WO2022188870A1 - Method and device for acquiring coronary artery functional indexes - Google Patents

Abstract

A method and device for acquiring coronary artery functional indexes. The method comprises: acquiring image data of a blood vessel to be measured (S101); using a non-invasive measurement method to acquire central arterial pressure of said blood vessel (S102); determining the internal pressure and flow velocity of said blood vessel at least according to the image data and the central arterial pressure (S103); and determining functional indexes of said blood vessel according to the internal pressure and flow velocity(S104). The method realizes non-invasive and accurate detection of coronary artery physiological functional indexes.

Description

Method and device for obtaining functional index of coronary artery

This disclosure claims the priority of the Chinese patent application with the application number 202110269802.2 and the application title "Method and Apparatus for Obtaining Coronary Coronary Functional Indexes" filed with the China Patent Office on March 12, 2021, the entire contents of which are incorporated herein by reference Public.

technical field

The present disclosure relates to the field of coronary physiology, and in particular, to a method, a device, a computer-readable storage medium, and a processor for acquiring coronary function indexes.

Background technique

Coronary physiology plays an increasingly important clinical role in cardiology. Coronary function indexes include: fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), resting full-cycle ratio (RFR) , circulatory resistance coefficient (Index of Microcirculatory Resistance, referred to as IMR) and vessel wall shear stress (Wall Shear Stress, referred to as WSS) and so on.

In the related art, the main clinical acquisition methods of FFR, iFR, RFR, IMR, and WSS are invasive single-point measurement with a pressure guide wire at a designated position in the target blood vessel. This measurement method has various intraoperative risks and is expensive. It has high professional requirements for operators, and it is difficult to obtain the parameter values of all positions of the coronary artery. It is urgent to reduce the risks and risks caused by invasiveness through technological upgrading. cost. In recent years, a variety of medical imaging techniques have provided auxiliary options for the diagnosis and treatment of coronary vessels, including digital silhouette angiography (DSA), positron emission tomography (PET) and cardiac magnetic resonance, myocardial contrast-enhanced ultrasound and computed tomography imaging etc.

The new medical imaging technology can more intuitively and accurately present the geometric information of the real coronary artery and blood flow, which is very helpful for clinicians to complete the diagnosis and treatment of the disease. However, the accuracy of functional metrics such as FFR, iFR, RFR, IMR, and WSS obtained with existing medical imaging technology-assisted techniques is low.

SUMMARY OF THE INVENTION

At least one embodiment of the present disclosure provides a method for obtaining a functional index of a coronary artery, comprising: obtaining image data of a blood vessel to be measured; obtaining central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method; at least according to the image The data and the central arterial pressure are used to determine the internal pressure and flow rate of the blood vessel to be measured; and the functional index of the blood vessel to be measured is determined according to the internal pressure and the flow rate.

Optionally, using a noninvasive measurement method to obtain the central arterial pressure of the blood vessel to be measured includes: using the noninvasive measurement method to obtain brachial artery pressure, radial artery pressure and carotid artery pressure; The central arterial pressure is calculated from at least one of arterial pressure and the carotid pressure.

Optionally, calculating the central arterial pressure according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure includes: according to the brachial artery pressure, the radial artery pressure and At least one of the carotid pressures, using a transfer function method, calculates the central arterial pressure.

Optionally, calculating the central arterial pressure according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure includes: according to the brachial artery pressure, the radial artery pressure and For at least one of the carotid pressures, the central arterial pressure is calculated using a one-dimensional hemodynamic method.

Optionally, calculating the central arterial pressure according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure includes: according to the brachial artery pressure, the radial artery pressure and At least one of the carotid arterial pressures uses the Tube-Load method to calculate the central arterial pressure.

Optionally, obtaining the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method further includes: obtaining a parameter set of the blood vessel to be measured, the parameter set including geometric information, arterial inlet flow, outlet boundary model and blood vessel elasticity. model; determine a one-dimensional hydrodynamic model according to the parameter set; calculate the first pressure waveform at the measuring point according to the one-dimensional hydrodynamic model, the measuring point includes the radial artery and the brachial artery; use the non-invasive measurement method to obtain the second pressure waveform at the measuring point, the non-invasive measurement method includes ultrasonic method and nuclear magnetic method; determine a target difference, the target difference is the difference between the first pressure waveform and the second pressure waveform ; optimize the one-dimensional fluid mechanics model according to the target difference to obtain an optimized one-dimensional fluid mechanics model; determine the central arterial pressure based on the optimized one-dimensional fluid mechanics model.

Optionally, acquiring the geometric information of the blood vessel to be measured includes: constructing 55 segments of the human arterial network structure; and determining the geometric information of the blood vessel to be measured according to the 55 segments of the human arterial network structure.

Optionally, acquiring the arterial inlet flow of the blood vessel to be measured includes: determining a flow-time relationship within a complete heartbeat cycle at the entrance of the arterial tree; determining the arterial inlet flow of the blood vessel to be measured according to the flow-time relationship .

Optionally, acquiring the outlet boundary model of the blood vessel to be measured includes: determining relevant parameters of each truncated blood vessel at the outlet of the arterial tree based on the circuit model, the relevant parameters including impedance and capacitive reactance; determining the relevant parameters according to the relevant parameters. Outlet boundary model of the vessel to be measured.

