CN110393516A - The square law device and system of microcirculation index are calculated based on image and pressure sensor - Google Patents
The square law device and system of microcirculation index are calculated based on image and pressure sensor Download PDFInfo
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Abstract
This application provides a kind of square law devices and system that microcirculation index is calculated based on image and pressure sensor, and blood flow reserve measurement method includes: injection dilator, carry out coronary angiography to measurement blood vessel；Choose the second position contrastographic picture under at least first position contrastographic picture and expansion state under measurement blood vessel tranquillization state；It chooses one section of blood vessel from coronary artery proximal end to distal end to be split, three-dimensional modeling obtains coronary artery three-dimensional blood vessel model；Contrast agent is injected, according to flowing of the contrast agent in coronary artery three-dimensional blood vessel model, obtains the contrast agent in the first position contrastographic picture and the second position contrastographic picture respectively from vessel segment entrance to outlet elapsed time T1、T2；According to T1、T2Obtain microcirculation index.The application only injects dilator in radiography, reduces the injection time of dilator, and based on coronary arteries assessment parameters such as coronary angiography image measurement microcirculation indexs, measurement process is simple, and test result is accurate.
Description
Technical field
The present invention relates to coronary artery medicine technology fields, are calculated more particularly to one kind based on image and pressure sensor
Method, apparatus, coronary analysis system and the storage medium of microcirculation index.
Background technique
Heart belongs to highly energy-consuming organ.Under quiescent condition, the oxygen uptake of myocardial metabolism is 60% up to blood oxygen levels
~80%.Therefore, under the stress situations such as movement, heart is difficult to the oxygen uptake capacity by improving tissue to meet myocardial anoxia amount
Increased demand, and be mostly to guarantee the oxygen requirement of myocardial metabolism by increasing myocardial blood flow.Myocardial Microcirculation
The 95% of coronary artery circulation composition is accounted for, is sent out by various factors such as local metabolic product, endothelium, neuroendocrine, muscle-deriveds
Wave the effect of regulation myocardial blood flow.Studies have shown that coronary artery microcirculation function be extremely patients with coronary heart disease long term prognosis not
Good important predictive factors.
It is changed in guide in 2013, it is indicated that " for suspecting that there are the patients of Microvascular Angina, if coronary artery
Radiography is shown no obvious abnormalities, it may be considered that intracavitary administration acetylcholine or adenosine carry out Doppler measurement during radiography, calculate
CFR since endothelium dependence or non-endothelium, clearly whether there is microcirculation/external membrane of heart blood vessel spasm ", and this is classified as IIB
The recommendation of class.
Guide in 2019, which increases 1 IIA class, to be recommended to recommend with 2 IIB classes.It proposes " for persistently there is the trouble of symptom
The patient that person but Normal Coronary Angiography or medium narrow and iwfr/FFR value retain is contemplated that use is measured based on seal wire
CFR and/or microcirculation drag measurement ", is listed as the recommendation of IIA class.
Coronary microvascular function is that the reaction of vasodilator is completed by detection capilary.Guide this
The transition of two aspects also prompt the importance of coronary microvascular function inspection.What coronary microvascular function used
Measurement index refers to coronary microvascular maximum extension degree i.e. Coronary Blood Flow Reserve (Coronary Flow Reserve)
CFR, used vasodilator mainly include non-endothelium-dependent relaxation vasodilator and the effect of vasoactive smooth muscle
In the endothelium-dependent relaxation vasodilator of vascular endothelial cell, including adenosine and acetylcholine.
Obvious stenosis is had no for Gender Diversity, but suspects the patient of coronary heart disease (CAD), we are at the detection methods of the past
Adenosine and acetylcholine are injected, to detect reaction of the capilary for vasodilator.Present inspection method mainly includes hat
Shape artery blood flow lays in score (FFR) and microcirculation drag index (IMR), and IMR passes through soft stress seal wire synchronous recording coronary artery pressure
Power and temperature, the time difference that two thermoreceptors on conducting wire pole detect temperature change just may know that salt water from guiding catheter
The average conduction time (transit mean time, Tmn) for reaching the operation of seal wire head end thermoreceptor, according to definition coronary artery
The product of the pressure Pd and Tmn of distal end can obtain IMR value.But the assessment method of microcirculation and few now on the whole.
Existing detection methods simplify process, improve safety, and result is also optimized, thus the recommendation rank of guide compared with
It was promoted in the past.In addition to this, noninvasive test includes through chest doppler ultrasound, radionuclide image technology, nuclear magnetic resonance
The means such as imaging technique have value in the diagnosis of microcirculatory disorders, but have different degrees of deficiency, fail to become micro-
The recommended method of circulatory function assessment.
Existing CFR measurement method includes: (1) Doppler guide wire measurement method, and Doppler guide wire is sent into coronary artery
Coronary artery flow speed under intravascular (lesion distal end) directly measurement tranquillization and maximum congestive state, can calculate CFR.
(2) heat dilution curved measurement method has temperature and pressure receptor by dual sense seal wire down, can direct feeling coronary artery
The variation of interior temperature can get heat dilution curve in the coronary artery under tranquillization and maximum congestive state, averagely be passed using blood flow
Time substitution coronary flow speed is led to calculate CFR.
By Pressure wire sensor measurement IMR and CFR, there are the following problems: (1) Pressure wire sensor is from coronary artery mouth
The Tmn closely measured very much is too small to cause IMR result less than normal.It is too far and can measure Tmn causes greatly IMR result bigger than normal very much；(2) in tranquillization
6 physiological saline are injected altogether when state and maximum congested state, and Pressure wire sensor position will lead to each survey if there is movement
The result of amount does not have comparativity, and measurement process is cumbersome；(3) Tmn that per injection salt water is likely to be obtained differs greatly, if
Certain numerical value and other 2 numerical value differ by more than 30%, need pump pickle measurement again, increase salt water frequency injection；(4) it presses
The measurement pump pickle temperature decline of power seal wire receptor, which not enough will lead to rapidly, can not record numerical value, and Yao Tigao injection speed mentions
High injection volume, with the salt water of lower temperature.Influence factor is too many；(5) temperature does not have sufficiently fast recovery original value can yet after injecting
It is too long (> 0.6 second) to restore normal time to temperature from starting to inject for error；It may be that injection is too slow, and injection speed is uneven,
Injection volume is too big etc..Therefore, the distance of Pressure wire receptor, pump pickle speed, injection volume, salt water temperature can be direct
Measurement result is influenced, causes result inaccurate, measurement process is cumbersome；And long lasting for injection dilator, to patient have compared with
It is big to influence to generate serious sense of discomfort.
