Noninvasive CABG Connection Position Determination via FFR Simulation
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Solution Overview
Problem
Current methods for determining the connection position of a graft vessel in coronary artery bypass grafting (CABG) are invasive and burdensome, and there is a need for a noninvasive method to accurately interpret blood vessel states from medical images.
Innovation Solution
A medical image processing apparatus that includes a first specifier to identify the culprit vessel and stenosis, a determiner to determine the optimal connection position for a bypass vessel, and a display controller to visualize this information, allowing for a preoperative plan for CABG to be created noninvasively.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a pressure wire is inserted into the blood vessel to measure pressures for FFR calculation, then the measurement precision of blood flow resistance is improved, but the ease of operation deteriorates due to the invasive procedure
Solution Approach 1:
The patent uses medical images (CTA, MRA, or angiography) as an intermediary to noninvasively obtain blood vessel shape information, replacing the direct invasive measurement with pressure wire insertion. The image-based simulation serves as a mediator to calculate FFR values without physical intrusion into the vessel.
Solution Approach 2:
The patent replaces the mechanical invasive pressure wire insertion system with an image processing and computational simulation system. By substituting physical mechanical measurement with digital image analysis and fluid dynamics simulation, the system achieves noninvasive FFR calculation.
2Measurement precision
If a 3D image simulation is used to calculate FFR, then the measurement precision is improved, but the productivity deteriorates due to long calculation time
Solution Approach 1:
The patent segments the blood vessel into multiple cross-sectional slices from the 3D medical image. By dividing the continuous 3D structure into discrete 2D sections, the simulation can process each slice independently and efficiently, reducing overall calculation time while maintaining accuracy.
Solution Approach 2:
The patent transforms the 3D blood vessel structure into multiple 2D cross-sectional images for simulation processing. This dimensionality reduction from 3D to 2D allows for faster computational processing while preserving the essential geometric information needed for accurate FFR calculation.
3Ease of operation
If medical images are used to determine connection position, then the ease of operation is improved by eliminating invasive procedures, but the measurement precision deteriorates due to difficulty in interpreting blood vessel state details
Solution Approach 1:
The patent uses simulated blood flow information and FFR calculation results as intermediaries to enhance the interpretation of medical images. These computational overlays serve as mediators that provide detailed functional information about blood vessel states, enabling accurate connection position determination from noninvasive images.
Solution Approach 2:
The patent transforms static anatomical image data into dynamic functional parameters through FFR simulation. By calculating and displaying FFR values, blood flow velocities, and pressure distributions as additional parameters overlaid on the images, the system provides comprehensive information for accurate vessel state interpretation.
Data Source
AI summary
According to one embodiment, a medical image processing apparatus includes first specifier, second specifier, determiner and display controller. First specifier collates an ischemic region calculated from a blood vessel visualized into a three-dimensional image in a plurality of phases with a dominating region of the blood vessel, and specifies a culprit vessel in the ischemic region. Second specifier specifies a culprit stenosis in the culprit vessel based on a pressure index calculated from the blood vessel. Determiner determines a connection position to connect a bypass vessel that makes a detour around the culprit stenosis. Display controller displays the determined connection position on a display.