Optionally, optimizing the one-dimensional fluid mechanics model according to the target difference to obtain an optimized one-dimensional fluid mechanics model, including: when the target difference is greater than or equal to a predetermined value, Each parameter in the parameter set is updated until the target difference value is smaller than the predetermined value; an optimized one-dimensional fluid mechanics model is determined according to the updated parameter set.

Optionally, determining the internal pressure and flow velocity of the blood vessel to be measured according to at least the image data and the central arterial pressure, comprising: determining a blood vessel geometric model according to the image data; determining the blood vessel according to the central arterial pressure The pressure at the inlet of the blood vessel to be measured; according to the geometric model of the blood vessel and the pressure at the inlet of the blood vessel to be measured, construct a 3D coronary CFD model of the blood vessel to be measured; The internal pressure and the flow rate of the blood vessel are measured.

Optionally, the image data includes at least one of the following: CTA images, CTP images, DSA images, OCT images and IVUS images.

Optionally, the functional index includes at least one of the following: FFR, iFR, RFR, IMR and WSS.

At least one embodiment of the present disclosure provides an apparatus for acquiring coronary function indexes, including: a first acquiring unit configured to acquire image data of blood vessels to be measured; a second acquiring unit configured to use a non-invasive measurement method Acquiring the central arterial pressure of the blood vessel to be measured; a first determining unit, configured to determine the internal pressure and flow rate of the blood vessel to be measured at least according to the image data and the central arterial pressure; a second determining unit, being It is configured to determine the functional index of the blood vessel to be measured according to the internal pressure and the flow rate.

According to yet another aspect of the present disclosure, a computer-readable storage medium is provided, the computer-readable storage medium includes a stored program, wherein when the program is executed, a device on which the computer-readable storage medium is located is controlled to execute any arbitrary program. A method for obtaining the functional index of coronary artery.

According to yet another aspect of the present disclosure, a processor is provided, the processor is configured to run a program, wherein when the program is run, any one of the methods for obtaining a coronary artery function index is executed.

Description of drawings

The accompanying drawings that constitute a part of the present disclosure are used to provide further understanding of the present disclosure, and the exemplary embodiments of the present disclosure and their descriptions are used to explain the present disclosure and do not constitute an improper limitation of the present disclosure. In the attached image:

FIG. 1 shows a flowchart of a method for obtaining coronary function indexes according to an embodiment of the present disclosure;

2 shows a schematic diagram of a 55-segment human arterial network according to an embodiment of the present disclosure;

3 illustrates a central arterial pressure waveform diagram according to an embodiment of the present disclosure;

Figure 4 shows a Tube-Load model according to an embodiment of the present disclosure;

FIG. 5 shows a schematic diagram of a device for acquiring coronary function indexes according to an embodiment of the present disclosure.

Detailed ways

It should be noted that the embodiments of the present disclosure and the features of the embodiments may be combined with each other under the condition of no conflict. The present disclosure will be described in detail below with reference to the accompanying drawings and in conjunction with embodiments.

In order to make those skilled in the art better understand the solutions of the present disclosure, the technical solutions in the embodiments of the present disclosure will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present disclosure. Obviously, the described embodiments are only The embodiments are part of the present disclosure, but not all of the embodiments. Based on the embodiments in the present disclosure, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present disclosure.

It should be noted that the terms "first", "second" and the like in the description and claims of the present disclosure and the above drawings are used to distinguish similar objects, and are not necessarily used to describe a specific sequence or sequence. It is to be understood that the data so used are interchangeable under appropriate circumstances for the embodiments of the present disclosure described herein. Furthermore, the terms "comprising" and "having" and any variations thereof, are intended to cover non-exclusive inclusion, for example, a process, method, system, product or device comprising a series of steps or units is not necessarily limited to those expressly listed Rather, those steps or units may include other steps or units not expressly listed or inherent to these processes, methods, products or devices.

It will be understood that when an element such as a layer, film, region, or substrate is referred to as being "on" another element, it can be directly on the other element or intervening elements may also be present. Also, in the specification and claims, when an element is described as being "connected" to another element, the element can be "directly connected" to the other element or "connected" to the other element through a third element.

As described in the background art, the accuracy of functional indicators such as FFR, iFR, RFR, IMR and WSS obtained by using the existing medical imaging technology-assisted technology in the related art is relatively low. To solve the problem of low accuracy of functional indicators such as FFR, iFR, RFR, IMR, and WSS obtained by imaging technology-assisted technology, the embodiments of the present disclosure provide a method, device, and computer-readable method for obtaining coronary functional indicators. storage medium and processor.

According to an embodiment of the present disclosure, there is provided a method for obtaining a coronary function index.

FIG. 1 is a flowchart of a method for obtaining a coronary function index according to an embodiment of the present disclosure. As shown in Figure 1, the method includes the following steps:

Step S101, acquiring image data of the blood vessel to be measured;

Step S102, using a non-invasive measurement method to obtain the central arterial pressure of the blood vessel to be measured;

Step S103, determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

In step S104, the functional index of the blood vessel to be measured is determined according to the above-mentioned internal pressure and the above-mentioned flow rate.

Specifically, the central arterial pressure of the blood vessel to be measured can be acquired by means of non-invasive measurement such as ultrasonic detection, nuclear magnetic resonance detection, and a blood pressure measuring instrument capable of recording waveforms.

