冠状动脉树重建扩大到较小动脉提高FFRCT准确性的研究  

Clinical Study of Expanding Coronary Tree Reconstruction to Smaller Arteries to Improve the Accuracy of FFRCT

作　　者：周建昌[1] 纪丽萍[1] 蒙志宏[1] 张帆[1] 曹宇佳[1] ZHOU Jian-chang;JI Li-ping;MENG Zhi-hong;ZHANG Fan;CAO Yu-jia(Department of Medical Imaging,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China)

机构地区：[1]河北北方学院附属第二医院医学影像科,河北张家口075100

出　　处：《中国CT和MRI杂志》2024年第8期54-56,共3页Chinese Journal of CT and MRI

基　　金：河北省卫生健康委科研基金项目(20231469)。

摘　　要：目的本研究旨在通过在计算流体动力学(CFD)领域扩展冠脉树来提高基于冠状动脉CT血管成像(coronary CT angiography,CCTA)的血流储备分数(FFR)的准确性。进行了一项观察性研究,以评估将冠状动脉树分析从最小直径1.2mm扩展到0.8 mm的效果。方法对接受CCTA和介入性FFR治疗的患者进行回顾性研究。76名患者符合纳入标准。重建三维冠状动脉树,生成具有不同管腔直径下限(1.2 mm和0.8 mm)的有限元网格。根据Murray定律定义了出口边界条件。应用NKS方法求解CFD控制方程,得到FFRCT。结果在个体患者水平上,将冠状动脉树的最小直径从1.2mm扩大到0.8mm,FFRCT的灵敏度提高了16.7%(P=0.022),这导致四个假阴性病例转变为真阳性病例。ROC曲线的AUC值由0.74增至0.83。此外,NKS方法可以解决在2160个处理器核的情况下,在10.5分钟内将冠状动脉树扩展到0.8 mm管腔直径的计算问题。结论将重建的冠脉扩大到较小的管腔直径可以显著提高FFRCT的敏感性,NKS方法可以为未来的临床应用提供良好的计算时间。Objective This study aims to improve the accuracy of coronary CT angiography(CCTA)based blood flow reserve fraction(FFR)by expanding the coronary tree in the field of computational fluid dynamics(CFD).A Observational study was conducted to evaluate the effect of expanding the coronary tree analysis from a minimum diameter of 1.2 mm to 0.8 mm.Methods A retrospective study was conducted on patients receiving CCTA and interventional FFR treatment.76 patients met the inclusion criteria.Reconstruct a three-dimensional coronary artery tree and generate a finite element mesh with different lower limits of lumen diameter(1.2 mm and 0.8 mm).The exit boundary conditions are defined according to Murray's law.Apply the NKS method to solve the CFD control equation and obtain FFRCT.Results At the individual patient level,expanding the minimum diameter of the coronary artery tree from 1.2mm to 0.8mm increased the sensitivity of FFRCT by 16.7%(P=0.022),resulting in four false negative cases turning into true positive cases.AUC value of Receiver operating characteristic increased from 0.74 to 0.83.In addition,the NKS method can solve the computational problem of expanding the coronary artery tree to 0.8 mm lumen diameter within 10.5 minutes with 2160 processor cores.Conclusion Expanding the reconstructed coronary artery to a smaller lumen diameter can significantly improve the sensitivity of FFRCT,and the NKS method can provide good computational time for future clinical applications.

关 键 词：冠状动脉狭窄 心肌血流储备分数 计算机断层血管造影术 流体力学 

分 类 号：R543.5[医药卫生—心血管疾病]