Summary of the invention
The present invention provides a kind of method, apparatus, coronal dynamic that microcirculation index is calculated based on image and pressure sensor
Arteries and veins analysis system and computer storage medium exist when solving to measure CFR by Pressure wire in the prior art and hold for a long time
Continuous injection dilator has the serious sense of discomfort of larger impact generation and Pressure wire measurement process cumbersome patient, measurement
As a result inaccurate problem.
To achieve the above object, in a first aspect, this application provides one kind to calculate micro- follow based on image and pressure sensor
Fourth finger calibration method, comprising:
Conventional radiography；
Dilator is injected, coronary angiography is carried out to measurement blood vessel；
Choose second measured under at least a first position contrastographic picture and expansion state under the blood vessel tranquillization state
Position contrastographic picture；
It chooses one section of blood vessel from coronary artery proximal end to distal end to be split, according to the first position contrastographic picture and described
Second position contrastographic picture three-dimensional modeling obtains coronary artery three-dimensional blood vessel model；
Contrast agent is injected, according to the coronary artery three-dimensional blood vessel model and hydrodynamics formula, according to the contrast agent
Flowing in the coronary artery three-dimensional blood vessel model obtains the contrast agent in the first position contrastographic picture from vessel segment entrance
To outlet elapsed time T1, obtain what the contrast agent in the second position contrastographic picture was passed through from vessel segment entrance to outlet
Time T2；
According to T1、T2Obtain microcirculation index.
Optionally, above-mentioned that calibration method, the microcirculation index are referred to based on image and pressure sensor calculating microcirculation
Including coronary flow reserve CFR, the CFR=T1/T2。
Optionally, above-mentioned that calibration method, the time T are referred to based on image and pressure sensor calculating microcirculation1And T2Root
The ratio calculation of the frame number for the local area image being divided into according to heart beat cycle region and transmission frame number per second.
Optionally, above-mentioned microcirculation is calculated based on image and pressure sensor to refer to calibration method, first position with
The angle of second position is greater than 30 °.
Optionally, above-mentioned microcirculation is calculated based on image and pressure sensor to refer to calibration method, it is described according to described the
One position contrastographic picture and the second position contrastographic picture three-dimensional modeling obtain coronary artery three-dimensional blood vessel model
The interference blood vessel for removing the first position contrastographic picture and the second position contrastographic picture, obtains result figure
Picture；
Along the extending direction coronarius, the coronary artery center line and diameter of result images described in every width are extracted；
The every coronary artery center line and diameter are projeced on three-dimensional space and carry out three-dimensional modeling, coronary artery is obtained
Three-dimensional blood vessel model.
Optionally, above-mentioned to refer to calibration method based on image and pressure sensor calculating microcirculation, microcirculation index includes:
Coronary artery microcirculation drag index IMR；
Coronary artery inlet pressure P is measured by pressure sensora, obtain under expansion state, coronary artery entrance is remote to coronary stenosis
The pressure drop Δ P at endi；
According to coronary artery inlet pressure Pa, pressure drop Δ Pi、T2, obtain coronary artery microcirculation drag index IMR.
Optionally, above-mentioned that calibration method, the IMR=(P are referred to based on image and pressure sensor calculating microcirculationa-Δ
Pi)×T2。
Optionally, above-mentioned to refer to that calibration method, the measurement coronary artery enter based on image and pressure sensor calculating microcirculation
Mouth arrives the pressure drop Δ P of coronary stenosis distal endiInclude:
Grid dividing is carried out to coronary artery three-dimensional blood vessel model, using coronary artery center line as the longitudinal axis, grid is along the hat
Arteries and veins center line is divided into m point, and the cross section that the coronary artery center line each pair of point is answered is divided into n node, Δ PiIt indicates
On the coronary artery center line on i-th point of cross section the pressure of all nodes average value；
The pressure drop Δ PiIt is calculated using following formula:
P1Indicate the pressure value of first node in three-dimensional blood vessel model grid on i-th point of cross section, P2Indicate three
Tie up the pressure value of second node in vascular pattern grid on i-th point of cross section, PnIt indicates on i-th point of cross section
N-th of node pressure value, m, n are positive integer；
The pressure value of each node is calculated using Navier Stokes equation.
Second aspect, this application provides a kind of devices that microcirculation index is obtained based on image and pressure sensor, use
Calibration method is referred to based on image and pressure sensor calculating microcirculation in above-mentioned, comprising: pressure sensor extracts coronary angiography
Unit, three-dimensional modeling unit and parameter measurement unit, the extraction coronary angiography unit are connect with three-dimensional modeling unit, the ginseng
Number measuring unit is connect with the pressure sensor, the three-dimensional modeling unit；
The pressure sensor is for measuring coronary artery inlet pressure Pa；
The extraction coronary angiography unit, for choosing the first position contrastographic picture and the second position of the measurement blood vessel
Contrastographic picture；
The three-dimensional modeling unit, for receive it is described extraction coronary angiography unit transmitting the first position contrastographic picture and
The second position contrastographic picture, three-dimensional modeling obtain coronary artery three-dimensional blood vessel model；
The parameter measurement unit, for receiving the coronary artery three-dimensional blood vessel model of the three-dimensional modeling unit transmitting,
The contrast agent in the first position contrastographic picture is obtained from vessel segment entrance to outlet elapsed time T1, obtain the second position and make
Contrast agent in shadow image is from vessel segment entrance to outlet elapsed time T2；According to T1、T2Obtain microcirculation index.
