Computational Fluid Dynamics and Acoustics Laboratory, School of Mechanical Engineering, Korea University, Seoul, Republic of Korea.
Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2018 Mar 16;8(1):4692. doi: 10.1038/s41598-018-23134-7.
Invasive procedure is a prerequisite for studying coronary physiology. We established the measurement of non-invasive physiological parameters including coronary blood flow (CBF), flow velocity, and microvascular resistance using coronary computed tomography angiography (CCTA). Vessel-specific CBF was derived from transluminal attenuation flow encoding (TAFE) and then tested using three separate datasets consisted of computational simulation, human perfusion CT, and human CCTA. TAFE-derived CBF correlated well with measured vessel-specific myocardial blood flow and CBF. TAFE-derived CBF per myocardial mass consistently decreased with the progressive severity of stenosis, and it was found to better to detect significant stenosis than transluminal attenuation gradient (TAG). With the addition of vessel anatomy, TAFE-derived CBF could calculate flow velocity and microvascular resistance. The results of non-invasively acquired parameters according to the severity of stenosis were similar to those obtained through invasive physiology studies. Our study demonstrated that non-invasive comprehensive coronary physiology parameters can be derived from CCTA without any pre-specified condition or performing complex heavy computational processes. Our findings are expected to expand the clinical coverage of CCTA and coronary physiology.
介入性操作是研究冠状动脉生理学的前提。我们建立了使用冠状动脉计算机断层血管造影术（CCTA）测量包括冠状动脉血流量（CBF）、血流速度和微血管阻力在内的非侵入性生理参数的方法。通过管腔衰减流速编码（TAFE）得出特定于血管的 CBF，并使用包括计算模拟、人体灌注 CT 和人体 CCTA 的三个独立数据集进行测试。TAFE 衍生的 CBF 与测量的特定于血管的心肌血流量和 CBF 相关性良好。TAFE 衍生的 CBF 与狭窄的严重程度呈负相关，与管腔衰减梯度（TAG）相比，其能更好地检测出明显的狭窄。通过添加血管解剖结构，TAFE 衍生的 CBF 可以计算血流速度和微血管阻力。根据狭窄严重程度非侵入性获取的参数的结果与通过侵入性生理学研究获得的结果相似。我们的研究表明，无需任何预设条件或进行复杂的繁重计算过程，就可以从 CCTA 中得出非侵入性的综合冠状动脉生理学参数。我们的研究结果有望扩大 CCTA 和冠状动脉生理学的临床应用范围。
