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CN110384493A - Measure the system and coronary artery analysis system of microcirculation drag index - Google Patents

Measure the system and coronary artery analysis system of microcirculation drag index Download PDF

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Publication number
CN110384493A
CN110384493A CN201910704327.XA CN201910704327A CN110384493A CN 110384493 A CN110384493 A CN 110384493A CN 201910704327 A CN201910704327 A CN 201910704327A CN 110384493 A CN110384493 A CN 110384493A
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module
image
measuring
coronary artery
coronary
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Inventor
刘广志
王之元
戴威
曹文斌
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Suzhou Yun Medsphere Co Ltd
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Suzhou Yun Medsphere Co Ltd
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Priority claimed from CN201811093192.XA external-priority patent/CN109363651A/en
Priority claimed from CN201910206541.2A external-priority patent/CN109770888A/en
Application filed by Suzhou Yun Medsphere Co Ltd filed Critical Suzhou Yun Medsphere Co Ltd
Priority to CN201910704327.XA priority Critical patent/CN110384493A/en
Priority to PCT/CN2019/102259 priority patent/WO2020057324A1/en
Publication of CN110384493A publication Critical patent/CN110384493A/en
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Abstract

This application provides a kind of systems and coronary analysis system for measuring microcirculation drag index, comprising: three-dimensional modeling apparatus, invasive blood pressure sensor and IMR measuring device, IMR measuring device are connect with three-dimensional modeling apparatus, invasive blood pressure sensor；Three-dimensional modeling apparatus measures the length L of the blood vessel in heart beat cycle region, three-dimensional modeling obtains coronary artery three-dimensional structure for reading coronarogram picture；Invasive blood pressure sensor is for measuring coronary artery inlet pressure Pa；IMR measuring device is used for blood vessel under maximum congestive state, the pressure drop Δ P and blood flow velocity V of measurement coronary artery entrance to coronary stenosis distal endh, calculate microcirculation resistance coefficient IMR, IMR=(Pa- Δ Pi)×L/Vh.The application reduces operating difficulty and risk without coronary stricture distal end is needed guiding through；And the measurement of IMR is realized by contrastographic picture, the blank in industry is compensated for, is operated simpler.

Description

System for measuring microcirculation resistance index and coronary artery analysis system
Technical Field
The invention relates to the technical field of coronary artery medicine, in particular to a system for measuring microcirculation resistance index and a coronary artery analysis system.
Background
The effects of coronary microcirculation dysfunction on myocardial ischemia are gradually being noticed, and the coronary system is composed of epicardial coronary arteries and microcirculation.
Generally, the myocardial ischemia caused by epicardial coronary stenosis at a level of 50% or more is clinically diagnosed as coronary heart disease. However, clinical studies have shown that coronary microcirculation abnormalities can also lead to insufficient blood supply to the myocardium.
Coronary microcirculation refers to the circulation of blood between the arteriole and the venule, and is the place where blood exchanges substances with tissue cells. Research has shown that although coronary blood flow reaches TIMI3 grade after percutaneous coronary intervention, nearly 30% of patients have microvascular dysfunction, resulting in poor prognosis. Therefore, with the continuous and intensive research, it is gradually recognized that coronary microvascular dysfunction is an important mechanism in the pathophysiology of many heart diseases, and it is necessary to accurately evaluate the functional state of coronary microcirculation.
The coronary microcirculation resistance index (index of microcirculation resistance IMR) is an index for evaluating the functional status of coronary microcirculation.
In the existing IMR measuring device, the pressure and the temperature of the coronary artery are synchronously recorded through a soft pressure guide wire, the average transit time (Tmn) of the saline from a guide catheter to the temperature sensor at the head end of the guide wire can be known by detecting the time difference of the temperature change through two temperature sensors on a guide wire rod, and the IMR value can be obtained according to the product of the pressure Pd and the Tmn which define the far end of the coronary artery.
However, the above-mentioned pressure guide wire measurement IMR requires the pressure guide wire to be passed through the distal end of the coronary stenosis, which increases the difficulty and risk of the operation, and the expensive price of the pressure guide wire also limits the large-scale application thereof.
Disclosure of Invention
The invention provides a system for measuring a microcirculation resistance index and a coronary artery analysis system, which aim to solve the problems of high operation difficulty and high risk caused by the fact that a pressure guide wire needs to penetrate through the narrow far end of a coronary artery blood vessel to measure IMR in the prior art.
To achieve the above object, in a first aspect, the present application provides a system for measuring a microcirculation resistance index, comprising: the measuring device comprises a three-dimensional modeling device, an invasive blood pressure sensor and an IMR measuring device, wherein the IMR measuring device is connected with the three-dimensional modeling device and the invasive blood pressure sensor;
the three-dimensional modeling device is used for reading a coronary angiography image, selecting a heartbeat period region of the coronary angiography image, measuring the length L of a blood vessel in the heartbeat period region, and performing three-dimensional modeling to obtain a three-dimensional structure of the coronary artery;
the invasive blood pressure sensor is used for measuring coronary artery inlet pressure Pa;
the IMR measuring device is used for measuring the pressure drop delta P from the coronary artery inlet to the distal end of coronary artery stenosis under the maximum hyperemia state of the blood vesseliAnd measuring the blood flow velocity VhReading the length L and the coronary inlet pressure Pa, and calculating the microcirculation resistance coefficient IMR, wherein the calculation formula is as follows:
IMR＝(Pa-ΔPi)×L/Vh。
optionally, in the system for measuring a microcirculation resistance index, the three-dimensional modeling device includes an image reading module and a segmentation module, a blood vessel length measuring module and a three-dimensional modeling module, the segmentation module is connected with the image reading module, the blood vessel length measuring module and the three-dimensional modeling module, and the blood vessel length measuring module is connected with the IMR measuring device;
the image reading module is used for reading a contrast image;
the segmentation module is used for selecting a heartbeat period region of the coronary angiography image;
the blood vessel length measuring module is used for measuring the length L of a blood vessel in the heartbeat cycle region and transmitting the length L of the blood vessel to the IMR measuring device;
and the three-dimensional modeling module is used for carrying out three-dimensional modeling according to the coronary angiography image selected by the segmentation module to obtain a three-dimensional structure of the coronary artery.
