On-site evaluation of CT-based fractional flow reserve using simple boundary conditions for computational fluid dynamics
On-site evaluation of CT-based fractional flow reserve using simple boundary conditions for computational fluid dynamics
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使用计算流体动力学的简单边界条件对基于 CT 的分数流量储备进行现场评估
DOI：
10.1007/s10554-019-01709-3
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Naritatsu
中科院分区：
文献类型：
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作者：
Yoshikawa;Yusuke Nakamoto;Masahiko Nakamura;Masanori Hoshi;Takeharu Yamamoto;Erika Imai;Shunsuke Kawase;Yoshiaki Okubo;Munenori Shiomi;Hiroki Kondo;Takeshi Matsuo;Hitoshi Kimura;Takeshi Saito;Naritatsu
血流储备分数（FFR）是诊断生理性冠状动脉狭窄的既定方法。最近开发了一种使用冠状动脉计算机断层扫描（CT）图像计算FFR的方法。然而，它的计算需要场外超级计算机分析。在这里，我们报告的方法使用简单的边界条件估计的初步结果。冠状动脉的管腔边界是使用CT数字轮廓的半高全宽半自动描绘的。使用冠状动脉口处的固定压力和每个出口处的流速的边界条件进行血流的计算流体动力学（CFD）。基于均匀壁面剪切应力假设估计冠状动脉口处的总流入量，并使用充血乘数进行校正以获得充血流速。根据默里定律确定从母血管到下游子血管的流量分布。通过计算流体力学估算的血流储备分数计算为：FFRCFD= Pd/Pa。我们收集了接受冠状动脉CT和冠状动脉血管造影术的患者，随后进行了有创性FFR测量，并将FFFCFD与FFR进行了比较。敏感性，特异性和相关性进行了评估。共评估了48例患者和72条动脉。FFRFCFD与FFR的相关系数为0.56。临界值≤ 0.80，敏感性为59.1%，特异性为94.0%。使用简单边界条件进行现场临床计算的基于CFD的FFR提供了与侵入性测量的FFR中度相关的FFRFCFD值。
Fractional flow reserve (FFR) is an established method for diagnosing physiological coronary artery stenosis. A method for computing FFR using coronary computed tomography (CT) images was recently developed. However, its calculation requires off-site supercomputer analysis. Here, we report the preliminary result of a method using simple estimation of boundary conditions. The lumen boundaries of the coronary arteries were semi-automatically delineated using full width at half maximum of CT number profiles. The computational fluid dynamics (CFD) of the blood flow was performed using the boundary conditions of a fixed pressure at the coronary ostium and flow rates at each outlet. The total inflow at the coronary ostium was estimated based on the uniform wall shear stress hypothesis and corrected using a hyperemic multiplier to gain a hyperemic flow rate. The flow distribution from a parent vessel to the downstream daughter vessels was determined according to Murray’s law. FFR estimated by CFD was calculated as FFRCFD= Pd/Pa. We collected patients who underwent coronary CT and coronary angiography followed by invasively measured FFR and compared FFRCFDwith FFR. Sensitivity, specificity, and correlations were assessed. A total of 48 patients and 72 arteries were assessed. The correlation coefficient of FFRCFDwith FFR was 0.56. The cut-off value was ≤ 0.80, sensitivity was 59.1%, and specificity was 94.0%. CFD-based FFR using simple boundary conditions for on-site clinical computation provided FFRCFDvalues that were moderately correlated with invasively measured FFR.