METHOD OF DETERMINING THE BLOOD FLOW THROUGH CORONARY ARTERIES

• US 20150297161A1
• Filed: 11/21/2013
• Published: 10/22/2015
• Est. Priority Date: 12/11/2012
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: GRASS, Michael, SCHMITT, Holger, NICKISCH, Hannes
• Granted Patent: US 9,867,584 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/482 involving multiple energy imaging
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/5205 involving processing of raw data to produce diagnostic data
• CPC Class Codes: A61B 6/5217 extracting a diagnostic or physiological parameter from medical diagnostic data
• CPC Class Codes: A61B 6/5288 involving retrospective matching to a physiological signal
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: G06T 2207/10081 Computed x-ray tomography [CT]
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 2207/30104 Vascular flow; Blood flow; Perfusion
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A method of determining the blood flow through coronary arteries comprises generating (S1) a 3D image data set of at least the coronary arteries and the myocardial muscle, generating (S2) a 3D marker data set of at least the myocardial muscle from a dual-energy or spectral 3D data set obtained after administration of a marker, said 3D marker data set indicating the amount of said marker contained within voxels of said myocardial muscle, subdividing (S3) the myocardial muscle into myocardial muscle segments, determining (S4) which coronary artery supplies the respective myocardial muscle segments, determining (S5) the volume of blood that flows into the respective myocardial muscle segments from said 3D marker data set, and determining (S6) the total volume of blood that flows into a coronary artery of interest by summing the volume of blood flowing into all myocardial muscle segments supplied by said coronary artery.

Claims

1. A method of determining the blood flow through coronary arteries, comprising

generating a 3D image data set of at least the coronary arteries and the myocardial muscle,

generating a 3D marker data set of at least the myocardial muscle from a dual-energy or spectral 3D data set obtained after administration of a marker, said 3D marker data set indicating the amount of said marker contained within voxels of said myocardial muscle,

subdividing the myocardial muscle into myocardial muscle segments using a segmentation model,

determining which coronary artery supplies the respective myocardial muscle segments by assuming that a coronary artery in a subdivided myocardial muscle segment supplies the myocardial muscle segment arranged in the same subdivided myocardial muscle segment,

determining the volume of blood that flows into the respective myocardial muscle segments from said 3D marker data set, and

determining the total volume of blood that flows into a coronary artery of interest by summing the volume of blood flowing into all myocardial muscle segments supplied by said coronary artery.

2. The method as claimed in claim 1, wherein said 3D image data sets of at least the coronary arteries and the myocardial muscle and the 3D marker data set of at least the myocardial muscle are generated from a dual-energy or spectral 3D data set acquired by use of a dual-energy or spectral CT scanner.

3. The method as claimed in claim 1, further comprising the steps of

determining the total volume of blood ejected by the heart during one cardiac cycle from at least two 3D image data sets of the heart, wherein a first 3D image data set is obtained at a state of substantially maximal filling of the heart and a second 3D image data set is obtained at a state of substantially minimal filling of the heart,

determining the total volume of blood that flows into all coronary arteries by summing the volume of blood flowing into all myocardial muscle segments, and

determining the total volume of blood that flows into the aorta by subtracting the total volume of blood that flows into all coronary arteries from the total volume of blood ejected by the heart during one cardiac cycle.

4. The method as claimed in claim 1, further comprising the step of using said total volume of blood that flows into a coronary artery to determine the fractional flow reserve in or along said coronary artery.

5. The method as claimed in claim 4, wherein said fractional flow reserve is determined by use of a computational fluid dynamics computation, an analytical pressure calculation model or a reduced order parameter model.

6. The method as claimed in claim 1, wherein the myocardial muscle is subdivided into myocardial muscle segments by use of a 17-segment model.

7. The method as claimed in claim 1, wherein the myocardial muscle is subdivided into myocardial muscle segments by use of patient-individual model and/or from at least one of said at least two 3D image data sets.

8. The method as claimed in claim 1, wherein the cross section and/or the resistance of coronary arteries is additionally used in the step determining the total volume of blood that flows into a coronary artery of interest.

9. The method as claimed in claim 1, further comprising the steps of

segmenting the left ventricle within said 3D image data set,

determining the total volume of blood ejected by the heart from the segmented left ventricle,

determining the total volume of blood that flows into all coronary arteries by summing the volume of blood flowing into all myocardial muscle segments, and

determining the total volume of blood that flows into the aorta by subtracting the total volume of blood that flows into all coronary arteries from the total volume of blood ejected by the heart during one cardiac cycle.

10. The method as claimed in claim 2, further comprising the step of acquiring said dual-energy or spectral 3D data set by use of a dual-energy or spectral CT scanner.

11. The method as claimed in claim 1, further comprising the steps of

generating a plurality of 3D marker data sets of at least the myocardial muscle from a plurality of dual-energy or spectral 3D data sets obtained at consecutive times after said administration of said marker,

determining the volume of blood that flows into the respective myocardial muscle segments over time from said plurality of 3D marker data set,

determining the volume of blood that flows into a coronary artery of interest over time by summing the volume of blood flowing into all myocardial muscle segments supplied by said coronary artery at the respective consecutive times.

12. The method as claimed in claim 1, further comprising the steps of

generating a plurality of 3D marker data sets of at least the myocardial muscle, the coronary arteries and the heart from a plurality of dual-energy or spectral 3D data sets obtained at consecutive times after said administration of said marker and

performing a fractional flow reserve simulation at a plurality of consecutive points in time.

14. An imaging device comprising:

an acquisition unit for acquiring a dual-energy or spectral 3D data set,

a processor as claimed in claim 12 for determining the blood flow through a coronary arteries, and

an output unit for outputting the determined total volume of blood that flows into a coronary artery of interest.

15. A computer program comprising program code means for causing a computer to carry out the steps of the method as claimed in claim 1 when said computer program is carried out on the computer.

13. A processor for determining the blood flow through coronary arteries, said processor being configured to

generate a 3D image data set of at least the coronary arteries and the myocardial muscle,

generate a 3D marker data set of at least the myocardial muscle from a dual-energy or spectral 3D data set obtained after administration of a marker, said 3D marker data set indicating the amount of said marker contained within voxels of said myocardial muscle,

subdivide the myocardial muscle into myocardial muscle segments usine a segmentation model,

determine which coronary artery supplies the respective myocardial muscle segments by assuming that a coronary artery in a subdivided myocardial muscle segment supplies the myocardial muscle segment arranged in the same subdivided myocardial muscle segment,

determine the volume of blood that flows into the respective myocardial muscle segments from said 3D marker data set, and

determine the total volume of blood that flows into a coronary artery of interest by summing the volume of blood flowing into all myocardial muscle segments supplied by said coronary artery.