Optionally, in the system for measuring a microcirculation resistance index, the IMR measuring device includes a pressure drop measuring module, a blood flow velocity measuring module, and an IMR calculating module, and the pressure drop measuring module, the blood flow velocity measuring module, the invasive blood pressure sensor, and the blood vessel length measuring module are all connected to the IMR calculating module;
the pressure drop measuring module is used for measuring the pressure drop delta P from the coronary artery inlet to the distal end of the coronary artery stenosis under the maximum hyperemia state of the blood vesseli；
The blood flow velocity measuring module is used for measuring the blood flow velocity V of the blood vessel in the maximum hyperemia stateh；
The IMR calculation module is used for calculating the microcirculation resistance coefficient IMR, and the calculation formula is as follows:
IMR＝(Pa-ΔPi)×L/Vh。
optionally, in the system for measuring a microcirculation resistance index, the pressure drop measuring module includes: meshing module and pressure drop Δ PiA calculation module, the pressure drop Δ PiThe computing module is connected with the grid division module and the IMR computing module;
the meshing module is used for meshing the three-dimensional structure of the coronary artery, the coronary artery central line is taken as a longitudinal axis, the mesh is divided into m points along the coronary artery central line, the cross section corresponding to each point of the coronary artery central line is divided into n nodes, and delta P is obtainediThe average value of the pressure of all nodes on the cross section of the ith point on the central line of the coronary artery is represented, namely the pressure drop from the entrance of the coronary artery to the far end of the coronary artery stenosis;
the pressure drop Δ PiThe calculation module is used for calculating by adopting the following formula:
P1representing the pressure value, P, of a first node on a cross-section of an ith point in the three-dimensional structural mesh2Representing the pressure value, P, of a second node on a cross-section of the ith point in the three-dimensional structural meshnThe pressure value of the nth node on the cross section of the ith point is represented, and m and n are positive integers;
and calculating the pressure value of each node by adopting a Navier-Stokes equation.
Optionally, in the system for measuring a resistance to microcirculation index as described above, the blood flow velocity measuring module includes an average blood flow velocityMeasurement module and blood flow velocity VhA calculation module, the mean blood flow velocityA measurement module, an IMR calculation module, a blood flow velocity V and a blood flow velocity VhThe calculation module is connected;
the average blood flow velocityMeasurement module for using contrast agentMeasuring by a traversal distance algorithm, a Stewart-Hamilton algorithm, a First-pass distribution analysis method, an optical flow method or a fluid continuous method; or dividing the heart cycle region into N local region images;
wherein,the average blood flow velocity in the heart cycle region is measured, L represents the length of a blood vessel, N represents the number of frames of local region images into which the heart cycle region is divided, and fps represents the interval time for switching between two adjacent frames of images;
the blood flow velocity VhA computing module for computing based onAnd (4) calculating by using a formula, wherein a and b both represent constants, a represents a constant with a value range of 1-3, and b represents a constant with a value range of 50-300.
Optionally, in the system for measuring the microcirculation resistance index, the value range of L is 50-150 mm; or L100 mm.
Optionally, in the system for measuring a microcirculation resistance index, the three-dimensional modeling apparatus further includes: the coronary artery three-dimensional modeling device comprises an image processing module, a coronary artery central line extraction module and a blood vessel diameter measurement module, wherein the image processing module is connected with the coronary artery central line extraction module, and the three-dimensional modeling module is connected with the coronary artery central line extraction module and the blood vessel diameter measurement module;
the image processing module is used for receiving the coronary angiography images of at least two postures transmitted by the segmentation module and removing interfering blood vessels of the coronary angiography images to obtain a result image;
the coronary artery central line extraction module is used for extracting the coronary artery central line of each result image along the extension direction of the coronary artery;
the blood vessel diameter measuring module is used for extracting the blood vessel diameter;
the three-dimensional modeling module is used for projecting each coronary artery central line and the diameter on a three-dimensional space for three-dimensional modeling to obtain a coronary artery three-dimensional structure.
Optionally, in the system for measuring a microcirculation resistance index, an image denoising module is disposed inside the image processing module, and is configured to denoise the coronary angiography image, and the system includes: static noise and dynamic noise.
Optionally, in the system for measuring a microcirculation resistance index, a catheter feature point extraction module and a coronary artery extraction module, both of which are connected to the coronary artery centerline extraction module, are arranged inside the image processing module, and the coronary artery extraction module is connected to the catheter feature point extraction module;
the catheter feature point extraction module is used for defining a first frame of segmentation image with a catheter as a reference image, defining a kth frame of segmentation image with a complete coronary artery as a target image, wherein k is a positive integer greater than 1; subtracting the target image from the reference image, and extracting a characteristic point O of the catheter;
the coronary artery extraction module is used for subtracting the reference image from the target image and extracting a region image of the position of the coronary artery; and the region image takes the characteristic points of the catheter as seed points to carry out dynamic growth, and the result image is obtained.
Optionally, in the system for measuring a microcirculation resistance index, a first denoising module, a first image enhancement module and a first binarization processing module are sequentially arranged in the catheter feature point extraction module, and the first binarization processing module is connected with the coronary artery extraction module;
the first denoising module is used for subtracting the target image from the reference image and denoising, and comprises: static noise and dynamic noise;
the first image enhancement module is used for enhancing the image of the denoised image;
and the first binarization processing module is used for carrying out binarization processing on the enhanced catheter image to obtain a binarization image with a group of catheter characteristic points O.
Optionally, in the system for measuring a microcirculation resistance index, the coronary artery extraction module includes a second denoising module, a second image enhancement module and an area image extraction module, which are connected in sequence, and the area image extraction module is connected to the first binarization processing module;
the second denoising module is used for subtracting the reference image from the target image and denoising, and comprises: static noise and dynamic noise;
the second image enhancement module is used for enhancing the image of the denoised image;
the region image extraction module is used for determining and extracting a region of a coronary artery according to the position relation between each region in the enhanced target image and the catheter feature point, namely the region image of the position of the coronary artery.
