CN111166315A - Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image - Google Patents
Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image Download PDFInfo
- Publication number
- CN111166315A CN111166315A CN201811344060.XA CN201811344060A CN111166315A CN 111166315 A CN111166315 A CN 111166315A CN 201811344060 A CN201811344060 A CN 201811344060A CN 111166315 A CN111166315 A CN 111166315A
- Authority
- CN
- China
- Prior art keywords
- blood
- pressure
- dimensional
- blood vessel
- calculating
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 238000000034 method Methods 0.000 title claims abstract description 33
- 230000035487 diastolic blood pressure Effects 0.000 title claims abstract description 23
- 230000000284 resting effect Effects 0.000 title claims abstract description 21
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 50
- 230000017531 blood circulation Effects 0.000 claims abstract description 34
- 210000004351 coronary vessel Anatomy 0.000 claims abstract description 17
- 201000000057 Coronary Stenosis Diseases 0.000 claims abstract description 9
- 239000008280 blood Substances 0.000 claims abstract description 8
- 210000004369 blood Anatomy 0.000 claims abstract description 8
- 239000002872 contrast media Substances 0.000 claims abstract description 8
- 238000002601 radiography Methods 0.000 claims abstract description 8
- 230000036772 blood pressure Effects 0.000 claims description 15
- 230000003205 diastolic effect Effects 0.000 claims description 14
- 238000002586 coronary angiography Methods 0.000 claims description 6
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 3
- 238000013507 mapping Methods 0.000 claims description 3
- 239000011780 sodium chloride Substances 0.000 claims description 3
- 229940124549 vasodilator Drugs 0.000 abstract description 4
- 239000003071 vasodilator agent Substances 0.000 abstract description 4
- 238000003384 imaging method Methods 0.000 abstract 1
- 206010020565 Hyperaemia Diseases 0.000 description 10
- OIRDTQYFTABQOQ-KQYNXXCUSA-N adenosine Chemical compound C1=NC=2C(N)=NC=NC=2N1[C@@H]1O[C@H](CO)[C@@H](O)[C@H]1O OIRDTQYFTABQOQ-KQYNXXCUSA-N 0.000 description 10
- 239000002126 C01EB10 - Adenosine Substances 0.000 description 5
- 229960005305 adenosine Drugs 0.000 description 5
- 210000004165 myocardium Anatomy 0.000 description 4
- 208000031481 Pathologic Constriction Diseases 0.000 description 3
- 238000005259 measurement Methods 0.000 description 3
- 208000031225 myocardial ischemia Diseases 0.000 description 3
- 230000036262 stenosis Effects 0.000 description 3
- 208000037804 stenosis Diseases 0.000 description 3
- 206010003671 Atrioventricular Block Diseases 0.000 description 2
- 210000000709 aorta Anatomy 0.000 description 2
- 230000000747 cardiac effect Effects 0.000 description 2
- 208000029078 coronary artery disease Diseases 0.000 description 2
- 238000011156 evaluation Methods 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000002107 myocardial effect Effects 0.000 description 2
- 238000000547 structure data Methods 0.000 description 2
- 208000004476 Acute Coronary Syndrome Diseases 0.000 description 1
- 206010011089 Coronary artery stenosis Diseases 0.000 description 1
- 206010020751 Hypersensitivity Diseases 0.000 description 1
- 206010040738 Sinus arrest Diseases 0.000 description 1
- 206010040741 Sinus bradycardia Diseases 0.000 description 1
- 208000007718 Stable Angina Diseases 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 208000026935 allergic disease Diseases 0.000 description 1
- 238000002583 angiography Methods 0.000 description 1
- 230000004872 arterial blood pressure Effects 0.000 description 1
- 208000006673 asthma Diseases 0.000 description 1
- 238000009530 blood pressure measurement Methods 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000009610 hypersensitivity Effects 0.000 description 1
- 208000030603 inherited susceptibility to asthma Diseases 0.000 description 1
- 230000030214 innervation Effects 0.000 description 1
- 238000001361 intraarterial administration Methods 0.000 description 1
- 238000010253 intravenous injection Methods 0.000 description 1
- 230000000250 revascularization Effects 0.000 description 1
- 208000020926 sinoatrial node disease Diseases 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 230000002966 stenotic effect Effects 0.000 description 1
- 230000000304 vasodilatating effect Effects 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T17/00—Three dimensional [3D] modelling, e.g. data description of 3D objects
- G06T17/20—Finite element generation, e.g. wire-frame surface description, tesselation