Optionally, the above-mentioned device that microcirculation index is obtained based on image and pressure sensor, the parameter measurement list
Member includes: CFR measurement module, the CFR measurement module, for measuring coronary flow reserve CFR, the CFR=T1/T2；
And/or
The device for calculating microcirculation index further include: the microcirculation drag index being connect with the parameter measurement unit
Measuring device, the microcirculation drag index measuring device is for measuring microcirculation drag index IMR, IMR=(Pa-ΔPi)×
T2；And/or
The device for calculating microcirculation index further include: the coronary flow storage being connect with the parameter measurement unit
Back-up number measuring device, the coronary flow reserve fraction measurement device, for measuring coronary flow reserve score
FFR, FFR=(Pa-ΔPi)/Pa。
The third aspect, this application provides a kind of coronary analysis systems, comprising: above-mentioned to be passed based on image and pressure
The device of sensor acquisition microcirculation index.
Fourth aspect, this application provides a kind of computer storage medium, realization when computer program is executed by processor
Above-mentioned refers to calibration method based on image and pressure sensor calculating microcirculation.
Scheme bring beneficial effect provided by the embodiments of the present application includes at least:
This application provides calculating microcirculation based on image and pressure sensor to refer to calibration method, only in radiography, inject
Dilator, angiographic procedure only need that dilator injection can be stopped within several seconds, reduce the injection time of dilator, then lead to
It crosses coronary angiography image and carries out three-dimensional modeling, obtain the contrast agent in the first position contrastographic picture from vessel segment entrance to outlet institute
Elapsed time T1, obtain the contrast agent under expansion state in the second position contrastographic picture and passed through from vessel segment entrance to outlet
Time T2；According to T1、T2CFR is measured, Pressure wire is not necessarily to, measurement process is simple, and test result is accurate, overcomes using pressure
Power seal wire measures the problem of CFR.
Detailed description of the invention
The drawings described herein are used to provide a further understanding of the present invention, constitutes a part of the invention, this hair
Bright illustrative embodiments and their description are used to explain the present invention, and are not constituted improper limitations of the present invention.In the accompanying drawings:
Fig. 1 is the stream of one embodiment for referring to calibration method based on image and pressure sensor calculating microcirculation of the application
Cheng Tu；
Fig. 2 is the flow chart of the step S130 of the application；
Fig. 3 is the stream of another embodiment for referring to calibration method based on image and pressure sensor calculating microcirculation of the application
Cheng Tu；
Fig. 4 is the knot of one embodiment of the device that microcirculation index is obtained based on image and pressure sensor of the application
Structure block diagram；
Fig. 5 is the structural schematic diagram of the pressure sensor of the application；
Fig. 6 is the knot of another embodiment of the device that microcirculation index is obtained based on image and pressure sensor of the application
Structure block diagram；
Fig. 7 is the structural block diagram of one embodiment of the three-dimensional modeling unit of the application；
Fig. 8 is the structural block diagram of another embodiment of the three-dimensional modeling unit of the application；
Fig. 9 is the structural block diagram of the image processing module of the application；
Figure 10 is reference picture；
Figure 11 is a target image to be split；
Figure 12 is another target image to be split；
Figure 13 is enhanced conduit image；
Figure 14 is the binary image of conduit characteristic point；
Figure 15 is enhanced target image；
Figure 16 is the area image of coronary artery present position；
Figure 17 is result images；
Figure 18 is two position contrastographic pictures；
Figure 19 is the coronary artery three-dimensional blood vessel model figure generated by Figure 18 combination parallactic angle degree and coronary artery center line；
Appended drawing reference is illustrated below:
Pressure sensor 110, pressure experience chip 1, Wriggling Pump Head 2, hose 3, female Luer 4, laser emitter 5 are shown
Display screen 6, check valve 7 extract coronary angiography unit 120, three-dimensional modeling unit 130, and image reading module 131 divides module
132, length of vessel measurement module 133, three-dimensional modeling module 134, image processing module 135, image denoising module 1350, conduit
Feature point extraction module 1351, coronary artery extraction module 1352, coronary artery central line pick-up module 136, blood vessel diameter measure mould
Block 137, parameter measurement unit 140, CFR measurement module 141, microcirculation drag index measuring device 200, coronary flow storage
Back-up number measuring device 300.
Specific embodiment
To make the object, technical solutions and advantages of the present invention clearer, below in conjunction with the specific embodiment of the invention and
Technical solution of the present invention is clearly and completely described in corresponding attached drawing.Obviously, described embodiment is only the present invention one
Section Example, instead of all the embodiments.Based on the embodiments of the present invention, those of ordinary skill in the art are not doing
Every other embodiment obtained under the premise of creative work out, shall fall within the protection scope of the present invention.
Multiple embodiments of the invention will be disclosed with schema below, as clearly stated, the details in many practices
It will be explained in the following description.It should be appreciated, however, that the details in these practices is not applied to limit the present invention.Also
It is to say, in some embodiments of the invention, the details in these practices is non-essential.
As shown in Figure 1, calculating microcirculation based on image and pressure sensor this application provides one kind refers to calibration method, wrap
It includes:
S100, conventional radiography；
S110 injects dilator, carries out coronary angiography to measurement blood vessel；
S120 chooses second under at least first position contrastographic picture and expansion state under measurement blood vessel tranquillization state
Position contrastographic picture；
S130 chooses one section of blood vessel from coronary artery proximal end to distal end and is split, according to the first position contrastographic picture and the
Two position contrastographic picture three-dimensional modelings obtain coronary artery three-dimensional blood vessel model；
S140, injection contrast agent are being preced with according to coronary artery three-dimensional blood vessel model and hydrodynamics formula according to contrast agent
Flowing in shape artery three-dimensional blood vessel model obtains the contrast agent in the first position contrastographic picture from vessel segment entrance to outlet institute
Elapsed time T1, the contrast agent in the second position contrastographic picture is obtained from vessel segment entrance to outlet elapsed time T2；
S150, according to T1、T2Obtain microcirculation index.