Optionally, in the system for measuring a microcirculation resistance index, the region extracting module includes: the dynamic area growing module is connected with the first binarization processing module;
the second binarization processing module is used for carrying out binarization processing on the region image of the position where the coronary artery is located to obtain a binarization coronary artery image;
the dynamic region growing module is used for performing morphological operation on the binary coronary artery image, taking the feature point of the catheter as a seed point, and performing dynamic region growing on the binary coronary artery image according to the position of the seed point to obtain the result image.
Optionally, the system for measuring a microcirculation resistance index further includes: coronary diastolic blood flow velocity VfThe measuring module and the instantaneous waveless microcirculation resistance index iFMR measuring device, the three-dimensional modeling device, the invasive blood pressure sensor and the coronary diastole blood flowVelocity VfThe measurement module is connected;
the instantaneous waveform-free microcirculation resistance index iFMR measuring device is used for measuring a three-dimensional coronary structure in a waveform-free period and respectively measuring the pressure drop delta P from the coronary inlet to the distal end of coronary stenosis in a diastole waveform-free periodi' and measurement of coronary diastolic blood flow velocity VfReading the length L of the blood vessel and the coronary artery inlet pressure Pa' during the non-waveform diastolic period, and calculating the instantaneous non-waveform microcirculation resistance index iFMR, wherein the calculation formula is as follows:
iFMR＝(Pa’-ΔP′i)×L/Vf；
where L denotes the length of a blood vessel, N denotes the number of frames of a local region image into which a coronary angiography image is divided, and fps' denotes the interval time between two adjacent frames of images in the diastolic waveform-free period.
In a second aspect, the present application provides a coronary artery analysis system comprising a system for measuring a resistance index of microcirculation according to any of the above-mentioned claims.
The beneficial effects brought by the scheme provided by the embodiment of the application at least comprise:
the application provides a system for measuring microcirculation resistance index, including three-dimensional modeling device, invasive blood pressure sensor and IMR measuring device, IMR measuring device with three-dimensional modeling device, invasive blood pressure sensor are connected. Performing three-dimensional modeling by reading a coronary angiography image to obtain a three-dimensional structure of a coronary artery; measuring the pressure drop Δ P from the coronary inlet to the distal end of the coronary stenosis, based on the length L of the blood vessel, the coronary inlet pressure Pa, and the maximum hyperemiaiAnd blood flow velocity VhThen according to the formula IMR ═ Pa- Δ Pi)×L/VhAnd calculating to obtain an IMR value. The coronary artery stenosis monitoring device does not need expanding medicines or pressure guide wire measuring time, only needs to measure the coronary artery inlet pressure, does not need to penetrate through the coronary artery stenosis far end, and reduces the operation difficulty and risk; and realize through contrast imageThe measurement of IMR makes up the blank in the industry, and the operation is simpler.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the invention and not to limit the invention. In the drawings:
FIG. 1 is a block diagram illustrating an embodiment of a system for measuring a microcirculation resistance index according to the present application;
FIG. 2 is a block diagram of the three-dimensional modeling apparatus of the present application;
FIG. 3 is a block diagram of an IMR measurement apparatus according to the present application;
fig. 4 is a block diagram of a blood flow velocity measurement module according to the present application;
FIG. 5 is a block diagram of the three-dimensional modeling apparatus of the present application;
FIG. 6 is a block diagram of an image processing module according to the present application;
FIG. 7 is a block diagram of the catheter feature point extraction module of the present application;
FIG. 8 is a block diagram of the structure of the region image extraction module of the present application;
FIG. 9 is a schematic structural diagram of an invasive blood pressure sensor of the present application;
FIG. 10 is a reference image;
FIG. 11 is a target image to be segmented;
FIG. 12 is another target image to be segmented;
FIG. 13 is an enhanced catheter image;
FIG. 14 is a binarized image of catheter feature points;
FIG. 15 is an enhanced target image;
FIG. 16 is an image of a region where a coronary artery is located;
FIG. 17 is a resulting image;
FIG. 18 is a cross-sectional view of a screenshot;
FIG. 19 is a longitudinal sectional view of a screen shot;
FIG. 20 is two postural contrast images;
the left image of fig. 21 is a plot of blood vessel length versus blood vessel diameter;
FIG. 22 is a three-dimensional block diagram of the coronary artery created from FIG. 21 in combination with postural angles and coronary centerlines;
FIG. 23 is a graph showing the number of frames of a cut image;
FIG. 24 is a coronary inlet pressure test chart;
FIG. 25 is an IMR test chart;
FIG. 26 is an iFMR test chart;
FIG. 27 is a block diagram of another embodiment of a system for measuring a microcirculation resistance index according to the present application;
the following reference numerals are used for the description:
the three-dimensional modeling device 100, the image reading module 110, the segmentation module 120, the blood vessel length measurement module 130, the three-dimensional modeling module 140, the image processing module 150, the image denoising module 151, the catheter feature point extraction module 152, the first denoising module 1521, the first image enhancement module 1522, the first binarization processing module 1523, the coronary artery extraction module 153, the second denoising module 1531, the second image enhancement module 1532, the region image extraction module 1533, the second binarization processing module 15331, the dynamic region growth module 15332, the coronary artery centerline extraction module 160, the blood vessel diameter measurement module 170, the invasive blood pressure sensor 200, the pressure sensing chip 1, the peristaltic pump head 2, the hose 3, the luer connector 4, the laser emitter 5, the display screen 6 and the one-way valve 7; IMR measurement device 300, pressure drop measurement module 310, meshing module 311, pressure drop Δ PiCalculation module 312, blood flow velocity measurement module 320, average blood flow velocityMeasurement Module 321, blood flow velocity VhComputing module 322, IMR computing module 330, coronary diastolic blood flow velocity VfThe measurement module 400 is an instantaneous waveform-free microcirculation resistance index iFMR measurement device 500.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the specific embodiments of the present invention and the accompanying drawings. It is to be understood that the described embodiments are merely exemplary of the invention, and not restrictive of the full scope of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
In the following description, for purposes of explanation, numerous implementation details are set forth in order to provide a thorough understanding of the various embodiments of the present invention. It should be understood, however, that these implementation details are not to be interpreted as limiting the invention. That is, in some embodiments of the invention, such implementation details are not necessary. In addition, some conventional structures and components are shown in simplified schematic form in the drawings.