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Physiology (AREA)
- Vascular Medicine (AREA)
- Hematology (AREA)
- Software Systems (AREA)
- Geometry (AREA)
- General Physics & Mathematics (AREA)
- Computer Graphics (AREA)
- Theoretical Computer Science (AREA)
- High Energy & Nuclear Physics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Apparatus For Radiation Diagnosis (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Abstract
The invention discloses a method for calculating instantaneous no-wave type ratio and resting state diastolic pressure ratio based on a contrast image, which comprises the following steps: measuring the pressure P at the coronary ostia of the heart in diastolea(ii) a Acquiring the two-dimensional caliber and the length of a blood vessel through a radiography image, generating a three-dimensional blood vessel grid model through two radiography images and acquiring the three-dimensional caliber and the length of the blood vessel; during diastole, the time taken by blood containing a contrast agent from a starting point to an ending point of a specified blood vessel is measured, and the blood flow velocity V is calculated from the time and the three-dimensional length of the blood vessel1(ii) a Calculating to obtain the blood flow velocity V in the resting state2(ii) a Will V2Calculating the pressure drop DeltaP from the coronary artery inlet to the distal coronary stenosis and the mean pressure P in the distal coronary arteryd=Pa- Δ P, calculating the instantaneous wave-free ratio and the resting diastolic pressure ratio. The iFR, dFR and DFR can be obtained by conventional contrast imaging without using vasodilators.
Description
Technical Field
The invention relates to the field of coronary angiography evaluation, in particular to a method for determining an instantaneous wave-free ratio (iFR) and a resting diastolic pressure ratio (dFR and DFR) only through an angiogram and an aortic pressure.
Background
The Fractional Flow Reserve (FFR) can indicate the influence of coronary stenosis lesion on distal blood flow, and whether myocardial ischemia exists is diagnosed, which is a recognized index for functional evaluation of coronary stenosis. FFR is defined as the ratio of the maximum blood flow provided by a narrowed coronary artery to the myocardium in the innervation area to the maximum blood flow provided to the myocardium in the normal case of the same coronary artery. Can be simplified into the narrow distal coronary artery internal pressure equalizing (P) under the maximal hyperemia state of the cardiac muscled) And mean pressure (P) of coronary artery and oral aortaa) I.e. FFR ═ Pd/Pa。
When the FFR is determined, the FFR is calculated by obtaining the mean pressure in the coronary artery at the distal end of the stenosis by different means based on the blood flow velocity in the maximal hyperemia state of the myocardium and the mean pressure in the aorta at the mouth of the coronary artery. However, maximal myocardial hyperemia requires coronary or intravenous injection of adenosine or ATP, which causes a decrease in aortic pressure and has certain side effects such as atrioventricular block, sinus bradycardia, sinus arrest, etc., contraindications including 2 or 3 degree atrioventricular block, sinoatrial node disease, tracheal or bronchial asthma, and adenosine hypersensitivity.
The instantaneous waveform-free ratio (iFR) can provide a coronary intra-arterial pressure measurement similar to Fractional Flow Reserve (FFR). The iFR does not need a vasodilator, is simple to operate and can be more applied to coronary intervention treatment. The ADVISE study found that the intracoronary microvascular resistance was relatively most stable and minimal during a certain time of diastole (referred to as the no-waveform phase), similar to the mean resistance achieved during coronary hyperemia with vasodilatory drugs such as adenosine. As shown in fig. 1, i.e., iFR ═ PdWave-free period/PaWave-free period(PdWave-free period: the distal coronary artery is evenly compressed during the absence of the waveform. PaWave-free period: the mean aortic pressure during the absence of the waveform. Operation time of the instantaneous waveform-free period: 25% of the time after the start of the waveform-free period in diastole, and stop counting at 5ms before the start of systole). A study article was published in top-grade medical journal NEJM that the IFR-directed revascularization strategy was not inferior to the FFR-directed reconstruction strategy in patients with stable angina or acute coronary syndrome, and was similar in the incidence of major adverse cardiac events over 12 months.