This application provides the methods for obtaining coronary flow reserve based on contrastographic picture, and only in radiography, injection is expanded
Drug is opened, angiographic procedure only needs that dilator injection can be stopped within several seconds, reduces the injection time of dilator, then pass through
Coronary angiography image carries out three-dimensional modeling, and the contrast agent obtained in the first position contrastographic picture is passed through from vessel segment entrance to outlet
The time T crossed1, obtain what the contrast agent under expansion state in the second position contrastographic picture was passed through from vessel segment entrance to outlet
Time T2；According to T1、T2CFR is measured, is not necessarily to Pressure wire, measurement process is simple, and test result is accurate, overcomes using pressure
Seal wire measures the problem of CFR.
It is to be noted that injection dilator includes: vein or intracoronary injection dilator, mode packet is squeezed into
Include: dilator can enter vein or coronary artery with contrast agent hybrid injection, can also be spaced injection by several times in the application
Protection scope in；As long as the drug that dilating effect can be played include adenosine, ATP etc. within the scope of protection of this application.
In one embodiment of the application, microcirculation index includes coronary flow reserve CFR, CFR=T1/T2.This Shen
Please according to the second position contrastographic picture under expansion state, pass through CFR=T1/T2Company obtains CFR value.
Time T in one embodiment of the application, in S1401And T2The partial zones being divided into according to heart beat cycle region
The ratio calculation of the frame number of area image and transmission frame number per second；That is:
T=N/fps, N indicate that the frame number for the local area image that heart beat cycle region is divided into, fps indicate that picture is per second
Frame number is played, the frame numbers of animation or video are just referred to for popular, T indicates the contrast agent in a certain position contrastographic picture from blood
Pipeline section entrance is to outlet elapsed time T, therefore T1And T2It can be calculated according to above-mentioned formula.The reality of the application
It applies in example, fps=10~30；Preferably, fps=15.
Due to T1And T2The coronary artery three-dimensional blood vessel model for being all based on contrastographic picture acquisition measures, therefore CFR is also logical
It crosses coronary artery three-dimensional blood vessel model to measure, needs not rely upon Pressure wire sensor, therefore overcome Pressure wire sensor
It is easy movement under the impact of salt water, is not necessarily to pump pickle when measuring the problem of inaccuracy, and measuring based on contrastographic picture, therefore
Influence of the temperature to CFR measurement result for avoiding pump pickle speed, injection volume, salt water, improves the accuracy rate of measurement.
In one embodiment of the application, the angle of the first position and the second position is greater than 30 °.
As shown in Fig. 2, in one embodiment of the application, S130 includes:
S131 removes the interference blood vessel of the first position contrastographic picture and the second position contrastographic picture, obtains result images, has
Body are as follows:
Remove the interference blood vessel of the first position contrastographic picture and the second position contrastographic picture；
To coronary angiography image denoising, comprising: static noise and dynamic noise；
The first frame segmented image for having conduit to occur is defined as reference picture, the kth that there will be complete coronary artery to occur
Segmented image described in frame is defined as target image, and k is the positive integer greater than 1；
The reference picture is subtracted into the target image, extracts the characteristic point O of the conduit, method particularly includes: by institute
It states reference picture and subtracts the target image；Denoising, comprising: static noise and dynamic noise；To the image after the denoising into
Row image enhancement；Binary conversion treatment is carried out to enhanced conduit image, obtains the binary picture with one group of conduit characteristic point O
Picture；
The target image is subtracted into the reference picture, extracts the area image of the coronary artery present position, is had
Body method are as follows: the target image is subtracted into the reference picture；Denoising, comprising: static noise and dynamic noise；After denoising
Described image carry out image enhancement；According to the position in each region and the conduit characteristic point in the enhanced target image
Relationship determines and extracts region coronarius, the area image of the as described coronary artery present position；
The area image carries out dynamic growth using the characteristic point of the conduit as seed point, obtains the result figure
Picture, method particularly includes: binary conversion treatment is carried out to the area image of the coronary artery present position, it is coronal dynamic to obtain binaryzation
Arteries and veins image；Morphology operations, using the characteristic point of the conduit as seed point, institute are carried out to the binaryzation coronary artery images
It states binaryzation coronary artery images and carries out dynamic area growth according to the seed point present position, obtain the result images；
S132 extracts the coronary artery center line and diameter of every width result images along extending direction coronarius；
Every root cap arteries and veins center line and diameter are projeced on three-dimensional space and carry out three-dimensional modeling by S133, obtain coronal dynamic
Arteries and veins three-dimensional blood vessel model, method particularly includes:
Obtain the position shooting angle of every width coronary angiography image；
The every coronary artery center line combination position shooting angle is projeced on three-dimensional space, is projected, hat is generated
Shape artery three-dimensional blood vessel model.
As shown in figure 3, microcirculation index includes: coronary artery microcirculation drag index in one embodiment of the application
IMR, specific measurement method are as follows:
S100, conventional radiography；
S110 injects dilator, carries out coronary angiography to measurement blood vessel；
S200 obtains coronary artery inlet pressure coronary artery entrance P by pressure sensoraAnd under expansion state, coronary artery entrance
To the pressure drop Δ P of coronary stenosis distal endi；
S120 chooses second under at least first position contrastographic picture and expansion state under measurement blood vessel tranquillization state
Position contrastographic picture；
S130 chooses one section of blood vessel from coronary artery proximal end to distal end and is split, according to the first position contrastographic picture and the
Two position contrastographic picture three-dimensional modelings obtain coronary artery three-dimensional blood vessel model；
S300 chooses a heart beat cycle region of coronary artery three-dimensional blood vessel model, measures in heart beat cycle region
The length L of blood vessel；
S140, injection contrast agent are being preced with according to coronary artery three-dimensional blood vessel model and hydrodynamics formula according to contrast agent
Flowing in shape artery three-dimensional blood vessel model obtains the contrast agent in the first position contrastographic picture from vessel segment entrance to outlet institute
Elapsed time T1, the contrast agent in the second position contrastographic picture is obtained from vessel segment entrance to outlet elapsed time T2；
S400, according to coronary artery inlet pressure Pa, pressure drop Δ Pi、T2, obtain coronary artery microcirculation drag index IMR.
