北京生物醫(yī)學工程

基于冠狀動脈血管分支流量分配方法的血流儲備分數(shù)數(shù)值模擬研究

Numerical simulation of fractional flow reserve based on coronary artery branch flow distribution method

作者：夏駿喬愛科楊青青侯陽馬躍

單位：北京工業(yè)大學生命科學與生物工程學院（北京 100124）中國醫(yī)科大學附屬第二臨床醫(yī)院（沈陽 110001）

關鍵詞：冠狀動脈狹窄；血流儲備分數(shù)；數(shù)值模擬；標度律；血流量分配

分類號：R318.04

出版年·卷·期（頁碼）：2019·38·3（251-256）

摘要：

目的在個性化無創(chuàng)計算血流儲備分數(shù)（fractional flow reverse,FFRCT）中，流量邊界條件的分配準確性往往是一個問題。本文基于種內(nèi)標度律，提出了一種體積-流量關系的冠脈血流量分配方法進行血流量分配。方法對16例患者血管造影（CT angiography，CTA）圖像進行重建，測量出患者各分支的體積，再經(jīng)過標度律的方法將冠脈總流量以體積分配比分配到各分支出口。以臨床FFR值和最終計算的血流動力學模擬值作分類對比，比較了以往的管徑流量模型分配方法和體積流量分配方法的準確性。結(jié)果基于體積法計算的FFRCT誤差為10.47%，基于管徑法計算的FFRCT為11.76%，并且體積分配方法與管徑分配方法具有較好的一致性（80%）。結(jié)論本文結(jié)果可為臨床無創(chuàng)檢測FFR提出新的計算方法并推動FFRCT的臨床應用研究。

objective For the personalized non-invasive calculation offractional flow reverse(FFRCT), the accuracy of the distribution of flow boundary conditions is a key issue. According to the intra-species scaling law, we propose a volume-flow relationship based coronary blood flow distribution method for blood flow in coronary branches. Methods The CT angiography (CTA) images of 16 patients were reconstructed, and the volume of each branch of the patient was measured. The total volume of the coronary artery was distributed to each branch outlet by volumetric ratio. The clinical FFR values and the final calculated hemodynamic simulation values were compared, and the accuracy of the commonly used diameter flow model and volume flow distribution method was compared. Results The FFFCT error calculated by the volume method and by the diameter method was 10.47% and 11.76% respectively, and the volume distribution method had the same consistency (80%) with the diameter distribution method. Conclusions This work may provide a new calculation method for clinical non-invasive detection FFR and promote the clinical application of FFRCT.

參考文獻：

[1] Mandelbrot B B. Fractals: form, chance and dimension[J]. Physics Today, 1979, 32(5):65-66.

[2] West G B, Brown J H, Enquist B J. A general model for the origin of allometric scaling laws in biology.[J]. Science, 1997, 276(5309):122-126.

[3] Huo Y, Kassab G S. Intraspecific scaling laws of vascular trees[J]. Journal of the Royal Society Interface, 2012, 9(66):190-200.

[4] Huo Y, Kassab G S. Scaling laws of coronary circulation in health and disease[J]. Journal of Biomechanics, 2016, 49(12):2531-2539.

[5] 姜宗來, 何光麓. 人冠狀動脈的幾何形態(tài)學[J]. 第三軍醫(yī)大學學報, 1989,11(2):85-91.

Jiang ZL, He GL. Geometric Morphology of Human Coronary Artery[J]. Journal of Third Military Medical University, 1989(2): 85-91.

[6] Miyoshi T, Osawa K, Ito H, et al. Non-invasive computed fractional flow reserve from computed tomography (CT) for diagnosing coronary artery disease – Japanese results from NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps)[J]. Circulation Journal, 2015, 79(2):406-412.

[7] 喬愛科, 侯映映, 侯陽. 冠狀動脈狹窄幾何構(gòu)型對血流儲備分數(shù)影響的有限元分析[J]. 中國生物醫(yī)學工程學報. 2015, 34(2): 198-203.

Qiao AK, Hou YY, Hou Y. Finite element analysis of the influence of geometric configuration of coronary artery stenosis on blood flow reserve fraction[J]. Chinese Journal of Biomedical Engineering, 2015, 34(2): 198-203.

[8] Morris P D, Ryan D, Morton A C, et al. Virtual fractional flow reserve from coronary angiography: modeling the significance of coronary lesions: results from the VIRTU-1 (Virtual Fractional Flow Reserve From Coronary Angiography) study[J]. Jacc Cardiovasc Interv, 2013, 6(2):149-157.

[9] Morris PD, van de Vosse FN, et al. “Virtual” (Computed) Fractional Flow Reserve[J]. Jacc Cardiovascular Interventions, 2015, 8(8):1009-1017.

[10] Pijls NH, van Son JA, Kirkeeide R L, et al. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty[J]. Circulation, 1993, 87(4):1354.

[11] Pijls NH, De BB, Peels K, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses[J]. New England Journal of Medicine, 1996, 334(26):1703.

[12] Tu S, Echavarriapinto M, Von BC, et al. Fractional flow reserve and coronary bifurcation anatomy: a novel quantitative model to assess and report the stenosis severity of bifurcation lesions[J]. Jacc Cardiovasc Interv, 2015, 8(4):564-574.

[13] Taylor CA, Fonte T A, Min JK. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis[J]. Journal of the American College of Cardiology,2013,61(22),2233-2241.

[14] N?rgaard BL, Leipsic J, Gaur S, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps)[J]. Journal of the American College of Cardiology, 2014, 63(12):1145-1155.

[15] Min J K, Taylor CA, Achenbach S, et al. Noninvasive fractional flow reserve derived from coronary CT angiography: clinical data and scientific principles[J]. Jacc Cardiovascular Imaging,2015,8(10),1209-1222.

[16] Uren NG, Melin JA, De BB, et al. Relation between myocardial blood flow and the severity of coronary-artery stenosis[J]. New England Journal of Medicine，1994，330(25)： 1782-1788.

[17] Zhang J M, Zhong L, Luo T, et al. Simplified models of non-invasive fractional flow reserve based on CT images[J]. Plos One,2016,11(5): e0153070.

[18] 李榮娟, 蘇武錦. Bland-Altman分析法在臨床檢驗方法比較的實例應用和繪圖介紹[J]. 國際檢驗醫(yī)學雜志, 2013, 34(20):2727-2729.

Li RJ, Su WJ. An example application and mapping of Bland-Altman analysis in the comparison of clinical test methods[J]. International Journal of Laboratory Medicine, 2013, 34(20): 2727-2729.

[19] 高昊, 劉建平, 仝識非, 等. 心肌聲學造影對冠脈狹窄臨界病變的功能性診斷價值[J]. 第三軍醫(yī)大學學報, 2018, 40(7):603-609.

Gao H, Liu JP, Tong SF, et al. Functional diagnostic value of myocardial contrast echocardiography for critical lesions of coronary artery stenosis[J]. Journal of Third Military Medical University, 2018, 40(7): 603-609.

服務與反饋：

【文章下載】【加入收藏】

提示：您還未登錄，請登錄！點此登錄

51黑料吃瓜在线观看,51黑料官网|51黑料捷克街头搭讪_51黑料入口最新视频