The resting diastolic pressure ratio (dFR and DFR) as shown in FIG. 2 can be expressed as: dFR ═ PdDiastolic period/PaDiastolic period(PdDiastolic period: the mean coronary pressure distal to the stenotic lesion during the diastolic phase. PaDiastolic period: aortic mean pressure during diastolic state); as shown in fig. 3, DFR ═ PdDiastolic hyperemia free period/PaDiastolic hyperemia free period(PdDiastolic hyperemia free period: in the interval from the aorta pressure being less than the average aortic pressure to the minimum aortic pressure, the coronary artery pressure at the distal end of the stenosis is averaged. PaDiastolic hyperemia free period: the mean aortic pressure in the interval from the aortic pressure being less than the mean aortic pressure to the aortic pressure being the lowest). Further studies have shown that resting diastolic pressure ratios (dFR and DFR) are substantially fully equivalent to the instantaneous waveform-free ratio (iFR). Therefore, we can obtain iFR ≡ DFR ≡ dFR ═ PdDiastolic period/PaDiastolic period。
Currently, the existing methods for measuring instantaneous mode-free ratio (iFR) and resting diastolic pressure ratio (dFR and DFR) are mainly: and measuring corresponding diastolic intervals in the resting state of the pressure guide wire to determine iFR, dFR and DFR. The measurement needs to be carried out by depending on a pressure guide wire, the tail end of a blood vessel needs to be intervened when the pressure guide wire is used for measurement, the operation difficulty and risk are increased, and meanwhile, the large-scale application of the pressure guide wire is limited due to the expensive price of the pressure guide wire.
Disclosure of Invention
In order to solve the technical problems, the invention aims to: a method for calculating an instantaneous wave-free ratio and a resting-state diastolic pressure ratio based on a contrast image is provided, which detects myocardial ischemia by a conventional coronary angiography procedure in patients with coronary heart disease, i.e., without the use of vasodilators (i.e., without the need for a myocardial maximal hyperemia state and without the use of adenosine or ATP). Instantaneous mode-free ratio (iFR), resting diastolic pressure ratio (dFR and DFR) were calculated from conventional contrast images, aortic pressure and blood flow.
The technical scheme of the invention is as follows:
a method of calculating an instantaneous mode-free ratio and a resting-state diastolic pressure ratio based on a contrast image, comprising the steps of:
s01: measuring the pressure P of the coronary ostia of the heart in diastole by means of a blood pressure sensora；
S02: acquiring the two-dimensional diameter and length of a blood vessel through a radiography image, generating a three-dimensional blood vessel grid model through two radiography images with an included angle of more than 30 degrees, and acquiring the three-dimensional diameter and length of the blood vessel;
s03: during diastole, the time taken by blood containing a contrast agent from a starting point to an ending point of a specified blood vessel is measured, and the blood flow velocity V is calculated from the time and the three-dimensional length of the blood vessel1；
S04: calculating the blood flow velocity V in the rest state according to the following calculation formula2The calculation formula is as follows:
when V is1When the thickness is less than or equal to 100mm/s, V2＝0.53*V1+20；
When the thickness is 100mm/s<V1When the thickness is less than or equal to 200mm/s, V2＝0.43*V1+35；
When V is1>At 200mm/s, V2＝0.35*V1+55；
S05: calculating the blood flow velocity V in the contrast state2Calculating the pressure drop DeltaP from the coronary artery inlet to the distal coronary stenosis and the mean pressure P in the distal coronary arteryd＝PaΔ P by the formula iFR≌DFR≌dFR＝Pd/PaInstantaneous mode-free ratio (iFR) and resting diastolic pressure ratio (dFR and DFR) were calculated.
In a preferred technical scheme, the step S01 includes connecting a pressure tube of a blood pressure sensor to a multi-connected tee, connecting the pressure tube to a coronary ostium of the heart through an angiographic catheter, filling saline in the pressure tube of the blood pressure sensor, and keeping the blood pressure sensor and the heart at the same horizontal position, where the pressure wave measured by the blood pressure sensor is the pressure wave of the coronary ostium of the heart, and during diastole, the average value of the instantaneous pressure is Pa。
In a preferred embodiment, the method for generating a three-dimensional blood vessel mesh model in step S02 includes the following steps:
s21: performing three-dimensional reconstruction on 2D structure data of two segmented blood vessels with a mapping relation on two X-ray coronary angiography images with an included angle of more than 30 degrees to obtain 3D structure data of the segmented blood vessels;
s22: and repeating the step S21 until the three-dimensional reconstruction of all the segmented blood vessels is completed, and combining the reconstructed segmented blood vessels to obtain a complete three-dimensional blood vessel mesh model.