The application is according to the second position contrastographic picture under the expansion state obtained, according to IMR=(Pa-ΔPi)×T2；
The evaluation criterion that IMR > 25 is then considered there are Micro-circutation syndrome, when measuring acquisition IMR with Pressure wire is consistent, but this Shen
Please without Pressure wire, measurement process is simple, overcome Pressure wire measurement IMR when the problem of.
In one embodiment of the application, in S400, the pressure drop Δ P of measurement coronary artery entrance to coronary stenosis distal endiPacket
It includes:
Grid dividing is carried out to coronary artery three-dimensional blood vessel model, using coronary artery center line as the longitudinal axis, grid is along coronary artery
Heart line is divided into m point, and the cross section that coronary artery center line each pair of point is answered is divided into n node, Δ PiIndicate coronary artery center
On line on i-th point of cross section the pressure of all nodes average value；
Pressure drop Δ PiIt is calculated using following formula:
P1Indicate the pressure value of first node in three-dimensional blood vessel model grid on i-th point of cross section, P2Indicate three
Tie up the pressure value of second node in vascular pattern grid on i-th point of cross section, PnIt indicates on i-th point of cross section
N-th of node pressure value, m, n are positive integer；
The pressure value of each node is calculated using Navier Stokes equation.
As shown in figure 4, being used this application provides a kind of device for obtaining microcirculation index based on image and pressure sensor
Calibration method is referred to based on image and pressure sensor calculating microcirculation in above-mentioned, comprising: pressure sensor 110 extracts coronary artery
Radiography unit 120, three-dimensional modeling unit 130 and parameter measurement unit 140 extract coronary angiography unit 120 and three-dimensional modeling list
Member 130 connects, and parameter measurement unit 140 is connect with pressure sensor 110, three-dimensional modeling unit 130；Pressure sensor 110 is used
In measurement coronary artery inlet pressure Pa；Extract coronary angiography unit 120 be used for chooses measurement blood vessel the first position contrastographic picture with
Second position contrastographic picture；Three-dimensional modeling unit 130, which is used to receive, extracts the first position radiography that coronary angiography unit 120 transmits
Image and the second position contrastographic picture, three-dimensional modeling obtain coronary artery three-dimensional blood vessel model；Parameter measurement unit 140 is for connecing
Receive three-dimensional modeling unit 130 transmit coronary artery three-dimensional blood vessel model, obtain the first position contrastographic picture in contrast agent from
Vessel segment entrance to outlet elapsed time T1, the contrast agent in the second position contrastographic picture is obtained from vessel segment entrance to out
Mouth elapsed time T2；According to T1、T2Obtain coronary flow reserve CFR, CFR=T1/T2。
Parameter measurement unit 140 includes: T1Measurement module, T2Measurement module and CFR measurement module, with three-dimensional modeling list
Member 130 connects, and T1Measurement module, T2Measurement module is connect with CFR measurement module.
As shown in figure 5, pressure sensor 110 includes pressure experience chip 1 in one embodiment of the application, further include
Wriggling Pump Head 2, Wriggling Pump Head 2 include rotating wheel, and rotating wheel is equipped with the connection structure with external motor rotation axis connection, wriggles
Pump head 2 is built-in with hose 3, and 3 one end of hose is connect with pressure experience chip 1, and the other end is connect by perfusion tube with bag of saline.Pressure
Force snesor one end is connect with bag of saline, and the other end is connected to patient sustainer, the purposes of pressure sensor by external device (ED)
Patient sustainer is exactly connected, centre can form access with aorta full of physiological saline, and pressure sensor inside has
The dynamic pressure of aorta can be converted into analog signal by pressure experience chip 1, will by the circuit of pressure sensor inside
Collected analog signal is converted into digital model, obtains the coronary artery inlet pressure Pa of aortic pressure, this coronary artery inlet pressure Pa
Using the average value of the sum of systolic pressure and diastolic pressure；Systolic pressure, diastolic pressure and coronary artery inlet pressure Pa are shown on display screen 6.
As shown in figure 5, hose 3 and perfusion tube connecting pin are equipped with female Luer 4 and with it in one embodiment of the application
It is connect with perfusion tube；Check valve 7 is connected between hose 3 and pressure experience chip 1, check valve 7 allows to flow to as bag of saline extremely
Pressure experience chip 1；Pressure sensor further includes laser emitter 5, and laser emitter 5 is located at same with pressure experience chip 1
Level height.Laser emitter 5 can emit a horizontal light beam and be irradiated to patient body cardia, guarantee laser emitter
In same level, light beam plays auxiliary alignment effect for 5 height and heart, is aligned simpler.Pressure experience chip 1 be designed as with
5 same level height of laser emitter ensures that pressure experience chip 1 and heart in same level height, can be surveyed accurately in this way
Measure aortic pressure.
As shown in fig. 6, parameter measurement unit 140 includes: CFR measurement module 141, CFR in one embodiment of the application
Measurement module 141 is for measuring coronary flow reserve CFR, CFR=T1/T2；And/or
Calculate the device of microcirculation index further include: the microcirculation drag index measurement connecting with parameter measurement unit 140
Device 200, microcirculation drag index measuring device 200 is for measuring microcirculation drag index IMR, IMR=(Pa-ΔPi)×T2；
And/or
Calculate the device of microcirculation index further include: the coronary flow reserve connecting with parameter measurement unit 140 point
Number measuring device 300, coronary flow reserve fraction measurement device 300 are used to measure coronary flow reserve score FFR,
FFR=(Pa-ΔPi)/Pa。
As shown in fig. 7, three-dimensional modeling unit 130 includes image reading module 131, divides in one embodiment of the application
Cut module 132, length of vessel measurement module 133 and three-dimensional modeling module 134, segmentation module 132 and image reading module 131,
Length of vessel measurement module 133, three-dimensional modeling module 134 connect；Image reading module 131 is for reading contrastographic picture；Segmentation
Module 132 is used to choose a heart beat cycle region of coronarogram picture；Length of vessel measurement module 133 is for measuring
The length L of blood vessel in heart beat cycle region, and the length L of blood vessel is passed into segmentation module 132；Three-dimensional modeling module 134
Coronary angiography image for being chosen according to segmentation module 132 carries out three-dimensional modeling, obtains coronary artery three-dimensional blood vessel model.