As shown in fig. 1, the present application provides a system for measuring a microcirculation resistance index, comprising: the three-dimensional modeling device 100, the invasive blood pressure sensor 200 and the IMR measuring device 300, wherein the IMR measuring device 300 is connected with the three-dimensional modeling device 100 and the invasive blood pressure sensor 200; the three-dimensional modeling device 100 is used for reading a coronary angiography image, selecting a heartbeat period region of the coronary angiography image, measuring the length L of a blood vessel in the heartbeat period region, and performing three-dimensional modeling to obtain a three-dimensional structure of the coronary artery; the invasive blood pressure sensor 200 is used for measuring coronary artery inlet pressure Pa; the IMR measurement device 300 is used for measuring the pressure drop delta P from the coronary artery inlet to the distal part of the coronary artery stenosis under the maximum hyperemia state of the blood vesseliAnd measuring the blood flow velocity VhReading the length L and the coronary inlet pressure Pa, and calculating the microcirculation resistance coefficient IMR, wherein the calculation formula is as follows: IMR ═ P (Pa- Δ P)i)×L/Vh。
In one embodiment of the application, in order to simplify the algorithm and accuracy of IMR, L is 50-150 mm; in another embodiment of the application, L is 80-120 mm; further, L is 100 mm.
The application provides a system for measuring microcirculation resistance index, which comprises a three-dimensional modeling device 100, an invasive blood pressure sensor 200 andthe IMR measuring device 300 is connected to the three-dimensional modeling device 100 and the invasive blood pressure sensor 200, and the IMR measuring device 300 is connected to the three-dimensional modeling device 100. Performing three-dimensional modeling by reading a coronary angiography image to obtain a three-dimensional structure of a coronary artery; measuring the pressure drop Δ P from the coronary inlet to the distal end of the coronary stenosis, based on the length L of the blood vessel, the coronary inlet pressure Pa, and the maximum hyperemiaiAnd blood flow velocity VhThen according to the formula IMR ═ Pa- Δ Pi)×L/VhAnd calculating to obtain an IMR value. The coronary artery stenosis monitoring device does not need expanding medicines or pressure guide wire measuring time, only needs to measure the coronary artery inlet pressure, does not need to penetrate through the coronary artery stenosis far end, and reduces the operation difficulty and risk; and IMR measurement is realized through the contrast image, the blank in the industry is made up, and the operation is simpler.
As shown in fig. 2, in an embodiment of the present application, the three-dimensional modeling apparatus 100 includes an image reading module 110, a segmentation module 120, a blood vessel length measurement module 130, and a three-dimensional modeling module 140, the segmentation module 120 is connected to the image reading module 110, the blood vessel length measurement module 130, and the three-dimensional modeling module 140, and the blood vessel length measurement module 130 is connected to the IMR measurement apparatus 300; the image reading module 110 is used for reading a contrast image; the segmentation module 120 is configured to select a heart cycle region of the coronary angiography image; the blood vessel length measuring module 130 is configured to measure a length L of a blood vessel in a heartbeat cycle region, and transmit the length L of the blood vessel to the IMR measuring apparatus 300; the three-dimensional modeling module 140 is configured to perform three-dimensional modeling according to the coronary angiography image selected by the segmentation module 120, so as to obtain a three-dimensional structure of the coronary artery.
As shown in fig. 3, the IMR measuring apparatus 300 includes a pressure drop measuring module 310, a blood flow velocity measuring module 320, and an IMR calculating module 330, wherein the pressure drop measuring module 310, the blood flow velocity measuring module 320, the invasive blood pressure sensor 200, and the blood vessel length measuring module 130 are all connected to the IMR calculating module 330; the pressure drop measuring module 310 is used for measuring the pressure drop deltaP from the coronary artery entrance to the distal end of the coronary artery stenosis under the maximum hyperemia state of the blood vesseli(ii) a The blood flow velocity measurement module 320 is used for measuring the blood flow velocity V under the maximum hyperemia state of the blood vesselh(ii) a IMR calculation Module 330 for computing micro-cyclesThe loop resistance coefficient IMR is calculated according to the following formula: IMR ═ P (Pa- Δ P)i)×L/Vh。
As shown in fig. 3, in one embodiment of the present application, the pressure drop measurement module 310 includes: meshing module 311 and pressure drop Δ PiCalculation Block 312, pressure drop Δ PiThe calculation module 312 is connected to the meshing module 311 and the IMR calculation module 330; as shown in fig. 18 and fig. 19, the meshing module 311 is configured to mesh the three-dimensional structure of the coronary artery, taking the coronary centerline as a longitudinal axis, and dividing the mesh into m points along the coronary centerline, where a cross section corresponding to each point of the coronary centerline is divided into n nodes, Δ PiThe average value of the pressure of all nodes on the cross section of the ith point on the central line of the coronary artery is represented, namely the pressure drop from the entrance of the coronary artery to the far end of the coronary artery stenosis;
the pressure drop Δ PiThe calculation module is used for calculating by adopting the following formula:
P1representing the pressure value, P, of a first node on a cross-section of an ith point in the three-dimensional structural mesh2Representing the pressure value, P, of a second node on a cross-section of the ith point in the three-dimensional structural meshnThe pressure value of the nth node on the cross section of the ith point is represented, and m and n are positive integers;
and calculating the pressure value of each node by adopting a Navier-Stokes equation.
