Fractional flow reserve measurement based on coronary angiographic images

基于冠状动脉造影图像的血流储备分数测量

• 批准号: 7469780
• 负责人: SABEE MOLLOI
• 金额: $ 43.23万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7469780
• 关键词: Algorithms; Anatomy; Angiography; Arteriogram; Arteriographies; Atherosclerosis; Autopsy; Blood flow; Caliber; Cardiac Catheterization Procedures; Chest Pain; Coronary; Coronary Arteriosclerosis; Coronary Stenosis; Coronary artery; Data; Development; Heart; Human; Image; Interobserver Variability; Investigation; Ischemia; Laboratories; Lesion; Measurement; Measures; Methods; Pathologic; Patients; Physiological; Regional Blood Flow; Research; Severities; Stenosis; Sum; Techniques; Trees; Visual; base; improved; public health relevance

DESCRIPTION (provided by applicant): Coronary arteriography is the standard method for determination of coronary anatomy and assessment of atherosclerosis. However, there are definite limitations to the use of visual estimation to assess the severity of coronary artery disease and luminal stenosis. These limitations include the large intraobserver and interobserver variability that result from subjective visual grading of coronary stenotic lesions. This is especially true in the case of an intermediate coronary lesion (30%-70% diameter stenosis), where coronary arteriography is very limited in distinguishing ischemia-producing intermediate coronary lesions from non- ischemia-producing ones. Furthermore, pathologic findings have shown a lack of correlation between the severity of coronary stenosis as estimated from coronary arteriogram and the actual severity of stenotic lesions measured in postmortem hearts. Because of the major limitations of standard coronary arteriography, a method for functional measure of stenosis severity such as measurement of fractional flow reserve obtainable during cardiac catheterization is desirable. The fractional flow reserve measurement would provide valuable functional information in addition to the anatomical data obtained during routine coronary arteriography. The purpose of this research plan is to develop a technique for quantification of fractional flow reserve by combining the first pass distribution algorithm with regional lumen volume measurement technique and its implementation in the cardiac catheterization laboratory. More specifically, the aims are: (1) Investigation of the hypothesis that the sum of arterial lumen volume can be used to predict the maximum hyperemic blood flow into the coronary artery tree. (2) Investigation of the hypothesis that fractional flow reserve can be measured using the sum of lumen volume and measured blood flow from angiographic images. (3) Implementation of the fractional flow reserve measurement technique in the cardiac catheterization laboratory for human studies. The results of this research will provide improved physiological methods of quantitating coronary artery stenosis severity in patients. This quantification technique could be used to measure fractional flow reserve in patients undergoing standard coronary arteriography. PUBLIC HEALTH RELEVANCE. Angiography is the standard method for determination of coronary anatomy and assessment of atherosclerosis. However, there are definite limitations to the use of visual estimation to assess the severity of coronary artery disease and luminal stenosis. These limitations include the large observer variability that result from subjective visual grading of coronary stenotic lesions. This is especially true in the case of an intermediate coronary lesion (30%-70% diameter stenosis), where angiography is very limited in distinguishing whether a coronary lesions is the cause of chest pain. Because of the major limitations of standard coronary arteriography, a method for functional measure of stenosis severity such as measurement of fractional flow reserve obtainable during cardiac catheterization is desirable. The fractional flow reserve measurement would provide valuable functional information in addition to the anatomical data obtained during routine coronary arteriography. The purpose of this research plan is to develop a technique for quantification of fractional flow reserve by combining the regional blood flow and lumen volume measurement technique and its implementation in the cardiac catheterization laboratory. The results of this research will provide improved physiological methods for quantification of coronary artery stenosis severity in patients. This quantification technique could be used to measure fractional flow reserve in patients undergoing standard coronary arteriography.

描述（由申请人提供）：冠状动脉造影是确定冠状动脉解剖结构和评估动脉粥样硬化的标准方法。然而，使用视觉估计来评估冠状动脉疾病和管腔狭窄的严重程度有一定的局限性。这些局限性包括由于冠状动脉狭窄病变的主观视觉分级而导致观察者内和观察者间的巨大变异性。这在中间冠状动脉病变（30%-70%直径狭窄）的情况下尤其如此，其中冠状动脉造影在区分产生缺血的中间冠状病变和非缺血的中间冠状病变方面非常有限。此外，病理结果表明，根据冠状动脉造影估计的冠状动脉狭窄严重程度与死后心脏中测量的狭窄病变的实际严重程度之间缺乏相关性。由于标准冠状动脉造影的主要局限性，需要一种用于狭窄严重程度的功能测量的方法，例如测量心导管插入术期间可获得的血流储备分数。除了在常规冠状动脉造影期间获得的解剖数据之外，血流储备分数测量还将提供有价值的功能信息。本研究计划的目的是开发一种将首过分布算法与区域腔体积测量技术相结合的血流储备分数量化技术，并在心导管实验室中实施。更具体地说，目标是：（1）研究动脉管腔容积之和可用于预测进入冠状动脉树的最大充血血流量的假设。 (2) 研究可以使用血管造影图像中的管腔体积和测量的血流量之和来测量血流储备分数的假设。 (3) 在人体研究心导管实验室中实施血流储备分数测量技术。这项研究的结果将为定量患者冠状动脉狭窄严重程度提供改进的生理学方法。这种量化技术可用于测量接受标准冠状动脉造影的患者的血流储备分数。公共卫生相关性。血管造影是确定冠状动脉解剖结构和评估动脉粥样硬化的标准方法。然而，使用视觉估计来评估冠状动脉疾病和管腔狭窄的严重程度有一定的局限性。这些局限性包括由于冠状动脉狭窄病变的主观视觉分级而导致观察者的巨大差异。在冠状动脉中间病变（直径狭窄30%-70%）的情况下尤其如此，血管造影在区分冠状动脉病变是否是胸痛的原因方面非常有限。由于标准冠状动脉造影的主要局限性，需要一种用于狭窄严重程度的功能测量的方法，例如测量心导管插入术期间可获得的血流储备分数。除了在常规冠状动脉造影期间获得的解剖数据之外，血流储备分数测量还将提供有价值的功能信息。本研究计划的目的是通过结合局部血流和管腔体积测量技术及其在心导管实验室的实施，开发一种血流储备分数的量化技术。这项研究的结果将为量化患者冠状动脉狭窄严重程度提供改进的生理学方法。这种量化技术可用于测量接受标准冠状动脉造影的患者的血流储备分数。