Specifically, the above-mentioned image data includes at least one of the following: CTA image, CTP image, DSA image, OCT image and IVUS image. Of course, the image data may also be other types of image data other than CTA images, CTP images, DSA images, OCT images and IVUS images.

Specifically, the above-mentioned functional index includes at least one of the following: FFR, iFR, RFR, IMR and WSS. Of course, the functional index can also be other types of functional index other than FFR, iFR, RFR, IMR and WSS.

In the above scheme, by acquiring the image data of the blood vessel to be measured, the central arterial pressure of the blood vessel to be measured is obtained by a non-invasive measurement method, and then the internal pressure and flow rate of the blood vessel to be measured are determined at least according to the image data and the central arterial pressure, and then according to the internal pressure. and flow rate, determine the functional index of the blood vessel to be measured, and realize the non-invasive and accurate detection of the physiological and functional index of the coronary artery.

It should be noted that the steps shown in the flowcharts of the accompanying drawings may be executed in a computer system, such as a set of computer-executable instructions, and, although a logical sequence is shown in the flowcharts, in some cases, Steps shown or described may be performed in an order different from that herein.

In some embodiments of the present disclosure, obtaining the central arterial pressure of the blood vessel to be measured by non-invasive measurement includes: obtaining brachial artery pressure, radial artery pressure, and carotid artery pressure by using the non-invasive measurement method; At least one of the pressure and the above-mentioned carotid artery pressure, the above-mentioned central arterial pressure is calculated. Specifically, the brachial artery pressure waveform, the radial artery pressure waveform, and the carotid artery pressure waveform can be acquired by non-invasive measurement, and then the above-mentioned center is calculated according to at least one of the brachial artery pressure waveform, the radial artery pressure waveform, and the carotid artery pressure waveform. Arterial pressure for accurate central arterial pressure.

In some embodiments of the present disclosure, the non-invasive measurement method is used to obtain the central arterial pressure of the blood vessel to be measured, and further includes: obtaining a parameter set of the blood vessel to be measured, where the parameter set includes geometric information, arterial inlet flow, outlet boundary model and blood vessel Elasticity model; determine a one-dimensional hydrodynamic model according to the above-mentioned parameter set; calculate the first pressure waveform at the measuring point according to the above-mentioned one-dimensional hydrodynamic model, the above-mentioned measuring point includes radial artery and brachial artery; use the above-mentioned non-invasive measurement method to obtain the above-mentioned measuring point The second pressure waveform at the location, the non-invasive measurement method includes ultrasonic method and nuclear magnetic method; determine the target difference, the target difference is the difference between the first pressure waveform and the second pressure waveform; according to the target difference The one-dimensional fluid mechanics model is optimized to obtain an optimized one-dimensional fluid mechanics model; the central arterial pressure is determined based on the optimized one-dimensional fluid mechanics model. Both the first pressure waveform and the second pressure waveform in this embodiment are pressure waveforms in the time domain, that is, the first pressure waveform and the second pressure waveform include time series information, which is compared with the radial artery pressure or brachial artery pressure in the related art. The arterial pressure is only a solution of a pressure value. Compared with the method of obtaining a mean arterial pressure by using a common empirical formula in the related art (accuracy has nothing to do with the time series), the solution of the present disclosure is a time series waveform, so that the determined The central arterial pressure is more accurate; it further ensures the accuracy of the functional index of the blood vessel to be measured.

In an optional embodiment of the present disclosure, acquiring the geometric information of the blood vessel to be measured includes: establishing a 55-segment human arterial network structure (the 55-segment human arterial network structure is shown in FIG. 2 ), and determining the 55-segment human arterial network structure according to the 55-segment human arterial network structure Initial network structure parameters. The initial network structure parameters include geometric information such as the length and radius of the blood vessel. The geometric information of the 55 segments of human arteries is shown in Table 1.

Table 1 Geometric information of 55 segments of human arteries

Numbering	arterial name	Length (cm)	Proximal radius (cm)	Distal radius (cm)
1	Ascending aorta	4	1.525	1.42
2	Aortic arch	3	1.42	1.342
3	Brachiocephalic	4	0.95	0.7
4, 15	R+L Subclavian	4	0.425	0.407
5, 11	R+L Com.carotid	17	0.525	0.4
6, 16	R+L Vertebral	14	0.2	0.2
7, 17	R+L Brachial	40	0.407	0.25
8, 19	R+L Radial	twenty two	0.175	0.175
9, 18	R+L Ulnar	twenty two	0.175	0.175
10	Aortic arch	4	1.342	1.246
12	Thoracic aorta	6	1.246	1.124
13	Thoracic aorta	11	1.124	0.924
14	Intercostals	7	0.63	0.5
20	Celiac axis	2	0.35	0.3
twenty one	Hepatic	2	0.3	0.25
twenty two	Hepatic	7	0.275	0.25
twenty three	Gastric	6	0.175	0.15
twenty four	Splenic	6	0.2	0.2
25	Abdominal aorta	5	0.924	0.838
26	Superior mesenteric	5	0.4	0.35
27	Abdominal aorta	2	0.838	0.814
28, 30	R+L Renal	3	0.275	0.275
29	Abdominal aorta	2	0.814	0.792
31	Abdominal aorta	13	0.792	0.627
32	Inferior mesenteric	4	0.2	0.175
33	Abdominal aorta	8	0.627	0.55
34, 47	R+L External iliac	6	0.4	0.37
35, 48	R+L Femoral	15	0.37	0.314
36, 49	R+L Internal iliac	5	0.2	0.2
37, 50	R+L Deep Femoral	11	0.2	0.2
38, 51	R+L Femoral	44	0.314	0.2
39, 40, 52, 53	R+L Ext.+Int.carotid	16	0.275	0.2
41, 54	R+L Post.tibial	32	0.125	0.125
42, 55	R+L Ant.tibial	32	0.125	0.125
43, 46	R+L Interosseous	7	0.1	0.1
44, 45	R+L Ulnar	17	0.2	0.2