As shown in FIG. 4, in one embodiment of the present application, the blood flow velocity measurement module 320 includes an average blood flow velocityMeasurement module 321 and blood flow velocity VhCalculation Module 322, average blood flow velocityThe measurement module 321, the IMR calculation module 330 and the blood flow velocity VhComputingThe modules 322 are connected; mean blood flow velocityThe measurement module 321 divides the heart cycle region into N local region images;wherein,the average blood flow velocity in a heart cycle region is measured, L represents the length of a blood vessel, N represents the number of frames of local region images into which the heart cycle region is divided, and fps represents the interval time for switching between two adjacent frames of images; blood flow velocity VhThe calculation module 322 is used forThe formula is calculated, wherein a and b both represent constants, a is 1-3, and b is 50-300.
In one embodiment of the present application, the mean blood flow velocityThe measurement module 321 is used for measuring by using a contrast agent traversal distance algorithm, a Stewart-Hamilton algorithm, a First-pass distribution analysis method, an optical flow method or a fluid continuity method.
As shown in fig. 5, in an embodiment of the present application, the three-dimensional modeling apparatus 100 further includes: the coronary artery three-dimensional modeling device comprises an image processing module 150, a coronary artery central line extraction module 160 and a blood vessel diameter measurement module 170, wherein the image processing module 150 is connected with the coronary artery central line extraction module 160, and a three-dimensional modeling module 140 is connected with the coronary artery central line extraction module 160 and the blood vessel diameter measurement module 170. The image processing module 150 is configured to receive the coronary angiography images of at least two body positions transmitted by the segmentation module 120, and remove interfering blood vessels of the coronary angiography images to obtain a result image as shown in fig. 17; the coronary artery centerline extraction module 160 is configured to extract the coronary artery centerline of each of the result images shown in fig. 17 along the extending direction of the coronary artery; the blood vessel diameter measuring module 170 is used for measuring the diameter of the blood vessel; the three-dimensional modeling module 140 is configured to project each coronary artery centerline and diameter onto a three-dimensional space for three-dimensional modeling, so as to obtain a three-dimensional structure of a coronary artery.
As shown in fig. 6, in an embodiment of the present application, the image processing module 150 is internally provided with an image denoising module 151 for denoising a coronary angiography image, including: static noise and dynamic noise. The denoising module 151 removes interference factors in the coronary angiography image, and the quality of image processing is improved.
As shown in fig. 6, in an embodiment of the present application, a catheter feature point extraction module 152 and a coronary artery extraction module 153, both connected to a coronary centerline extraction module 160, are disposed inside an image processing module 150, and the catheter feature point extraction module 152 is connected to the coronary artery extraction module 153 and an image denoising module 151; the catheter feature point extracting module 152 is configured to define a first frame of segmented image with a catheter appearing as a reference image as shown in fig. 10, and define a k-th frame of segmented image with a complete coronary artery appearing as a target image as shown in fig. 11 and fig. 12, where k is a positive integer greater than 1; subtracting the target images shown in fig. 11 and 12 from the reference image shown in fig. 10 to extract a feature point O of the catheter; the coronary artery extraction module 153 is used for subtracting the reference image shown in fig. 10 from the target image shown in fig. 11 and 12 to extract an image of a region where the coronary artery is located; the region image was dynamically grown with the feature points of the catheter as seed points, and the resulting image shown in fig. 17 was obtained.
As shown in fig. 7, in an embodiment of the present application, a first denoising module 1521, a first image enhancement module 1522 and a first binarization processing module 1523 are disposed inside the catheter feature point extracting module 152, and the first binarization processing module 1523 is connected to the coronary artery extracting module 153; the first denoising module 1521 is used for subtracting the target image shown in fig. 11 and 12 from the reference image shown in fig. 10 and denoising the target image, and includes: static noise and dynamic noise; the first image enhancement module 1522 is configured to perform image enhancement on the denoised image; preferably, the image is enhanced by adopting a multi-scale hessian matrix; the first binarization processing module 1523 is configured to perform binarization processing on the enhanced catheter image shown in fig. 13 to obtain a binarized image with a set of catheter feature points O.
As shown in fig. 8, in an embodiment of the present application, the coronary artery extraction module 153 includes a second denoising module 1531, a second image enhancement module 1532, and an area image extraction module 1533, which are connected in sequence, and the area image extraction module 1533 is connected to the first binarization processing module 1523; the second denoising module 1531 is for subtracting the reference image from the target image and denoising, and includes: static noise and dynamic noise; the second image enhancement module 1532 is configured to perform image enhancement on the denoised image; preferably, the image is enhanced by adopting a multi-scale hessian matrix; the region image extraction module 1533 is configured to determine and extract a region of a coronary artery according to the position relationship between each region in the enhanced target image and the catheter feature point, as shown in fig. 15, that is, a region image of the position where the coronary artery is located, as shown in fig. 16.
As shown in fig. 8, in an embodiment of the present application, the region image extraction module 1533 includes: a second binarization processing module 15331 and a dynamic region growing module 15332 connected in sequence, wherein the dynamic region growing module 15332 is connected to the first binarization processing module 1523; the second binarization processing module 15331 is configured to perform binarization processing on the region image, shown in fig. 16, of the position where the coronary artery is located, so as to obtain a binarized coronary artery image; the dynamic region growing module 15332 is configured to perform morphological operation on the binarized coronary artery image, take the feature point of the catheter as shown in fig. 14 as a seed point, and perform dynamic region growing on the binarized coronary artery image according to the position where the seed point is located, so as to obtain a result image as shown in fig. 17. The method and the device realize the synthesis of the three-dimensional structure of the coronary artery according to the coronary angiography image, make up the blank in the industry, and have positive effects on the technical field of medicine.