In a preferred embodiment, the blood flow velocity V is calculated in step S031The specific method comprises the following steps:
s31: the heart rate of a specified patient is acquired as H times/minute, the image frequency is acquired from contrast image information as S frames/second, and the calculation formula of the frame number X is as follows: x ═ 1 ÷ (H ÷ 60)) × S;
s32: respectively obtaining a starting point and an ending point of a diastolic period of a heartbeat cycle on images corresponding to a two-dimensional starting frame and an ending frame according to the number of frames of images in the diastolic period of the heartbeat cycle, and then intercepting the blood vessel length of the diastolic period of the heartbeat cycle in a three-dimensional blood vessel mesh model according to the starting point and the ending point;
s33: by the formula V1Calculating the blood flow velocity V as L/P1L is the length of the blood vessel, P is the time taken for one heart cycle to diastole, P ═ X ÷ S.
In a preferred embodiment, the specific method for calculating the pressure drop Δ P from the coronary artery entrance to the distal end of the coronary artery stenosis in step S05 is as follows:
s41: solving a basic formula of the incompressible flow based on the blood flow velocity and the three-dimensional blood vessel mesh model, solving the three-dimensional blood vessel mesh model, and solving continuity and a Navier-Stokes equation by using a numerical method:
wherein
P, rho and mu are respectively flow velocity, pressure, blood flow density and blood flow viscosity;
the inlet boundary condition is the blood flow velocity, and the outlet boundary condition is the out-flow boundary condition;
s42: the pressure drop ap from the entrance to various points downstream along the centerline of the vessel is calculated.
Compared with the prior art, the invention has the advantages that:
myocardial ischemia is detected by conventional coronary angiography procedures in patients with coronary heart disease, i.e., without the use of vasodilators (i.e., without the need for maximal hyperemia of the myocardium and without the use of adenosine or ATP). The instantaneous mode-free ratio (iFR), resting diastolic pressure ratio (dFR and DFR) were calculated from the conventional contrast image, aortic pressure and blood flow. The pressure guide wire does not need to be additionally inserted for measurement, the operation is simple and convenient, the operation difficulty and risk are greatly reduced, and the method can be clinically popularized and applied in a large scale.
Drawings
The invention is further described with reference to the following figures and examples:
FIG. 1 is a schematic illustration of instantaneous waveless ratio (iFR);
FIG. 2 is a schematic representation of the resting diastolic pressure ratio (dFR);
FIG. 3 is a schematic representation of resting diastolic pressure ratio (DFR);
FIG. 4 is a flow chart of a method of the present invention;
FIG. 5 is a two-dimensional blood vessel image;
FIG. 6.1 is an image of the body position-one contrast agent flow to the catheter port;
FIG. 6.2 is an image of body position-contrast agent flow to the distal end of the vessel;
FIG. 6.3 is an image of the second contrast agent flow to the catheter port;
FIG. 6.4 is an image of the second contrast agent flow to the distal end of the vessel;
FIG. 7 is a cross-sectional screen shot of a grid;
fig. 8 is a cross-sectional view of a grid.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention will be described in further detail with reference to the accompanying drawings in conjunction with the following detailed description. It should be understood that the description is intended to be exemplary only, and is not intended to limit the scope of the present invention. Moreover, in the following description, descriptions of well-known structures and techniques are omitted so as to not unnecessarily obscure the concepts of the present invention.
As shown in fig. 4, a method of the present invention for determining the instantaneous mode-free ratio (iFR), the resting-state diastolic pressure ratio (dFR and DFR) only from the contrast image and the aortic pressure comprises the following steps.
Step S1: measuring the pressure P of the coronary ostia of the heart in diastole by means of a blood pressure sensoraThe specific method comprises the following steps:
the pressure tube using the blood pressure sensor is connected to a multi-connected tee joint and then connected with a coronary ostium of the heart through an angiography catheter, saline is filled in the pressure tube of the blood pressure sensor, the blood pressure sensor and the heart are kept at the same horizontal position, the pressure wave measured by the blood pressure sensor is the pressure wave of the coronary ostium of the heart, and the average value of the instantaneous pressure is P in diastolea。
Step S2: acquiring the two-dimensional diameter and length of a blood vessel through a radiography image, as shown in fig. 5, generating a three-dimensional blood vessel mesh model through two radiography images with an included angle of more than 30 degrees, and acquiring the three-dimensional diameter and length of the blood vessel;
the specific method of the three-dimensional blood vessel mesh model is as follows:
performing three-dimensional reconstruction on the 2D structural data of two segmented blood vessels in a mapping relation on the X-ray coronary angiography images at two different angles to obtain the 3D structural data of the segmented blood vessels;
repeating the above steps until the three-dimensional reconstruction of all the segmented blood vessels is completed, and then combining the reconstructed segmented blood vessels to obtain the complete three-dimensional blood vessel, as shown in fig. 7 and 8.