In an optional embodiment of the present disclosure, acquiring the arterial inlet flow of the blood vessel to be measured includes: determining the flow-time relationship at the entrance of the arterial tree in a complete heartbeat cycle, and determining the arterial inlet of the blood vessel to be measured according to the flow-time relationship flow. Among them, the flow-time relationship can be determined through the fitting relationship of a large amount of data, that is to say, multiple flows at the entrance of the arterial tree are obtained, and the multiple flows are fitted in the time domain to obtain the flow in a complete heartbeat cycle- Time relationship; the flow-time relationship in a complete heartbeat cycle can also be obtained by non-invasive measurement methods such as ultrasonic detection or nuclear magnetic detection.

In an optional embodiment of the present disclosure, acquiring the outlet boundary model of the blood vessel to be measured includes: estimating parameters such as impedance and capacitive reactance of each truncated blood vessel at the outlet of the arterial tree based on the circuit model, and determining the to-be-measured reactance and other parameters according to the parameters such as impedance and capacitive reactance. Measure the outlet boundary model of the vessel.

In an optional embodiment of the present disclosure, acquiring the blood vessel elasticity model of the blood vessel to be measured includes: constructing a one-dimensional hemodynamic control equation based on a three-dimensional incompressible flow Navier-Stokes (NS) equation:

where A is the cross-sectional area of the blood vessel, q is the blood flow, v is the kinematic viscosity, δ is the thickness of the boundary layer, r ₀ is the radius of the vessel when it is not deformed, and the pressure p passes through the elastic model-based equation of state

Calculate, p ₀ , A ₀ are the pressure and cross-sectional area of the blood vessel when the vessel is not deformed, E is the Young's modulus of the blood vessel wall, h is the thickness of the blood vessel wall, where the blood vessel cross-sectional area is determined according to the radius of the blood vessel, and the blood vessel cross-sectional area is determined according to the arterial The blood flow is determined by the flow-time relationship over a complete heartbeat cycle at the entrance of the tree.

In an alternative embodiment of the present disclosure, the one-dimensional hemodynamic control equation can also be expressed in the following form:

where α is the Coriolis coefficient, μ is the dynamic viscosity, and γ _v is a parameter that defines the radial distribution of velocity. When α=1, the equation can also be written in the form of A, u:

where u is the axial velocity.

The equation of state based on the elastic model can also be written as:

where v is the Poisson's ratio.

In addition, the equation of state also has a form based on the viscoelastic model:

where _γs is the viscoelastic coefficient.

Of course, there are other forms of the one-dimensional hemodynamic control equation and state equation, which are not limited to the cases listed here.

In an optional embodiment of the present disclosure, the one-dimensional fluid mechanics model is optimized according to the target difference to obtain an optimized one-dimensional fluid mechanics model, including: when the target difference is greater than or equal to a predetermined value In this case, each parameter in the above-mentioned parameter set is updated until the above-mentioned target difference is smaller than the above-mentioned predetermined value; according to the above-mentioned updated parameter set, an optimized one-dimensional fluid mechanics model is determined. That is, by continuously adjusting each parameter in the parameter set until the target difference is smaller than the predetermined value, the one-dimensional hydrodynamic model at this time is determined to be closer to the real vascular hydrodynamic model when the target difference is small, so It is more accurate to determine the above-mentioned central arterial pressure based on the above-mentioned optimized one-dimensional hydrodynamic model.

Specifically, the intravascular arterial pressure is an indispensable parameter in the calculation of the functional index, and the parameters related to the arterial pressure are derived from the cardiac function index. The traditional method is to obtain the mean arterial pressure (MAP) through an empirical formula under statistical significance, and to estimate parameters such as FFR according to the mean arterial pressure (MAP). For example, the empirical formula is:

Among them, HR, SBP, and DBP represent the patient's heart rate, systolic blood pressure, and diastolic blood pressure, respectively. However, this empirical formula cannot fully reflect patient-specific physiological parameters. The one-dimensional computational fluid dynamics method, by establishing the arterial tree of the human body, corrects the patient-related parameters in the one-dimensional computational fluid dynamics model based on the non-invasive measurement of the upper extremity arteries. By continuously adjusting these patient-specific parameters, an optimal model can be obtained for the current patient. Therefore, the central arterial pressure can be calculated from the model, and the pressure-related parameters can be calculated more accurately. On the other hand, this method can obtain the complete central arterial pressure waveform in a heartbeat cycle, as shown in Figure 3, not only high and low pressure, average pressure. This is very beneficial for transient CFD simulations, which provide the full pressure boundary condition for one cycle.