As shown in fig. 9, in an embodiment of the present application, the invasive blood pressure sensor 200 includes a pressure sensing chip 1 and further includes a peristaltic pump head 2, the peristaltic pump head 2 includes a rotating wheel, the rotating wheel is provided with a connecting structure connected to a rotating shaft of an external motor, a hose 3 is disposed in the peristaltic pump head 2, one end of the hose 3 is connected to the pressure sensing chip 1, and the other end is connected to a saline bag through a perfusion tube. One end of the invasive blood pressure sensor is connected with a saline bag, the other end of the invasive blood pressure sensor is connected to the aorta of a patient through an external device, the invasive blood pressure sensor is used for connecting the aorta of the patient, physiological saline is filled in the middle of the invasive blood pressure sensor to enable the invasive blood pressure sensor to form a passage with the aorta, a pressure sensing chip 1 is arranged in the invasive blood pressure sensor and can convert the dynamic pressure of the aorta into an analog signal, the acquired analog signal is converted into a digital model through a circuit in the invasive blood pressure sensor to obtain the coronary inlet pressure Pa of the aortic pressure, and the coronary inlet pressure Pa adopts the average value of the sum of the systolic pressure and the diastolic pressure; the systolic, diastolic and coronary inlet pressures Pa are displayed on the display 6.
In one embodiment of the application, the connecting end of the hose 3 and the infusion tube is provided with a luer connector 4 and is connected with the infusion tube by the luer connector; a one-way valve 7 is connected between the hose 3 and the pressure sensing chip 1, and the allowable flow direction of the one-way valve 7 is from the saline bag to the pressure sensing chip 1; the invasive blood pressure sensor also comprises a laser emitter 5, and the laser emitter 5 and the pressure sensing chip 1 are positioned at the same horizontal height. The laser emitter 5 can emit a horizontal light beam to irradiate the heart of the patient body, the height of the laser emitter 5 is ensured to be in the same level with the heart, the light beam plays a role in auxiliary alignment, and the alignment is simpler. The pressure sensing chip 1 is designed to be at the same level as the laser emitter 5, so that the pressure sensing chip 1 is ensured to be at the same level as the heart, and the aortic pressure can be accurately measured.
As shown in fig. 27, in an embodiment of the present application, the method further includes: coronary diastolic blood flow velocity VfThe measuring module 400, the instantaneous waveless microcirculation resistance index iFMR measuring device 500, the three-dimensional modeling device 100, the invasive blood pressure sensor 200 and the coronary diastolic blood flow velocity VfThe measurement module 400 is connected; the instantaneous waveless microcirculatory resistance index iFMR measurement device 500 is used for measuring the three-dimensional coronary structure in a waveless period and respectively measuring the pressure drop delta P 'from the coronary inlet to the distal end of the coronary stenosis in the waveless period in the diastole period'iAnd measuring coronary diastolic blood flow velocity VfReading the length L of the blood vessel and the coronary artery inlet pressure Pa' during the non-waveform diastolic period, and calculating the instantaneous non-waveform microcirculation resistance index iFMR, wherein the calculation formula is as follows:
iFMR＝(Pa’-ΔP′i)×L/Vf；
where L denotes the length of a blood vessel, N denotes the number of frames of a local region image into which a coronary angiography image is divided, and fps' denotes the interval time between two adjacent frames of images in the diastolic waveform-free period.
The instantaneous waveless microcirculation resistance index iFMR measuring device can be connected with the IMR measuring device and is used for reading the blood vessel length L and the image segmentation frame number N of the three-dimensional coronary structure measured by the IMR measuring device so as to be used for directly calculating the iFMR; the iFMR device can also be internally provided with a pressure drop measuring module, a meshing module and a pressure drop delta P which are the same as or similar to the IMR deviceiA calculation module, an IMR calculation module, etc., for self-measuring or calculating a pressure drop Δ P 'from the coronary artery entrance to the distal end of the coronary stenosis during the diastole non-waveform period'iAnd a coronary inlet pressure Pa' during diastole without waveform; devices capable of performing the above-described functions are within the scope of the present application.
The invention is specifically illustrated below with reference to specific examples:
example 1:
as shown in fig. 20, a coronary angiography image of two positions taken for one patient; the posture angle of the left image is right anterior oblique RAO: 25 ° and head CRA: 23 °; the posture angle of the right image is right anterior oblique RAO: 3 ° and head CRA: 30 degrees;
as shown in fig. 21, the length L of the blood vessel of the three-dimensional structure of the coronary artery is 120 mm; the resulting three-dimensional structure of the coronary arteries is shown in fig. 22;
the diameter D of the blood vessel is 2-4 mm;
as shown in figure 23 of the drawings,
as shown in fig. 24, Pa ═ 100 mmHg;
as shown in FIG. 25, Δ Pi7; thus IMR ═ 18.9 (100-7) × 120/590;
as shown in fig. 26, iFMR ═ (Pa '- Δ P'i)×L/Vf＝(93-7)×120/300＝34.4。
Comparative example 1:
the same coronary angiography image was taken for both comparative example 1 and example 1 in the same patient as for example 1;
placing a pressure guidewire sensor at the distal coronary end of the patient (5 cm away from the opening of the guiding catheter); introducing a dilating drug into the blood vessel to enable the blood vessel to reach and maintain the maximum hyperemia state (ensuring that a pressure guide wire sensor before and after introducing the dilating drug is in the same position), injecting 3ml of normal saline into the blood vessel through a catheter, if the blood temperature is detected to return to a normal value, injecting 3ml of normal saline into the blood vessel through the catheter again, repeating the process for 3 times, recording Tmn for 0.2min, and measuring the pressure Pd at the distal end of the coronary artery to be 92.8 mmHg;
IMR＝Pd×Tmn＝92.8×0.20＝18.56；
the prior art cannot measure iFMR.
By comparing the example 1 with the comparative example 1, the IMR measurement results are basically the same, so that the measurement result of the example 1 is accurate, and the system adopted in the example 1 of the application does not need a dilatation drug, does not need a pressure guide wire, only needs to measure the coronary artery inlet pressure, does not need to pass through the narrow distal end of a coronary artery vessel, and reduces the operation difficulty and risk; and IMR measurement is realized through the contrast image, the blank in the industry is made up, and the operation is simpler.
The iFMR is an index which is newly proposed by the application and used for judging whether the myocardium is ischemic or not, the iFMR is calculated without simulating the flow velocity in the expansion state based on the diastolic flow velocity measured by the conventional contrast flow velocity, and the instantaneous wave-free microcirculation resistance index of the myocardium in the wave-free period is reflected by the iFMR; the iFMR and the IMR are combined to judge the coronary artery stenosis condition, so that the judgment accuracy is improved.