Step S3: as shown in FIGS. 6.1-6.4, during diastole, the time taken for blood (containing contrast agent) to pass from the starting point (6.1, 6.3) to the ending point (6.2, 6.4) of a specified segment of blood vessel (including a possible crime vessel) is measured, and the blood flow velocity V is calculated from the time and the three-dimensional length of the blood vessel1The specific method comprises the following steps:
the heart rate of a specified patient is acquired as H times/minute, the image frequency is acquired from contrast image information as S frames/second, and the calculation formula of the frame number X is as follows: x ═ 1 ÷ (H ÷ 60)) × S;
respectively obtaining a starting point and an ending point of the diastolic period of the heartbeat cycle on images corresponding to a two-dimensional starting frame and an ending frame, such as fig. 6.1 and 6.2 or fig. 6.3 and 6.4, according to the number of frames of the images in the diastolic period of the heartbeat cycle, and then cutting off the blood vessel length of the diastolic period of the heartbeat cycle from the three-dimensional synthetic data through the starting point and the ending point;
assuming that the length of the intercepted blood vessel is L and the time taken for the diastole of one heart cycle is P, the method is represented by the formula 1: p ═ X ÷ S; equation 2: v1Obtain the blood flow velocity V as L/P1。
Step S4: calculating the blood flow velocity V at rest2；
Blood flow velocity V in its resting state2The calculation formula of (a) is as follows:
when V is1V is less than or equal to 100 millimeters per second (mm/s)2＝0.53*V1+20；
When the thickness is 100mm/s<V1When the thickness is less than or equal to 200mm/s, V2＝0.43*V1+35；
When V is1>At 200mm/s, V2＝0.35*V1+55；
Step S5: the blood flow velocity V2 in the contrast state calculated in step S4 is used as a coronary artery entrance velocity, a pressure drop Δ P from the coronary artery entrance to the distal end of the coronary stenosis is calculated, the mean pressure Pd in the distal coronary artery of the diastolic stenosis is Pa- Δ P, and the instantaneous mode-free ratio (iFR) and the resting state diastolic pressure ratio (dFR and DFR) are calculated by the formula iFR ≈ DFR ≈ dFR ═ Pd/Pa.
The specific method for calculating the pressure drop Δ P from the coronary artery entrance to the distal end of the coronary stenosis in step S5 is as follows:
solving a basic formula of the incompressible flow based on the blood flow velocity and the three-dimensional blood vessel mesh model, solving the three-dimensional blood vessel mesh model, and solving continuity and a Navier-Stokes equation by using a numerical method:
wherein
P, rho and mu are respectively flow velocity, pressure, blood flow density and blood flow viscosity;
the inlet boundary condition is the blood flow velocity, and the outlet boundary condition is the out-flow boundary condition;
the pressure drop ap from the entrance to various points downstream along the centerline of the vessel is calculated.
It is to be understood that the above-described embodiments of the present invention are merely illustrative of or explaining the principles of the invention and are not to be construed as limiting the invention. Therefore, any modification, equivalent replacement, improvement and the like made without departing from the spirit and scope of the present invention shall be included in the protection scope of the present invention. Further, it is intended that the appended claims cover all such variations and modifications as fall within the scope and boundaries of the appended claims or the equivalents of such scope and boundaries.