Specifically, the one-dimensional computational fluid dynamics method corrects the patient-related parameters in the one-dimensional computational fluid dynamics model based on non-invasively measured upper extremity arteries by establishing the arterial tree of the human body. By continuously adjusting these patient-specific parameters, an optimal model can be obtained for the current patient. Therefore, the central arterial pressure can be calculated from the model, and the pressure-related parameters can be calculated more accurately.

In some embodiments of the present disclosure, determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure includes: determining a geometric model of the blood vessel according to the image data; determining the to-be-measured blood vessel according to the central arterial pressure The pressure at the entrance of the blood vessel; according to the above-mentioned geometric model of the blood vessel and the pressure at the entrance of the above-mentioned blood vessel to be measured, a 3D coronary CFD model of the above-mentioned blood vessel to be measured is constructed; according to the above-mentioned 3D coronary CFD model, the above-mentioned internal pressure and the above flow rate.

In some embodiments of the present disclosure, calculating the central arterial pressure according to at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure includes: according to the brachial artery pressure, the radial artery pressure, and the carotid artery pressure At least one of the arterial pressures is calculated using the transfer function method, the one-dimensional hemodynamic method or the Tube-Load method to calculate the above-mentioned central arterial pressure.

Specifically, the specific steps of the Tube-Load method include: 1) Establish a Tube-Load model as shown in Figure 4, where p _c (t) is the pressure of the central arterial pressure varying with time, and T _d is the pulse wave from the central artery inlet Propagation time to the measurement point (radial artery) at the place, Z _c is the characteristic impedance of the artery, R is the peripheral resistance; 2) According to the formula

Calculate the pulse wave reflection coefficient; 3) According to T _d , the physiological range of Γ, that is, T _d ∈ [0, 0.15] (unit: second), Γ ∈ [0, 1], with an interval ΔT _d = 5×10 ^{− 3} , ΔΓ = 5×10 ^-2 to generate (T _d , _Γ ) pairs; 4) measure the time-varying pressure waveform pr (t) at the brachial or radial artery; 5) by formula T-0.4(1-e ^-2T ), calculate the diastolic interval corresponding to the central arterial pressure waveform, where T=60/HR, HR is the number of heartbeats per minute; 6) For each (T _d , Γ) pair, according to the formula:

Calculate the corresponding central arterial pressure waveform, and smooth it through a low-pass filter; 7) For each pair of (T _d , Γ) calculated and smoothed central arterial pressure waveform, logarithmically transform the pressure corresponding to the diastolic interval, and pass Linear regression is used to fit a straight line, and the fitting errors of all (T _d , Γ) pairs are recorded; 8) The central arterial pressure waveform with the smallest fitting error is the final waveform.

In some embodiments of the present disclosure, the central arterial pressure is calculated by using a transfer function method according to at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure, including: collecting a carotid artery pressure waveform and radial artery pressure waveform; according to the above-mentioned carotid artery pressure waveform and the above-mentioned radial artery pressure waveform, construct a narrow-sense transfer function from the radial artery to the carotid artery; average a plurality of the above-mentioned narrow-sense transfer functions to obtain a generalized transfer function; use the above-mentioned generalized transfer function to calculate Central arterial pressure above.

Specifically, the specific steps of adopting the transfer function method include: 1) collecting a carotid artery pressure waveform and a set of brachial (radial) artery pressure waveforms; 2) constructing a personal transfer function y(t) from the radial artery to the carotid artery based on an autoregressive exogenous model )+a ₁ y(t-1)+…+a _na y(t-na)=b ₁ u(t-nk)+…+b _nb u(t-nb-nk+1)+e(t) , where na, nb are the order of the model, nk is the time delay of the model, e(t) is the white noise disturbance, u(t) is the input radial artery pressure, y(t) is the output carotid artery pressure; 3 ) average the personal transfer functions in all measured data sets, and finally obtain a general transfer function (generalized transfer function), which can be applied to the clinically measured brachial artery blood pressure waveform to obtain the central arterial pressure waveform.

An embodiment of the present disclosure further provides an apparatus for obtaining a coronary artery function index. It should be noted that the apparatus for obtaining a coronary artery function index according to the embodiment of the present disclosure may be used to execute the method for obtaining a coronary artery function index provided by the embodiment of the present disclosure. Methods for Coronary Functional Indicators. The following describes the device for acquiring coronary function indexes provided by the embodiments of the present disclosure.

FIG. 5 is a schematic diagram of an apparatus for acquiring coronary function indexes according to an embodiment of the present disclosure. As shown in Figure 5, the device includes:

The first acquiring unit 10 is configured to acquire image data of the blood vessel to be measured;

The second acquiring unit 20 is configured to acquire the central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method;

The first determining unit 30 is configured to determine the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

The second determination unit 40 is configured to determine the functional index of the blood vessel to be measured according to the internal pressure and the flow rate.

Specifically, the central arterial pressure of the blood vessel to be measured can be acquired by means of non-invasive measurement such as ultrasonic detection, nuclear magnetic resonance detection, and a blood pressure measuring instrument capable of recording waveforms.

Specifically, the above-mentioned image data includes at least one of the following: CTA image, CTP image, DSA image, OCT image and IVUS image. Of course, the image data may also be other types of image data other than CTA images, CTP images, DSA images, OCT images and IVUS images.