The present application provides a coronary artery analysis system comprising a system for measuring a microcirculation resistance index as described in any of the above.
As will be appreciated by one skilled in the art, aspects of the present invention may be embodied as a system, method or computer program product. Thus, various aspects of the invention may be embodied in the form of: an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.) or an embodiment combining hardware and software aspects that may all generally be referred to herein as a "circuit," module "or" system. Furthermore, in some embodiments, aspects of the invention may also be embodied in the form of a computer program product in one or more computer-readable media having computer-readable program code embodied therein. Implementation of the method and/or system of embodiments of the present invention may involve performing or completing selected tasks manually, automatically, or a combination thereof.
For example, hardware for performing selected tasks according to embodiments of the invention could be implemented as a chip or a circuit. As software, selected tasks according to embodiments of the invention could be implemented as a plurality of software instructions being executed by a computer using any suitable operating system. In an exemplary embodiment of the invention, one or more tasks according to exemplary embodiments of the methods and/or systems as described herein are performed by a data processor, such as a computing platform for executing a plurality of instructions. Optionally, the data processor comprises volatile storage for storing instructions and/or data and/or non-volatile storage for storing instructions and/or data, e.g. a magnetic hard disk and/or a removable medium. Optionally, a network connection is also provided. A display and/or a user input device, such as a keyboard or mouse, is optionally also provided.
Any combination of one or more computer readable media may be utilized. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following:
an electrical connection having one or more wires, a portable computer diskette, a hard disk, a Random Access Memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.
A computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated data signal may take many forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A computer readable signal medium may also be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device.
Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.
For example, computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C + + or the like and conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user's computer and partly on a remote computer or entirely on the remote computer or server. In the case of a remote computer, the remote computer may be connected to the user's computer through any type of network, including a Local Area Network (LAN) or a Wide Area Network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet service provider).
It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the computer program instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.
These computer program instructions may also be stored in a computer-readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer-readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks.
The computer program instructions may also be loaded onto a computer (e.g., a coronary artery analysis system) or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer, other programmable apparatus or other devices provide processes for implementing the functions/acts specified in the flowchart and/or block diagram block or blocks.
The above-mentioned embodiments of the present invention, which further illustrate the objects, technical solutions and advantages of the present invention, should be understood that the above-mentioned embodiments are only examples of the present invention and should not be construed as limiting the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (14)

1. A system for measuring a microcirculation resistance index, comprising: the measuring device comprises a three-dimensional modeling device, an invasive blood pressure sensor and an IMR measuring device, wherein the IMR measuring device is connected with the three-dimensional modeling device and the invasive blood pressure sensor;
the three-dimensional modeling device is used for reading a coronary angiography image, selecting a heartbeat period region of the coronary angiography image, measuring the length L of a blood vessel in the heartbeat period region, and performing three-dimensional modeling to obtain a three-dimensional structure of the coronary artery;
the invasive blood pressure sensor is used for measuring coronary artery inlet pressure Pa;
the IMR measuring device is used for measuring the pressure drop delta P from the coronary artery inlet to the distal end of coronary artery stenosis under the maximum hyperemia state of the blood vesseliAnd measuring the blood flow velocity VhReading the length L and the coronary inlet pressure Pa, and calculating the microcirculation resistance coefficient IMR, wherein the calculation formula is as follows:
IMR＝(Pa-ΔPi)×L/Vh。
2. the system for measuring a microcirculation resistance index according to claim 1, wherein the three-dimensional modeling device includes an image reading module and a segmentation module, a blood vessel length measuring module and a three-dimensional modeling module, the segmentation module is connected with the image reading module, the blood vessel length measuring module and the three-dimensional modeling module, and the blood vessel length measuring module is connected with the IMR measuring device;
the image reading module is used for reading a contrast image;
the segmentation module is used for selecting a heartbeat period region of the coronary angiography image;
the blood vessel length measuring module is used for measuring the length L of a blood vessel in the heartbeat cycle region and transmitting the length L of the blood vessel to the IMR measuring device;
and the three-dimensional modeling module is used for carrying out three-dimensional modeling according to the coronary angiography image selected by the segmentation module to obtain a three-dimensional structure of the coronary artery.
3. The system for measuring a resistance index of microcirculation according to claim 2, wherein the IMR measuring device includes a pressure drop measuring module, a blood flow velocity measuring module, and an IMR calculating module, the pressure drop measuring module, the blood flow velocity measuring module, the invasive blood pressure sensor, and the blood vessel length measuring module all being connected to the IMR calculating module;
the pressure drop measuring module is used for measuring the pressure drop delta P from the coronary artery inlet to the distal end of the coronary artery stenosis under the maximum hyperemia state of the blood vesseli；
The blood flow velocity measuring module is used for measuring the blood flow velocity V of the blood vessel in the maximum hyperemia stateh；
The IMR calculation module is used for calculating the microcirculation resistance coefficient IMR, and the calculation formula is as follows:
IMR＝(Pa-ΔPi)×L/Vh。
4. the system for measuring a microcirculation resistance index according to claim 3, wherein the pressure drop measurement module includes: meshing module and pressure drop Δ PiA calculation module, the pressure drop Δ PiThe computing module is connected with the grid division module and the IMR computing module;
the meshing module is used for meshing the three-dimensional structure of the coronary artery, the coronary artery central line is taken as a longitudinal axis, the mesh is divided into m points along the coronary artery central line, and the cross section corresponding to each point of the coronary artery central line is divided inton nodes, Δ PiRepresenting the average value of the pressures of all nodes on the cross section of the ith point on the coronary centerline;
the pressure drop Δ PiThe calculation module is used for calculating by adopting the following formula:
P1representing the pressure value, P, of a first node on a cross-section of an ith point in the three-dimensional structural mesh2Representing the pressure value, P, of a second node on a cross-section of the ith point in the three-dimensional structural meshnThe pressure value of the nth node on the cross section of the ith point is represented, and m and n are positive integers;
and calculating the pressure value of each node by adopting a Navier-Stokes equation.