Claims (5)
1. A method of calculating an instantaneous mode-free ratio and a resting diastolic pressure ratio based on a contrast image, comprising the steps of:
s01: measuring the pressure P of the coronary ostia of the heart in diastole by means of a blood pressure sensora；
S02: acquiring the two-dimensional diameter and length of a blood vessel through a radiography image, generating a three-dimensional blood vessel grid model through two radiography images with an included angle of more than 30 degrees, and acquiring the three-dimensional diameter and length of the blood vessel;
s03: during diastole, the time taken by blood containing a contrast agent from a starting point to an ending point of a specified blood vessel is measured, and the blood flow velocity V is calculated from the time and the three-dimensional length of the blood vessel1；
S04: calculating the blood flow velocity V in the rest state according to the following calculation formula2The calculation formula is as follows:
when V is1When the thickness is less than or equal to 100mm/s, V2＝0.53*V1+20；
When the thickness is 100mm/s<V1When the thickness is less than or equal to 200mm/s, V2＝0.43*V1+35；
When V is1>At 200mm/s, V2＝0.35*V1+55；
S05: calculating the blood flow velocity V in the contrast state2Calculating the pressure drop DeltaP from the coronary artery inlet to the distal coronary stenosis and the mean pressure P in the distal coronary arteryd＝Pa- Δ P, via the formula iFR ≡ DFR ≡ dFR ═ Pd/PaInstantaneous mode-free ratio (iFR) and resting diastolic pressure ratio (dFR and DFR) were calculated.
2. The method of claim 1, wherein calculating instantaneous no-wave type ratio and rest based on contrast imagesThe method for the diastolic pressure ratio, wherein the step S01 includes connecting a pressure tube of a blood pressure sensor to a multi-connected tee, connecting the pressure tube to the coronary ostia of the heart through a contrast catheter, filling saline in the pressure tube of the blood pressure sensor, and keeping the blood pressure sensor and the heart at the same horizontal position, wherein the pressure wave measured by the blood pressure sensor is the pressure wave of the coronary ostia of the heart, and the average value of the instantaneous pressures is P during the diastolic phasea。
3. The method for calculating the instantaneous wave-free ratio and the resting-state diastolic pressure ratio based on the contrast image as set forth in claim 1, wherein the method for generating the three-dimensional blood vessel mesh model in step S02 includes the steps of:
s21: performing three-dimensional reconstruction on 2D structural data of two segmented blood vessels with a mapping relation on two X-ray coronary angiography images with an included angle of more than 30 degrees to obtain 3D structural data of the segmented blood vessels;
s22: and repeating the step S21 until the three-dimensional reconstruction of all the segmented blood vessels is completed, and combining the reconstructed segmented blood vessels to obtain a complete three-dimensional blood vessel mesh model.
4. The method of calculating the instantaneous no-wave type ratio and the resting state diastolic pressure ratio based on the contrast image as set forth in claim 1, wherein the blood flow velocity V is calculated in step S031The specific method comprises the following steps:
s31: the heart rate of a specified patient is acquired as H times/minute, the image frequency is acquired from contrast image information as S frames/second, and the calculation formula of the frame number X is as follows: x ═ 1 ÷ (H ÷ 60)) × S;
s32: respectively obtaining a starting point and an ending point of a diastolic period of a heartbeat cycle on images corresponding to a two-dimensional starting frame and an ending frame according to the number of frames of images in the diastolic period of the heartbeat cycle, and then intercepting the length of a blood vessel in the diastolic period of the heartbeat cycle in a three-dimensional blood vessel mesh model according to the starting point and the ending point;
s33: by the formula V1Calculating to obtain bloodFluid flow velocity V1L is the length of the blood vessel, P is the time taken for one heart cycle to diastole, P ═ X ÷ S.
5. The method of calculating the instantaneous no-wave type ratio and the resting diastolic pressure ratio based on the contrast image as set forth in claim 1, wherein the specific method of calculating the pressure drop Δ Ρ from the coronary artery entrance to the distal end of the coronary stenosis in step S05 is as follows:
s41: solving a basic formula of the incompressible flow based on the blood flow velocity and the three-dimensional blood vessel mesh model, solving the three-dimensional blood vessel mesh model, and solving continuity and a Navier-Stokes equation by using a numerical method:
wherein
P, rho and mu are respectively flow velocity, pressure, blood flow density and blood flow viscosity;
the inlet boundary condition is the blood flow velocity, and the outlet boundary condition is the out-flow boundary condition;
s42: the pressure drop ap from the entrance to various points downstream along the centerline of the vessel is calculated.