As shown in figure 8, in one embodiment of the application, three-dimensional modeling unit 130 further include: image processing module 135,
Coronary artery central line pick-up module 136 and blood vessel diameter measurement module 137, image processing module 135 and coronary artery central line pick-up mould
Block 136 connects, and three-dimensional modeling module 134 is connect with coronary artery central line pick-up module 136, blood vessel diameter measurement module 137.Image
Processing module 135 is used to receive the coronary angiography image at least two positions that segmentation module 132 is transmitted, and removes coronary angiography
The interference blood vessel of image, obtains result images as shown in figure 17；Coronary artery central line pick-up module 136 is used for along coronary artery
Extending direction, extract the coronary artery center line of every width result images as shown in figure 17；Blood vessel diameter measurement module 137 is for surveying
Measure blood vessel diameter D；Three-dimensional modeling module 134 carries out three for every root cap arteries and veins center line and diameter to be projeced on three-dimensional space
Dimension modeling, obtains coronary artery three-dimensional blood vessel model.The application, which is realized, synthesizes coronary artery three-dimensional according to coronary angiography image
Vascular pattern compensates for the blank in industry, has the function of for medicine technology field positive.
In one embodiment of the application, image denoising module 1350 is set, for hat inside image processing module 135
Arteries and veins contrastographic picture denoising, comprising: static noise and dynamic noise.It is removed by denoising module 1350 dry in coronary angiography image
Factor is disturbed, the quality of image procossing is improved.
As shown in figure 9, in one embodiment of the application, be arranged inside image processing module 135 with coronary artery center line
The conduit feature point extraction module 1351 and coronary artery extraction module 1352 that extraction module 136 connects, conduit feature point extraction
Module 1351 is connect with coronary artery extraction module 1352, image denoising module 1350；Conduit feature point extraction module 1351 is used
In the first frame segmented image for having conduit to occur is defined as reference picture as shown in Figure 10, there will be complete coronary artery to occur
Kth frame segmented image be defined as such as Figure 11 and target image as shown in figure 12, k is positive integer greater than 1, to such as Figure 11 with
Target image shown in 12 is enhanced, and enhanced image as shown in figures 13 and 15 is obtained；By reference as shown in Figure 10
Image is subtracted such as Figure 11 and target image as shown in figure 12, extracts the characteristic point O of conduit as shown in figure 14；Coronary artery mentions
Modulus block 1352 is used to such as Figure 11 and target image as shown in figure 12 subtracting reference picture as shown in Figure 10, according to such as figure
The positional relationship in each region and conduit characteristic point in enhanced target image shown in 15 determines and extracts area coronarius
Domain, the area image of coronary artery present position as shown in figure 16；Area image as shown in figure 16 is with such as Figure 14 institute
The characteristic point of the conduit shown carries out dynamic growth as seed point, obtains result images as shown in figure 17.
Binary processing module is also set up inside image processing module 135, for carrying out binary conversion treatment to image, to obtain
Obtain coronary artery three-dimensional blood vessel model.
The application is specifically described combined with specific embodiments below:
Embodiment 1:
It as shown in figure 18, is the coronary angiography image of two positions of a patient；Left figure is that position angle is right
The contrastographic picture of first oblique RAO:25 ° and CRA:23 ° of head position；Right figure is under expansion state, and position angle be it is right before tiltedly RAO:3 °
With CRA:30 ° of the contrastographic picture in head position；
Length of vessel L value=120mm of coronary artery three-dimensional blood vessel model；The coronary artery three-dimensional blood vessel model of generation is such as
Shown in Figure 19；
Value=2 blood vessel diameter D~4mm, Pa=104mmHg；T2=N2/fps2=9/15=0.6s；T1=N1/fps1=
20/15=1.3s；
CFR=T1/T2=1.3/0.6=2.17；
Δ P=2；Therefore IMR=(104-2) × 0.6=61.2；
Comparative example 1:
Identical as the patient of embodiment 1, comparative example 1 and embodiment 1 are that same coronary artery of same position patient is made
Shadow image；
Pressure wire sensor is put into the coronary artery distal end (being open > 5cm from guiding catheter) of patient, by conduit to blood
3ml physiological saline is injected in pipe to inject again by conduit into blood vessel if detecting that blood temperature is returned to normal value
3ml physiological saline repeats the above process 3 times, then records T1, T1For 1.28s；It is passed through dilator to blood vessel, reaches blood vessel
And expansion state (the Pressure wire sensor that guarantee is passed through before and after dilator is in same position) is kept, by conduit to blood
3ml physiological saline is injected in pipe to inject again by conduit into blood vessel if detecting that blood temperature is returned to normal value
3ml physiological saline repeats the above process 3 times, then records T2, T2For 0.58s, the pressure P of coronary artery distal end is measuredd=
103.5mmHg；
CFR=1.28/0.58=2.21；
IMR=Pd×T2=103.5 × 0.6=60.03；
Pass through the comparison of embodiment 1 and comparative example 1, it is known that IMR measurement result is essentially identical, therefore the measurement of embodiment 1
As a result accurate, and embodiments herein is not necessarily to Pressure wire, need to only measure coronary artery inlet pressure, nothing needs guiding through coronary blood
Pipe narrow remote end, reduces operating difficulty and risk；And the measurement of IMR is realized by contrastographic picture, it compensates in industry
Blank operates simpler.
This application provides a kind of coronary analysis systems, comprising: above-mentioned to be obtained based on image and pressure sensor
The device of microcirculation index.
This application provides a kind of computer storage mediums, realized when computer program is executed by processor it is above-mentioned based on
Image and pressure sensor calculate microcirculation and refer to calibration method.
Those skilled in the art will appreciate that various aspects of the invention can be implemented as system, method or calculating
Machine program product.Therefore, various aspects of the invention can be embodied in the following forms, it may be assumed that complete hardware embodiment,
The embodiment party combined in terms of complete Software Implementation (including firmware, resident software, microcode etc.) or hardware and software
Formula may be collectively referred to as circuit, " module " or " system " here.In addition, in some embodiments, various aspects of the invention are also
It can be implemented as the form of computer program product in one or more computer-readable medium, the computer-readable medium
In include computer-readable program code.The method of the embodiment of the present invention and/or the embodiment of system can be related to
Manually, automatically or in a manner of a combination thereof execute or complete selected task.