5. The system of claim 3, wherein the blood flow velocity measurement module comprises an average blood flow velocityMeasurement module and blood flow velocity VhA calculation module, the mean blood flow velocityA measurement module, an IMR calculation module, a blood flow velocity V and a blood flow velocity VhThe calculation module is connected;
the average blood flow velocityThe measurement module is used for measuring by adopting a contrast agent traversal distance algorithm, a Stewart-Hamilton algorithm, a First-pass distribution analysis method, an optical flow method or a fluid continuous method; or dividing the heart cycle region into N local region images;
wherein,the average blood flow velocity in the heart cycle region is measured, L represents the length of a blood vessel, N represents the number of frames of local region images into which the heart cycle region is divided, and fps represents the interval time for switching between two adjacent frames of images;
the blood flow velocity VhA computing module for computing based onAnd (4) calculating by using a formula, wherein a represents a constant with a value range of 1-3, and b represents a constant with a value range of 50-300.
6. The system for measuring the microcirculation resistance index according to any one of claims 1 to 5, wherein the value of L ranges from 50mm to 150 mm; or L100 mm.
7. The system for measuring a microcirculation resistance index according to any of claims 2 to 5, wherein the three-dimensional modeling device further includes: the coronary artery three-dimensional modeling device comprises an image processing module, a coronary artery central line extraction module and a blood vessel diameter measurement module, wherein the image processing module is connected with the coronary artery central line extraction module, and the three-dimensional modeling module is connected with the coronary artery central line extraction module and the blood vessel diameter measurement module;
the image processing module is used for receiving the coronary angiography images of at least two postures transmitted by the segmentation module and removing interfering blood vessels of the coronary angiography images to obtain a result image;
the coronary artery central line extraction module is used for extracting the coronary artery central line of each result image along the extension direction of the coronary artery;
the blood vessel diameter measuring module is used for extracting the blood vessel diameter;
the three-dimensional modeling module is used for projecting each coronary artery central line and the diameter on a three-dimensional space for three-dimensional modeling to obtain a coronary artery three-dimensional structure.
8. The system for measuring the index of resistance to microcirculation according to claim 7, wherein the image processing module is internally provided with an image denoising module for denoising the coronary angiography image, comprising: static noise and dynamic noise.
9. The system for measuring the index of resistance to microcirculation according to claim 7, wherein the image processing module is internally provided with a catheter feature point extraction module and a coronary artery extraction module which are both connected with the coronary artery centerline extraction module, and the coronary artery extraction module is connected with the catheter feature point extraction module;
the catheter feature point extraction module is used for defining a first frame of segmentation image with a catheter as a reference image, defining a kth frame of segmentation image with a complete coronary artery as a target image, wherein k is a positive integer greater than 1; subtracting the target image from the reference image, and extracting a characteristic point O of the catheter;
the coronary artery extraction module is used for subtracting the reference image from the target image and extracting a region image of the position of the coronary artery; and the region image takes the characteristic points of the catheter as seed points to carry out dynamic growth, and the result image is obtained.
10. The system for measuring the microcirculation resistance index as recited in claim 9, wherein the catheter feature point extraction module is internally provided with a first denoising module, a first image enhancement module and a first binarization processing module which are connected in sequence, and the first binarization processing module is connected with the coronary artery extraction module;
the first denoising module is used for subtracting the target image from the reference image and denoising, and comprises: static noise and dynamic noise;
the first image enhancement module is used for enhancing the image of the denoised image;
and the first binarization processing module is used for carrying out binarization processing on the enhanced catheter image to obtain a binarization image with a group of catheter characteristic points O.
11. The system for measuring the index of resistance to microcirculation according to claim 10, wherein the coronary extraction module includes a second denoising module, a second image enhancement module and a region image extraction module connected in sequence, the region image extraction module is connected with the first binarization processing module;
the second denoising module is used for subtracting the reference image from the target image and denoising, and comprises: static noise and dynamic noise;
the second image enhancement module is used for enhancing the image of the denoised image;
the region image extraction module is used for determining and extracting a region of a coronary artery according to the position relation between each region in the enhanced target image and the catheter feature point, namely the region image of the position of the coronary artery.
12. The system for measuring a microcirculation resistance index of claim 10, wherein the region extraction module includes: the dynamic area growing module is connected with the first binarization processing module;
the second binarization processing module is used for carrying out binarization processing on the region image of the position where the coronary artery is located to obtain a binarization coronary artery image;
the dynamic region growing module is used for performing morphological operation on the binary coronary artery image, taking the feature point of the catheter as a seed point, and performing dynamic region growing on the binary coronary artery image according to the position of the seed point to obtain the result image.
13. The system for measuring a microcirculation resistance index according to any of claims 1 to 4, further comprising: coronary diastolic blood flow velocity VfThe measuring module and the instantaneous waveless microcirculation resistance index iFMR measuring device, the three-dimensional modeling device, the invasive blood pressure sensor and the coronary diastolic blood flow velocity VfThe measurement module is connected;
the instantaneous waveform-free microcirculation resistance index iFMR measuring device is used for measuring a three-dimensional coronary structure in a waveform-free period and respectively measuring the pressure drop delta P from the coronary inlet to the distal end of coronary stenosis in a diastole waveform-free periodi' and measurement of coronary diastolic blood flow velocity VfReading the length L of the blood vessel and the coronary artery inlet pressure Pa' during the non-waveform diastolic period, and calculating the instantaneous non-waveform microcirculation resistance index iFMR, wherein the calculation formula is as follows:
iFMR＝(Pa′-ΔPi′)×L/Vf；
where L denotes the length of a blood vessel, N denotes the number of frames of a local region image into which a coronary angiography image is divided, and fps' denotes the interval time between two adjacent frames of images in the diastolic waveform-free period.
14. A coronary artery analysis system comprising the system for measuring a microcirculation resistance index according to any one of claims 1 to 13.
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