Priority Applications (9)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811344060.XA CN111166315B (en) | 2018-11-13 | 2018-11-13 | Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image |
| PCT/CN2019/071205 WO2020098139A1 (en) | 2018-11-13 | 2019-01-10 | Method for calculating instantaneous wave-free ratio and resting diastolic pressure ratio on basis of contrast image |
| PCT/CN2019/118058 WO2020098705A1 (en) | 2018-11-13 | 2019-11-13 | Method and device for obtaining vascular assessment parameters in resting state on basis of angiographic image |
| CN201980040566.8A CN112384137B (en) | 2018-11-13 | 2019-11-13 | Method and device for acquiring blood vessel assessment parameters in resting state based on contrast image |
| JP2021523637A JP7162934B2 (en) | 2018-11-13 | 2019-11-13 | Method, apparatus and system for obtaining vascular assessment parameters based on contrast-enhanced images |
| EP19885173.5A EP3881758B1 (en) | 2018-11-13 | 2019-11-13 | Method, apparatus and system for acquiring vascular assessment parameter on basis of angiographic image |
| CN201980040404.4A CN112384136A (en) | 2018-11-13 | 2019-11-13 | Method, device and system for obtaining blood vessel evaluation parameters based on radiography images |
| PCT/CN2019/118053 WO2020098704A1 (en) | 2018-11-13 | 2019-11-13 | Method, apparatus and system for acquiring vascular assessment parameter on basis of angiographic image |
| US17/237,662 US20210236000A1 (en) | 2018-11-13 | 2021-04-22 | Method, device and system for acquiring blood vessel evaluation parameters based on angiographic image |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811344060.XA CN111166315B (en) | 2018-11-13 | 2018-11-13 | Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN111166315A true CN111166315A (en) | 2020-05-19 |
| CN111166315B CN111166315B (en) | 2023-03-28 |
Family
ID=70622245
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201811344060.XA Active CN111166315B (en) | 2018-11-13 | 2018-11-13 | Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN111166315B (en) |
| WO (1) | WO2020098139A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112704505A (en) * | 2020-11-20 | 2021-04-27 | 杭州阿特瑞科技有限公司 | Method for measuring coronary artery flow reserve fraction by using CTA (computed tomography angiography) and DSA (digital signal amplification) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112971818B (en) * | 2021-01-28 | 2022-10-04 | 杭州脉流科技有限公司 | Method and device for acquiring microcirculation resistance index, computer equipment and storage medium |
Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN201949502U (en) * | 2010-06-11 | 2011-08-31 | 侯绪伟 | Three-way connecting device used for radiography and pressure examination of coronary artery |
| US20140121513A1 (en) * | 2007-03-08 | 2014-05-01 | Sync-Rx, Ltd. | Determining a characteristic of a lumen by measuring velocity of a contrast agent |
| CN105078440A (en) * | 2014-05-09 | 2015-11-25 | 西门子公司 | Method and system for non-invasive computation of hemodynamic indices for coronary artery stenosis |
| CN106327487A (en) * | 2016-08-18 | 2017-01-11 | 苏州润心医疗科技有限公司 | Coronary artery blood flow reserve fraction calculation method based on X ray coronary artery angiographic image |
| CN106537392A (en) * | 2014-04-22 | 2017-03-22 | 西门子保健有限责任公司 | Method and system for hemodynamic computation in coronary arteries |
| CN107580470A (en) * | 2015-01-15 | 2018-01-12 | 皇家飞利浦有限公司 | Instantaneous delivery lays in computer tomography |
| CN108242075A (en) * | 2018-01-05 | 2018-07-03 | 苏州润迈德医疗科技有限公司 | A kind of multi-angle reconstructing blood vessel method based on X ray coronary angiography image |
| CN108245178A (en) * | 2018-01-11 | 2018-07-06 | 苏州润迈德医疗科技有限公司 | A kind of blood flowing speed computational methods based on X ray coronary angiography image |
| CN108550189A (en) * | 2018-05-03 | 2018-09-18 | 苏州润迈德医疗科技有限公司 | Microcirculation drag index computational methods based on contrastographic picture and fluid mechanic model |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9087147B1 (en) * | 2014-03-31 | 2015-07-21 | Heartflow, Inc. | Systems and methods for determining blood flow characteristics using flow ratio |
-
2018
- 2018-11-13 CN CN201811344060.XA patent/CN111166315B/en active Active
-
2019
- 2019-01-10 WO PCT/CN2019/071205 patent/WO2020098139A1/en active Application Filing
Patent Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20140121513A1 (en) * | 2007-03-08 | 2014-05-01 | Sync-Rx, Ltd. | Determining a characteristic of a lumen by measuring velocity of a contrast agent |