Specifically, the above-mentioned functional index includes at least one of the following: FFR, iFR, RFR, IMR and WSS. Of course, the functional index can also be other types of functional index other than FFR, iFR, RFR, IMR and WSS.

In the above solution, the first acquisition unit acquires image data of the blood vessel to be measured, the second acquisition unit acquires the central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method, and the first determination unit determines the blood vessel to be measured according to at least the image data and the central arterial pressure. According to the internal pressure and flow velocity, the first determination unit determines the functional index of the blood vessel to be measured according to the internal pressure and flow velocity, and realizes the non-invasive and accurate detection of the physiological functional index of the coronary artery.

In some embodiments of the present disclosure, the second acquisition unit includes a first acquisition unit and a first calculation unit, the first acquisition unit is configured to acquire brachial artery pressure, radial artery pressure and carotid artery pressure by using the above-mentioned non-invasive measurement method; the first The calculation unit is configured to calculate the central arterial pressure based on at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure. Specifically, the brachial artery pressure waveform, the radial artery pressure waveform, and the carotid artery pressure waveform can be acquired by non-invasive measurement, and then the above-mentioned center is calculated according to at least one of the brachial artery pressure waveform, the radial artery pressure waveform, and the carotid artery pressure waveform. Arterial pressure for accurate central arterial pressure.

In some embodiments of the present disclosure, the second acquisition unit further includes a second acquisition module, a first determination module, a second calculation module, a third acquisition module, a second determination module, an optimization module, and a third determination module. The second acquisition module The module is configured to acquire the parameter set of the blood vessel to be measured, the parameter set includes geometric information, arterial inlet flow, outlet boundary model and blood vessel elasticity model; the first determination module is configured to determine a one-dimensional fluid mechanics model according to the parameter set; The second calculation module is configured to calculate the first pressure waveform at the measuring point according to the one-dimensional fluid dynamics model, the measuring point includes the radial artery and the brachial artery; the third acquisition module is configured to obtain the measuring point by the non-invasive measurement method. the second pressure waveform, the above-mentioned non-invasive measurement method includes ultrasonic method and nuclear magnetic method; the second determination module is configured as a target difference value, and the above-mentioned target difference value is the difference between the above-mentioned first pressure waveform and the above-mentioned second pressure waveform; optimization module is configured to optimize the above-mentioned one-dimensional fluid mechanics model according to the above-mentioned target difference to obtain an optimized one-dimensional fluid mechanics model; the third determination module is configured to determine the above-mentioned central arterial pressure based on the above-mentioned optimized one-dimensional fluid mechanics model . Both the first pressure waveform and the second pressure waveform in this embodiment are pressure waveforms in the time domain, that is, the first pressure waveform and the second pressure waveform include time series information, which is compared with the radial artery pressure or brachial artery pressure in the related art. The arterial pressure is only a solution of a pressure value. Compared with the method of obtaining a mean arterial pressure by using a common empirical formula in the related art (accuracy has nothing to do with the time series), the solution of the present disclosure is a time series waveform, so that the determined The central arterial pressure is more accurate; it further ensures the accuracy of the functional indexes of the blood vessels to be measured.

In some embodiments of the present disclosure, the optimization module is further configured to update each parameter in the parameter set when the target difference value is greater than or equal to a predetermined value until the target difference value is smaller than the predetermined value; according to The updated set of the above parameters determines the optimized one-dimensional fluid mechanics model. That is, by continuously adjusting each parameter in the parameter set until the target difference is smaller than the predetermined value, the one-dimensional hydrodynamic model at this time is determined to be closer to the real vascular hydrodynamic model when the target difference is small, so It is more accurate to determine the above-mentioned central arterial pressure based on the above-mentioned optimized one-dimensional hydrodynamic model.

In some embodiments of the present disclosure, the first determination unit includes a fourth determination module, a fifth determination module, a construction module, and a sixth determination module, and the fourth determination module is configured to determine the blood vessel geometric model according to the image data; the fifth determination The module is configured to determine the pressure at the entrance of the blood vessel to be measured according to the central arterial pressure; the building module is configured to construct the 3D coronary CFD model of the blood vessel to be measured according to the geometric model of the blood vessel and the pressure at the entrance of the blood vessel to be measured. ; The sixth determination module is configured to determine the above-mentioned internal pressure and the above-mentioned flow velocity of the above-mentioned blood vessel to be measured according to the above-mentioned 3D coronary artery CFD model.

The above-mentioned device for obtaining coronary function indexes includes a processor and a memory, and the above-mentioned first obtaining unit, second obtaining unit, first determining unit, and second determining unit, etc. are all stored in the memory as program units, and the processor executes the storage. The above program units in the memory implement the corresponding functions.

The processor includes a kernel, and the kernel calls the corresponding program unit from the memory. One or more kernels can be set, and accurate coronary function indexes can be obtained by adjusting kernel parameters.

Memory may include non-persistent memory in computer readable media, random access memory (RAM) and/or non-volatile memory, such as read only memory (ROM) or flash memory (flash RAM), the memory including at least one memory chip.

An embodiment of the present disclosure provides a computer-readable storage medium, where the computer-readable storage medium includes a stored program, wherein when the program is executed, the device where the computer-readable storage medium is located is controlled to execute the above-mentioned method for obtaining coronary function indexes. method.

An embodiment of the present disclosure provides a processor, where the processor is configured to run a program, wherein when the program runs, the above method for acquiring a coronary artery function index is executed.

An embodiment of the present disclosure provides a device, the device includes a processor, a memory, and a program stored in the memory and executable on the processor, where the processor implements at least the following steps when executing the program:

Step S101, acquiring image data of the blood vessel to be measured;

Step S102, using a non-invasive measurement method to obtain the central arterial pressure of the blood vessel to be measured;

Step S103, determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

In step S104, the functional index of the blood vessel to be measured is determined according to the above-mentioned internal pressure and the above-mentioned flow rate.

The devices in this article can be servers, PCs, PADs, mobile phones, and so on.

The present disclosure also provides a computer program product, when executed on a data processing device, adapted to execute a program initialized with at least the following method steps:

Step S101, acquiring image data of the blood vessel to be measured;

Step S102, using a non-invasive measurement method to obtain the central arterial pressure of the blood vessel to be measured;

Step S103, determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

In step S104, the functional index of the blood vessel to be measured is determined according to the above-mentioned internal pressure and the above-mentioned flow rate.

As will be appreciated by one skilled in the art, embodiments of the present disclosure may be provided as a method, system, or computer program product. Accordingly, the present disclosure may take the form of an entirely hardware embodiment, an entirely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, the present disclosure may take the form of a computer program product embodied on one or more computer-usable storage media having computer-usable program code embodied therein, including but not limited to disk storage, CD-ROM, optical storage, and the like.

The present disclosure is described with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the disclosure. It will be understood that each process and/or block in the flowchart illustrations and/or block diagrams, and combinations of processes and/or blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to the processor of a general purpose computer, special purpose computer, embedded processor or other programmable data processing device to produce a machine such that the instructions executed by the processor of the computer or other programmable data processing device produce An apparatus configured to implement the functions specified in a flow or flows of a flowchart and/or a block or blocks of a block diagram.

These computer program instructions may also be stored in a computer-readable memory capable of directing a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory result in an article of manufacture comprising instruction means, the instructions The apparatus implements the functions specified in the flow or flow of the flowcharts and/or the block or blocks of the block diagrams.

These computer program instructions can also be loaded on a computer or other programmable data processing device to cause a series of operational steps to be performed on the computer or other programmable device to produce a computer-implemented process such that The instructions provide steps for implementing the functions specified in the flow or blocks of the flowcharts and/or the block or blocks of the block diagrams.

In a typical configuration, a computing device includes one or more processors (CPUs), input/output interfaces, network interfaces, and memory.

Memory may include non-persistent memory in computer readable media, random access memory (RAM) and/or non-volatile memory in the form of, for example, read only memory (ROM) or flash memory (flash RAM). Memory is an example of a computer-readable medium.

Computer-readable media includes both persistent and non-permanent, removable and non-removable media, and storage of information may be implemented by any method or technology. Information may be computer readable instructions, data structures, modules of programs, or other data. Examples of computer storage media include, but are not limited to, phase-change memory (PRAM), static random access memory (SRAM), dynamic random access memory (DRAM), other types of random access memory (RAM), read only memory (ROM), Electrically Erasable Programmable Read Only Memory (EEPROM), Flash Memory or other memory technology, Compact Disc Read Only Memory (CD-ROM), Digital Versatile Disc (DVD) or other optical storage, Magnetic tape cassettes, magnetic tape magnetic disk storage or other magnetic storage devices or any other non-transmission medium that can be used to store information that can be accessed by a computing device. As defined herein, computer-readable media does not include transitory computer-readable media, such as modulated data signals and carrier waves.

It should also be noted that the terms "comprising", "comprising" or any other variation thereof are intended to encompass a non-exclusive inclusion such that a process, method, article of manufacture or device comprising a series of elements includes not only those elements, but also Other elements not expressly listed, or which are inherent to such a process, method, article of manufacture, or apparatus are also included. Without further limitation, an element qualified by the phrase "comprising a..." does not preclude the presence of additional identical elements in the process, method, article of manufacture or device that includes the element.

From the above description, it can be seen that the above-mentioned embodiments of the present disclosure achieve the following technical effects:

1) In the method for obtaining coronary functional indexes of the present disclosure, by obtaining the image data of the blood vessel to be measured, the central arterial pressure of the blood vessel to be measured is obtained by a non-invasive measurement method, and then at least according to the image data and the central arterial pressure, determine the blood vessel to be measured. The internal pressure and flow rate of the blood vessel, and then according to the internal pressure and flow rate, the functional index of the blood vessel to be measured is determined, and the non-invasive and accurate detection of the physiological functional index of the coronary artery is realized.

2) In the device for obtaining coronary functional indexes of the present disclosure, the first obtaining unit obtains the image data of the blood vessel to be measured, the second obtaining unit obtains the central arterial pressure of the blood vessel to be measured by non-invasive measurement, and the first determining unit at least according to Image data and central arterial pressure are used to determine the internal pressure and flow rate of the blood vessel to be measured. The first determination unit determines the functional index of the blood vessel to be measured according to the internal pressure and flow rate, and realizes non-invasive and accurate detection of coronary physiological and functional indicators. .

The above are only preferred embodiments of the present disclosure, and are not intended to limit the present disclosure. For those skilled in the art, the present disclosure may have various modifications and changes. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present disclosure shall be included within the protection scope of the present disclosure.

Claims (16)

1. A method for obtaining coronary function indexes, comprising:

   Obtain the image data of the blood vessel to be measured;

   Obtain the central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method;

   determining the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

   According to the internal pressure and the flow rate, the functional index of the blood vessel to be measured is determined.
2. The method according to claim 1, wherein the central arterial pressure of the blood vessel to be measured is obtained by a non-invasive measurement method, comprising:

   obtaining brachial artery pressure, radial artery pressure and carotid artery pressure using the non-invasive measurement method;

   The central arterial pressure is calculated based on at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure.
3. The method of claim 2, wherein calculating the central arterial pressure based on at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure comprises:

   The central arterial pressure is calculated according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure using a transfer function method.
4. The method of claim 2, wherein calculating the central arterial pressure based on at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure comprises:

   The central arterial pressure is calculated according to at least one of the brachial artery pressure, the radial artery pressure and the carotid artery pressure using a one-dimensional hemodynamic method.
5. The method of claim 2, wherein calculating the central arterial pressure based on at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure comprises:

   The central arterial pressure is calculated according to at least one of the brachial artery pressure, the radial artery pressure, and the carotid artery pressure using the Tube-Load method.
6. The method according to claim 1, wherein obtaining the central arterial pressure of the blood vessel to be measured by a non-invasive measurement method, further comprising:

   acquiring a parameter set of the blood vessel to be measured, the parameter set including geometric information, arterial inlet flow, outlet boundary model and blood vessel elasticity model;

   determining a one-dimensional fluid mechanics model according to the parameter set;

   Calculate the first pressure waveform at the measuring point according to the one-dimensional fluid mechanics model, the measuring point includes the radial artery and the brachial artery;

   Obtain the second pressure waveform at the measurement point by using the non-invasive measurement method, the non-invasive measurement method includes an ultrasonic method and a nuclear magnetic method;

   determining a target difference, the target difference being the difference between the first pressure waveform and the second pressure waveform;

   Optimizing the one-dimensional fluid 3-body mechanics model according to the target difference to obtain an optimized one-dimensional fluid mechanics model;

   The central arterial pressure is determined based on the optimized one-dimensional hydrodynamic model.
7. The method according to claim 6, wherein obtaining the geometric information of the blood vessel to be measured comprises:

   Build 55 segments of human arterial network structure;

   The geometric information of the blood vessel to be measured is determined according to the 55-segment human arterial network structure.
8. The method according to claim 6, wherein obtaining the arterial inlet flow of the blood vessel to be measured comprises:

   Determining the flow-time relationship at the entrance to the arterial tree over a complete heartbeat cycle;

   The arterial inlet flow of the blood vessel to be measured is determined according to the flow-time relationship.
9. The method according to claim 6, wherein acquiring the outlet boundary model of the blood vessel to be measured comprises:

   determining the relevant parameters of each truncated blood vessel at the outlet of the arterial tree based on the circuit model, the relevant parameters including impedance and capacitive reactance;

   An outlet boundary model of the blood vessel to be measured is determined according to the relevant parameters.
10. The method according to claim 6, wherein the one-dimensional fluid mechanics model is optimized according to the target difference to obtain an optimized one-dimensional fluid mechanics model, comprising:

    When the target difference value is greater than or equal to a predetermined value, update each parameter in the parameter set until the target difference value is smaller than the predetermined value;

    According to the updated set of parameters, an optimized one-dimensional fluid dynamics model is determined.
11. The method according to claim 1, wherein determining the internal pressure and flow rate of the blood vessel to be measured according to at least the image data and the central arterial pressure, comprising:

    determining a blood vessel geometric model according to the image data;

    determining the pressure at the inlet of the blood vessel to be measured according to the central arterial pressure;

    According to the blood vessel geometric model and the pressure at the inlet of the blood vessel to be measured, construct a 3D coronary artery CFD model of the blood vessel to be measured;

    The internal pressure and the flow rate of the blood vessel to be measured are determined according to the 3D coronary CFD model.
12. The method according to any one of claims 1 to 11, wherein the image data comprises at least one of the following:

    CTA images, CTP images, DSA images, OCT images, and IVUS images.
13. The method according to any one of claims 1 to 11, wherein the functional index comprises at least one of the following:

    FFR, iFR, RFR, IMR and WSS.
14. A device for obtaining coronary function indexes, comprising:

    a first acquiring unit, configured to acquire image data of the blood vessel to be measured;

    a second acquiring unit configured to acquire the central arterial pressure of the blood vessel to be measured by using a non-invasive measurement method;

    a first determination unit, configured to determine the internal pressure and flow velocity of the blood vessel to be measured at least according to the image data and the central arterial pressure;

    The second determination unit is configured to determine the functional index of the blood vessel to be measured according to the internal pressure and the flow rate.
15. A computer-readable storage medium, wherein the computer-readable storage medium includes a stored program, wherein when the program is run, a device where the computer-readable storage medium is located is controlled to execute any one of claims 1 to 13 The described method for obtaining coronary function indexes.
16. A processor, wherein the processor is configured to run a program, wherein when the program runs, the method for obtaining a coronary artery function index according to any one of claims 1 to 13 is executed.

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