For example, the hardware realization that will can be used to execute the selected task of embodiment according to the present invention is chip or electricity
Road.As software, the selected task of embodiment according to the present invention can be embodied as using any appropriate operation by computer
Multiple software instructions that system executes.In an exemplary embodiment of the present invention, the root such as this paper is executed by data processor
According to one or more tasks of the exemplary embodiment of method and/or system, such as executing the computing platform of multiple instruction.
Optionally, which includes for storing instruction and/or the volatile storage of data and/or for storing instruction
And/or the non-volatile storage of data, for example, magnetic hard disk and/or removable medium.Optionally, a kind of network is also provided
Connection.Display and/or user input equipment, such as keyboard or mouse are optionally also provided.
Using one or more computer-readable any combination.Computer-readable medium can be computer-readable letter
Number medium or computer readable storage medium.Computer readable storage medium for example may be-but not limited to-electricity, magnetic,
Optical, electromagnetic, the system of infrared ray or semiconductor, device or device, or any above combination.Computer-readable storage medium
The more specific example (non-exhaustive listing) of matter will include the following terms:
Electrical connection, portable computer diskette, hard disk, random access memory (RAM) with one or more conducting wires, only
Read memory (ROM), erasable programmable read only memory (EPROM or flash memory), optical fiber, portable compact disc read only memory
(CD-ROM), light storage device, magnetic memory device or above-mentioned any appropriate combination.In this document, computer-readable
Storage medium can be it is any include or storage program tangible medium, the program can be commanded execution system, device or
Device use or in connection.
Computer-readable signal media may include in a base band or as carrier wave a part propagate data-signal,
Wherein carry computer-readable program code.The data-signal of this propagation can take various forms, including but unlimited
In electromagnetic signal, optical signal or above-mentioned any appropriate combination.Computer-readable signal media can also be that computer can
Any computer-readable medium other than storage medium is read, which can send, propagates or transmit and be used for
By the use of instruction execution system, device or device or program in connection.
The program code for including on computer-readable medium can transmit with any suitable medium, including but not limited to
Wirelessly, wired, optical cable, RF etc. or above-mentioned any appropriate combination.
For example, can be write with any combination of one or more programming languages for executing for each aspect of the present invention
Operation computer program code, Object-Oriented Programming Languages and the conventional process such as including Java, Smalltalk, C++
Programming language, such as " C " programming language or similar programming language.Program code can execute fully on the user computer,
It partly executes, executed as an independent software package on the user computer, part is on the user computer partially remote
It executes on journey computer or executes on a remote computer or server completely.In situations involving remote computers, far
Journey computer can pass through the network of any kind -- and user, which is connected to, including local area network (LAN) or wide area network (WAN)-calculates
Machine, or, it may be connected to outer computer (such as being connected using ISP by internet).
It should be appreciated that the combination of each box in each box and flowchart and or block diagram of flowchart and or block diagram,
It can be realized by computer program instructions.These computer program instructions can be supplied to general purpose computer, special purpose computer
Or the processor of other programmable data processing units, so that a kind of machine is produced, so that these computer program instructions exist
When being executed by computer or the processor of other programmable data processing units, produce in implementation flow chart and/or block diagram
One or more boxes specified in function action device.
Can also these computer program instructions store in computer-readable medium, these instruct so that computer,
Other programmable data processing units or other equipment work in a specific way, thus, it stores in computer-readable medium
Instruction just produces the instruction including function action specified in one or more boxes in implementation flow chart and/or block diagram
Manufacture (article of manufacture).
Computer program instructions can be also loaded into computer (for example, coronary analysis system) or other programmable numbers
According in processing equipment with promote in computer, other programmable data processing devices or other equipment execute sequence of operations step
Suddenly process is realized to generate computer, so that the instruction executed in computer, other programmable devices or other equipment provides
For realizing the process for the function action specified in flow chart and/or one or more diagram blocks.
Above specific example of the invention has carried out further the purpose of the present invention, technical scheme and beneficial effects
Be described in detail, it should be understood that be not intended to restrict the invention the above is only specific embodiments of the present invention, it is all
Within the spirit and principles in the present invention, any modification, equivalent substitution, improvement and etc. done should be included in protection of the invention
Within the scope of.
Claims (12)
1. one kind, which calculates microcirculation based on image and pressure sensor, refers to calibration method characterized by comprising
Conventional radiography；
Dilator is injected, coronary angiography is carried out to measurement blood vessel；
Choose the second position measured under at least a first position contrastographic picture and expansion state under the blood vessel tranquillization state
Contrastographic picture；
It chooses one section of blood vessel from coronary artery proximal end to distal end to be split, according to the first position contrastographic picture and described second
Position contrastographic picture three-dimensional modeling obtains coronary artery three-dimensional blood vessel model；
Contrast agent is injected, according to the coronary artery three-dimensional blood vessel model and hydrodynamics formula, according to the contrast agent in institute
The flowing in coronary artery three-dimensional blood vessel model is stated, obtains the contrast agent in the first position contrastographic picture from vessel segment entrance to out
Mouth elapsed time T1, the contrast agent in the second position contrastographic picture is obtained from vessel segment entrance to outlet elapsed time
T2；
According to T1、T2Obtain microcirculation index.
2. according to claim 1 refer to calibration method based on image and pressure sensor calculating microcirculation, which is characterized in that
The microcirculation index includes coronary flow reserve CFR, the CFR=T1/T2。
3. according to claim 1 refer to calibration method based on image and pressure sensor calculating microcirculation, which is characterized in that
The time T1And T2According to the frame number and the radiometer per second for transmitting frame number of the local area image that heart beat cycle region is divided into
It calculates.
4. described in any item according to claim 1~3 refer to calibration method based on image and pressure sensor calculating microcirculation,
It is characterized in that, the angle of first position and second position is greater than 30 °.