| CN201949502U (en) * | 2010-06-11 | 2011-08-31 | 侯绪伟 | Three-way connecting device used for radiography and pressure examination of coronary artery |
| CN106537392A (en) * | 2014-04-22 | 2017-03-22 | 西门子保健有限责任公司 | Method and system for hemodynamic computation in coronary arteries |
| CN105078440A (en) * | 2014-05-09 | 2015-11-25 | 西门子公司 | Method and system for non-invasive computation of hemodynamic indices for coronary artery stenosis |
| CN107580470A (en) * | 2015-01-15 | 2018-01-12 | 皇家飞利浦有限公司 | Instantaneous delivery lays in computer tomography |
| CN106327487A (en) * | 2016-08-18 | 2017-01-11 | 苏州润心医疗科技有限公司 | Coronary artery blood flow reserve fraction calculation method based on X ray coronary artery angiographic image |
| CN108242075A (en) * | 2018-01-05 | 2018-07-03 | 苏州润迈德医疗科技有限公司 | A kind of multi-angle reconstructing blood vessel method based on X ray coronary angiography image |
| CN108245178A (en) * | 2018-01-11 | 2018-07-06 | 苏州润迈德医疗科技有限公司 | A kind of blood flowing speed computational methods based on X ray coronary angiography image |
| CN108550189A (en) * | 2018-05-03 | 2018-09-18 | 苏州润迈德医疗科技有限公司 | Microcirculation drag index computational methods based on contrastographic picture and fluid mechanic model |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112704505A (en) * | 2020-11-20 | 2021-04-27 | 杭州阿特瑞科技有限公司 | Method for measuring coronary artery flow reserve fraction by using CTA (computed tomography angiography) and DSA (digital signal amplification) |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2020098139A1 (en) | 2020-05-22 |
| CN111166315B (en) | 2023-03-28 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN111166317B (en) | Method for calculating contrast fractional flow reserve and resting state pressure ratio based on contrast image | |
| CN110226923B (en) | Method for measuring fractional flow reserve without vasodilator | |
| US20210361176A1 (en) | Method for calculating instantaneous wave-free ratio based on pressure sensor and angiogram images | |
| Masdjedi et al. | Validation of a three-dimensional quantitative coronary angiography-based software to calculate fractional flow reserve: the FAST study | |
| JP7136493B2 (en) | A Method for Calculating Coronary Flow Reserve Ratio Based on Pressure Sensors and Contrast-Enhanced Images | |
| Leighton et al. | Detection of hypokinesis by a quantitative analysis of left ventricular cineangiograms | |
| Boettler et al. | New aspects of the ventricular septum and its function: an echocardiographic study | |
| US9633454B2 (en) | Fluid-dynamic analysis of a vascular tree using angiography | |
| CN112384136A (en) | Method, device and system for obtaining blood vessel evaluation parameters based on radiography images | |
| JP6139116B2 (en) | Medical image processing device | |
| US20210259559A1 (en) | Method and device for obtaining vascular pressure difference | |
| CN112089433B (en) | Coronary artery blood flow reserve fraction measuring method based on CTA and DSA | |
| WO2020057324A1 (en) | System for measuring index of microcirculatory resistance and coronary artery analysis system | |
| CN109009061B (en) | Calculation method and device for obtaining blood flow characteristic value based on blood pressure correction | |
| CN111166315B (en) | Method for calculating instantaneous mode-free ratio and resting state diastolic pressure ratio based on contrast image | |
| CN108742587A (en) | The method and device of flow characteristic value is obtained based on history information | |
| CN108742570B (en) | Device for acquiring blood vessel pressure difference based on coronary artery advantage type | |
| CN111166316B (en) | Method for calculating instantaneous contrast wave-free ratio and contrast diastolic pressure ratio based on contrast images | |
| CN108742667B (en) | Method and device for obtaining blood flow characteristic value based on body quality index | |
| JP6449675B2 (en) | Nuclear medicine test method to calculate an index to predict partial coronary flow reserve | |
| CN108784676B (en) | Method and device for acquiring pressure difference based on age information | |
| CN109044324A (en) | Method and device based on plaque location amendment flow characteristic value | |
| CN116807514B (en) | Vascular imaging system, vascular imaging method, vascular imaging device, vascular imaging electronic device, and vascular imaging storage medium | |
| CN108777174A (en) | Method and device based on heart infarction history acquisition of information vascular pressure force difference | |
| EP4412528A1 (en) | Determining vessel parameters |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |