近端到远端的一段血管，根据所述第一体位造影图像和所述第二体位造影图像三维建模获得冠状动脉三维血管模型；
    注射造影剂，根据所述造影剂在所述冠状动脉三维血管模型内的流动，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；
    根据P d、T 1、T 2测量冠状动脉血管评定参数。
  2. 根据权利要求1所述的测量冠状动脉血管评定参数的简化方法，其特征在于，所述冠状动脉血管评定参数包括：冠脉血流储备CFR、微循环阻力系数IMR。
  3. 根据权利要求2所述的测量冠状动脉血管评定参数的简化方法，其特征在于，所述CFR＝T 1/T 2；和/或
    所述IMR＝P d×T 2。
  4. 根据权利要求1～3任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，所述第一体位与所述第二体位的夹角大于30°。
  5. 根据权利要求1～3任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，在所述通过压力导丝测量冠状动脉狭窄远端的压力P d之前，包括：向血管内注射扩张药物。
  6. 根据权利要求1～3任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，在所述通过压力导丝测量冠状动脉狭窄远端的压力P d之后，所述对测量血管进行冠脉造影之前，包括：在注射扩张药物的同时向所述血管内注射造影剂。
  7. 根据权利要求1～3任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，所述根据所述第一体位造影图像和所述第二体位造影图像三维建模获得冠状动脉三维血管模型包括：
    去除第一体位造影图像和所述第二体位造影图像的干扰血管，得到结果图像；
    沿着所述冠状动脉的延伸方向，提取每幅所述结果图像的冠脉中心线和直径；
    将每根所述冠脉中心线和直径均投射于三维空间上进行三维建模，获得冠状动脉三维血管模型。
  8. 根据权利要求1～3任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，所述时间T 1和T 2根据心跳周期区域被分成的局部区域图像的帧数与每秒传输帧数的比值计算。
  9. 一种测量冠状动脉血管评定参数的装置，用于权利要求1～8任一项所述的测量冠状动脉血管评定参数的简化方法，其特征在于，包括：压力导丝测量单元、提取冠脉造影单元、三维建模单元和参数测量单元，所述提取冠脉造影单元与三维建模单元连接，所述参数测量单元与所述压力导丝测量单元、所述三维建模单元连接；
    所述压力导丝测量单元，用于通过压力导丝测量冠状动脉狭窄远端的压力P d和冠状动脉入口压力P a；
    所述提取冠脉造影单元，用于选取所述测量血管的第一体位造影图像和第二体位造影图像；
    所述三维建模单元，用于接收所述提取冠脉造影单元传递的第一体位造影图像和所述第二体位造影图像，三维建模获得冠状动脉三维血管模型；
    所述参数测量单元，用于接收所述三维建模单元传递的冠状动脉三维血管模型，获得第一体位造影图像内的造影剂从血管段入口到出口所经过的时间T 1，获得第二体位造影图像内的造影剂从血管段入口到出口所经过的时间T 2；以及接收所述压力导丝测量单元传递的压力P d，根据P d、T 1、T 2测量冠状动脉血管评定参数。
  10. 根据权利要求9所述的测量冠状动脉血管评定参数的装置，其特征在于，所述参数测量单元包括：冠脉血流储备模块、微循环阻力系数模块，和/或冠状动脉血流储备分数模块；所述冠脉血流储备模块、所述微循环阻力系数模块均与所述三维建模单元连接；所述微循环阻力系数模块、所述冠状动脉血流储备分数模均与所述压力导丝测量单元连接；
    所述冠脉血流储备模块，用于测量冠脉血流储备CFR，CFR＝T 1/T 2；
    所述微循环阻力系数模块，用于测量微循环阻力系数IMR，IMR＝P d×T 2；
    所述冠状动脉血流储备分数模块，用于测量冠状动脉血流储备分数FFR，FFR＝P d/P a。
  11. 一种冠状动脉分析系统，其特征在于，包括：权利要求9或10所述的测量冠状动脉血管评定参数的装置。
  12. 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1～8任一项所述的测量冠状动脉血管评定参数的简化方法。
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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102525443A (zh) * 2010-09-16 2012-07-04 西门子公司 非侵入性冠状动脉病评估的方法和系统
US20150250395A1 (en) * 2014-03-10 2015-09-10 Kabushiki Kaisha Toshiba Medical image processing apparatus
CN106023202A (zh) * 2016-05-20 2016-10-12 苏州润心医疗科技有限公司 基于心脏ct图像的冠状动脉血流储备分数计算方法
CN108186038A (zh) * 2018-02-11 2018-06-22 杭州脉流科技有限公司 基于动脉造影影像计算冠脉血流储备分数的系统
CN108245178A (zh) * 2018-01-11 2018-07-06 苏州润迈德医疗科技有限公司 一种基于x射线冠脉造影图像的血液流动速度计算方法
CN108294735A (zh) * 2012-03-13 2018-07-20 西门子公司 用于冠状动脉狭窄的非侵入性功能评估的方法和系统
CN108550189A (zh) * 2018-05-03 2018-09-18 苏州润迈德医疗科技有限公司 基于造影图像和流体力学模型的微循环阻力指数计算方法
CN109523515A (zh) * 2018-10-18 2019-03-26 深圳市孙逸仙心血管医院（深圳市心血管病研究所） 血流储备分数的计算方法

Family Cites Families (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6672172B2 (en) * 2000-01-31 2004-01-06 Radi Medical Systems Ab Triggered flow measurement
EP2863802B1 (en) * 2012-06-26 2020-11-04 Sync-RX, Ltd. Flow-related image processing in luminal organs
EP2879573A4 (en) * 2012-08-03 2016-08-03 Volcano Corp DEVICES, SYSTEMS AND METHODS FOR EVALUATING A VESSEL
US9814433B2 (en) * 2012-10-24 2017-11-14 Cathworks Ltd. Creating a vascular tree model
EP2934307B1 (en) * 2012-12-21 2020-08-05 Volcano Corporation Functional gain measurement technique and representation
US20160000341A1 (en) * 2013-02-18 2016-01-07 Ramot At Tel-Aviv University Ltd. Intravascular pressure drop derived arterial stiffness and reduction of common mode pressure effect
EP3087921A1 (en) * 2015-04-27 2016-11-02 Coronary Technologies SARL Computer-implemented method for identifying zones of stasis and stenosis in blood vessels
US10872698B2 (en) * 2015-07-27 2020-12-22 Siemens Healthcare Gmbh Method and system for enhancing medical image-based blood flow computations using physiological measurements
CN108742587B (zh) * 2018-06-20 2021-04-27 博动医学影像科技（上海）有限公司 基于病史信息获取血流特征值的方法及装置
CN109770888A (zh) * 2019-03-19 2019-05-21 苏州润迈德医疗科技有限公司 基于压力传感器和造影图像计算瞬时无波形比率的方法

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102525443A (zh) * 2010-09-16 2012-07-04 西门子公司 非侵入性冠状动脉病评估的方法和系统
CN108294735A (zh) * 2012-03-13 2018-07-20 西门子公司 用于冠状动脉狭窄的非侵入性功能评估的方法和系统
US20150250395A1 (en) * 2014-03-10 2015-09-10 Kabushiki Kaisha Toshiba Medical image processing apparatus
CN106023202A (zh) * 2016-05-20 2016-10-12 苏州润心医疗科技有限公司 基于心脏ct图像的冠状动脉血流储备分数计算方法
CN108245178A (zh) * 2018-01-11 2018-07-06 苏州润迈德医疗科技有限公司 一种基于x射线冠脉造影图像的血液流动速度计算方法
CN108186038A (zh) * 2018-02-11 2018-06-22 杭州脉流科技有限公司 基于动脉造影影像计算冠脉血流储备分数的系统
CN108550189A (zh) * 2018-05-03 2018-09-18 苏州润迈德医疗科技有限公司 基于造影图像和流体力学模型的微循环阻力指数计算方法
CN109523515A (zh) * 2018-10-18 2019-03-26 深圳市孙逸仙心血管医院（深圳市心血管病研究所） 血流储备分数的计算方法

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP4026491A4

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