5. described in any item according to claim 1~3 refer to calibration method based on image and pressure sensor calculating microcirculation,
It is characterized in that, it is described that coronal move is obtained according to the first position contrastographic picture and the second position contrastographic picture three-dimensional modeling
Arteries and veins three-dimensional blood vessel model includes:
The interference blood vessel for removing the first position contrastographic picture and the second position contrastographic picture, obtains result images；
Along the extending direction coronarius, the coronary artery center line and diameter of result images described in every width are extracted；
The every coronary artery center line and diameter are projeced on three-dimensional space and carry out three-dimensional modeling, it is three-dimensional to obtain coronary artery
Vascular pattern.
6. described in any item according to claim 1~3 refer to calibration method based on image and pressure sensor calculating microcirculation,
It is characterized in that, microcirculation index includes: coronary artery microcirculation drag index IMR；
Coronary artery inlet pressure P is measured by pressure sensora, obtain under expansion state, pressure of the coronary artery entrance to coronary stenosis distal end
Δ P drops in poweri；According to coronary artery inlet pressure Pa, pressure drop Δ Pi、T2, obtain coronary artery microcirculation drag index IMR.
7. according to claim 6 refer to calibration method based on image and pressure sensor calculating microcirculation, which is characterized in that
IMR=(the Pa-ΔPi)×T2。
8. according to claim 7 refer to calibration method based on image and pressure sensor calculating microcirculation, which is characterized in that
Pressure drop Δ P of the measurement coronary artery entrance to coronary stenosis distal endiInclude:
Grid dividing is carried out to coronary artery three-dimensional blood vessel model, using coronary artery center line as the longitudinal axis, grid is along the coronary artery
Heart line is divided into m point, and the cross section that the coronary artery center line each pair of point is answered is divided into n node, Δ PiDescribed in expression
On coronary artery center line on i-th point of cross section the pressure of all nodes average value；
The pressure drop Δ PiIt is calculated using following formula:
P1Indicate the pressure value of first node in three-dimensional blood vessel model grid on i-th point of cross section, P2Indicate three-dimensional blood
The pressure value of second node in tube model grid on i-th point of cross section, PnIndicate on i-th point of cross section
The pressure value of n node, m, n are positive integer；
The pressure value of each node is calculated using Navier Stokes equation.
9. a kind of device for obtaining microcirculation index based on image and pressure sensor, for described in any one of claim 1~8
Microcirculation calculated based on image and pressure sensor refer to calibration method characterized by comprising pressure sensor extracts hat
Arteries and veins radiography unit, three-dimensional modeling unit and parameter measurement unit, the extraction coronary angiography unit are connect with three-dimensional modeling unit,
The parameter measurement unit is connect with the pressure sensor, the three-dimensional modeling unit；
The pressure sensor is for measuring coronary artery inlet pressure Pa；
The extraction coronary angiography unit, for choosing the first position contrastographic picture and the second position radiography of the measurement blood vessel
Image；
The three-dimensional modeling unit, for receiving the first position contrastographic picture and described of the extraction coronary angiography unit transmitting
Second position contrastographic picture, three-dimensional modeling obtain coronary artery three-dimensional blood vessel model；
The parameter measurement unit is obtained for receiving the coronary artery three-dimensional blood vessel model of the three-dimensional modeling unit transmitting
Contrast agent in first position contrastographic picture is from vessel segment entrance to outlet elapsed time T1, obtain the second position radiography figure
Contrast agent as in is from vessel segment entrance to outlet elapsed time T2；According to T1、T2Obtain microcirculation index.
10. the device according to claim 9 for being obtained microcirculation index based on image and pressure sensor, feature are existed
In the parameter measurement unit includes: CFR measurement module, the CFR measurement module, for measuring coronary flow reserve
CFR, the CFR=T1/T2；And/or
The device for calculating microcirculation index further include: the microcirculation drag index measurement being connect with the parameter measurement unit
Device, the microcirculation drag index measuring device is for measuring microcirculation drag index IMR, IMR=(Pa-ΔPi)×T2；
And/or
The device for calculating microcirculation index further include: the coronary flow reserve being connect with the parameter measurement unit point
Number measuring device, the coronary flow reserve fraction measurement device, for measuring coronary flow reserve score FFR,
FFR=(Pa-ΔPi)/Pa。
11. a kind of coronary analysis system characterized by comprising based on image and pressure described in claim 9 or 10
The device of sensor acquisition microcirculation index.
12. a kind of computer storage medium, which is characterized in that realize claim 1~8 when computer program is executed by processor
It is described in any item that calibration method is referred to based on image and pressure sensor calculating microcirculation.
Priority Applications (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910846497.1A CN110393516A (en) | 2018-09-19 | 2019-09-09 | The square law device and system of microcirculation index are calculated based on image and pressure sensor |
| PCT/CN2019/115072 WO2021046990A1 (en) | 2019-09-09 | 2019-11-01 | Microcirculatory index calculation method and apparatus based on image and pressure sensor, and system |
| JP2020573149A JP7093584B2 (en) | 2019-09-09 | 2019-11-01 | Methods, devices and systems for calculating microcirculation indicators based on images and pressure sensors |
| EP19938107.0A EP4029438A4 (en) | 2019-09-09 | 2019-11-01 | Microcirculatory index calculation method and apparatus based on image and pressure sensor, and system |
| US17/158,355 US11779294B2 (en) | 2019-09-09 | 2021-01-26 | Method, device and system for calculating microcirculation indicator based on image and pressure sensor |
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| CN201811093192X | 2018-09-19 | ||
| CN201811093192.XA CN109363651A (en) | 2018-09-19 | 2018-09-19 | It is a kind of for measuring blood flow reserve score when obtain aortic pressure device |
| CN2019102065412 | 2019-03-19 | ||
| CN201910206541.2A CN109770888A (en) | 2019-03-19 | 2019-03-19 | The method instantaneously without waveform ratio is calculated based on pressure sensor and contrastographic picture |
| CN201910846497.1A CN110393516A (en) | 2018-09-19 | 2019-09-09 | The square law device and system of microcirculation index are calculated based on image and pressure sensor |
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