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: 7884503
• 负责人: SABEE MOLLOI
• 金额: $ 43.46万
• 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 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7884503
• 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）：冠状动脉造影术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。这些局限性包括由冠状动脉狭窄病变的主观视觉分级导致的观察者内和观察者间的较大变异性。在中度冠状动脉病变（直径狭窄30%-70%）的情况下尤其如此，其中冠状动脉造影术在区分缺血产生的中度冠状动脉病变与非缺血产生的病变方面非常有限。此外，病理结果表明，冠状动脉狭窄的严重程度之间缺乏相关性，估计从冠状动脉造影和狭窄病变的实际严重程度测量在死后的心脏。由于标准冠状动脉造影术的主要局限性，需要一种用于狭窄严重程度的功能测量的方法，例如在心导管插入术期间可获得的血流储备分数的测量。血流储备分数的测量将提供有价值的功能信息，除了在常规冠状动脉造影获得的解剖数据。本研究计划的目的是开发一种将首过分布算法与局部管腔容积测量技术相结合的血流储备分数定量技术，并在心导管实验室中实施。更具体地说，目的是：（1）调查的假设，动脉管腔容积的总和可以用来预测最大充血血流量进入冠状动脉树。(2)研究假设血流储备分数可以使用管腔容积和血管造影图像中测得的血流量之和进行测量。(3)血流储备分数测量技术在心导管实验室中的应用。本研究的结果将提供一种改进的生理学方法来量化患者冠状动脉狭窄的严重程度。这种量化技术可用于测量接受标准冠状动脉造影术的患者的血流储备分数。公共卫生相关性。血管造影术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。这些局限性包括冠状动脉狭窄病变的主观视觉分级导致的较大观察者变异性。在中度冠状动脉病变（直径狭窄30%-70%）的情况下尤其如此，其中血管造影术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术的主要局限性，需要一种用于狭窄严重程度的功能测量的方法，例如在心导管插入术期间可获得的血流储备分数的测量。血流储备分数的测量将提供有价值的功能信息，除了在常规冠状动脉造影获得的解剖数据。本研究计划的目的是通过结合局部血流和管腔容积测量技术及其在心导管实验室的实施，开发一种用于定量血流储备分数的技术。本研究的结果将为冠状动脉狭窄程度的量化提供更好的生理学方法。这种量化技术可用于测量接受标准冠状动脉造影术的患者的血流储备分数。

项目成果

Assessment of coronary microcirculation in a swine animal model.

• DOI: 10.1152/ajpheart.00213.2011
• 发表时间: 2011-08
• 期刊: American journal of physiology. Heart and circulatory physiology
• 作者: Zhang Zhang-Zhang;Shigeho Takarada;S. Molloi

Quantification of coronary microvascular resistance using angiographic images for volumetric blood flow measurement: in vivo validation.

• DOI: 10.1152/ajpheart.01123.2010
• 发表时间: 2011-06
• 期刊: American journal of physiology. Heart and circulatory physiology
• 作者: Zhang Zhang-Zhang;Shigeho Takarada;S. Molloi

Quantification of fractional flow reserve based on angiographic image data.

• DOI: 10.1007/s10554-010-9767-0
• 发表时间: 2012-01
• 期刊: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
• 影响因子: 2.1
• 作者: Wong, Jerry T.;Le, Huy;Suh, William M.;Chalyan, David A.;Mehraien, Toufan;Kern, Morton J.;Kassab, Ghassan S.;Molloi, Sabee
• 通讯作者: Molloi, Sabee

Imaging of nanoparticles with dual-energy computed tomography.

• DOI: 10.1088/0031-9155/56/7/008
• 发表时间: 2011-04-07
• 期刊: Physics in medicine and biology
• 影响因子: 3.5
• 作者: Ducote JL;Alivov Y;Molloi S
• 通讯作者: Molloi S

An angiographic technique for coronary fractional flow reserve measurement: in vivo validation.

• DOI: 10.1007/s10554-012-0119-0
• 发表时间: 2013-03
• 期刊: The international journal of cardiovascular imaging
• 作者: Takarada S;Zhang Z;Molloi S
• 通讯作者: Molloi S