CN106886993B

CN106886993B - 17-segment myocardial scoring system

Info

Publication number: CN106886993B
Application number: CN201710066056.0A
Authority: CN
Inventors: 贺永明; 杨向军; 徐明星; 崔凤梅
Original assignee: Individual
Current assignee: Individual
Priority date: 2017-02-07
Filing date: 2017-02-07
Publication date: 2019-12-24
Anticipated expiration: 2037-02-07
Also published as: CN106886993A; WO2018148859A1

Abstract

The invention provides a 17-segment myocardial scoring system, which comprises a frame capturing end for capturing a dynamic contrast video frame, an image processing module, a segment scoring module and a segment scoring module, wherein the frame capturing end is used for capturing a blood vessel boundary and a heart boundary in the dynamic contrast image according to the video frame captured by the frame capturing end, the blood vessel boundary forms a blood vessel for segment scoring, when the minimum volume of the heart is reached, the blood vessel on the video frame of the dynamic contrast image at the moment is subjected to width sampling at equal intervals, the track of the blood vessel boundary where the width is located is recorded, the width is compared with the blood vessel width at the same position in the video frame between the minimum volume and the maximum volume of the heart, a blood vessel position record with the expansion ratio of the blood vessel width lower than a set threshold value is found, the segment setting end is used for segment division and scoring of the blood vessel on the video frame, the invention can, making the scoring more accurate.

Description

17-segment myocardial scoring system

Technical Field

The invention relates to identification and evaluation of a cardiac contrast image, in particular to a 17-segment myocardial scoring system.

Background

Coronary heart disease is the leading cause of death. Coronary angiography has been used clinically as a routine examination, and therefore, it has become both possible and a significant challenge to collect useful information for organizing the coronary arterial tree (normal or diseased) of a large number of patients. There is a need for a method for systematically characterizing coronary tree anatomy and quantitatively grading the complexity of vascular lesions in patients with coronary heart disease, thereby obtaining important information on patient health and prognosis. The Syntax score, developed based on the AHA recommended segmentation naming of coronary trees, may be used to determine the number, location, complexity, and impact on cardiac function of coronary lesions. The higher the Syntax score, the more complex the lesion. It must be recognized that the Syntax system has its limitations. One obvious disadvantage is that in the Syntax system, coronary circulation typing is simplistic, only type 2: namely a left dominant type and a right dominant type. This excessive simple typing does not reflect the large variation in coronary vasculature. More importantly, the Syntax scoring system is essentially vessel-based, rather than a scoring system based on vessel importance, and thus its limitations are self-evident. For example, the coronary segment 12 is the middle branch vessel, which is weighted 1 regardless of its size (> 1.5 mm) according to the Syntax system. In fact, the variation of the middle branch vessels among individuals is extremely large, negligibly small, and large enough to supply blood to the whole blunt edge region. The traditional Syntax scoring has less classification and longer calculation time.

Disclosure of Invention

In order to solve the above problems, it is an object of the present invention to provide a 17-segment myocardial scoring system capable of rapidly and quantitatively scoring a cardiac angiogram.

The technical scheme adopted by the invention for solving the technical problems is as follows:

the 17-segment myocardial scoring system comprises:

the frame capturing end is used for capturing video frames of the dynamic contrast video;

the image processing module is used for extracting a blood vessel boundary and a heart boundary in the dynamic contrast image according to a video frame captured by the frame capturing end, wherein the blood vessel boundary forms a blood vessel for section scoring, the heart boundary is used for determining regular waveform of heart pulsation, according to the regular waveform, when the minimum volume of the heart exists, the blood vessel on the video frame of the dynamic contrast image at the moment is subjected to width sampling at equal intervals, the track of the blood vessel boundary where the width is located is recorded, the width is compared with the blood vessel width at the same position in the video frame between the minimum volume and the maximum volume of the heart, and a blood vessel position record with the expansion ratio of the blood vessel width lower than a set threshold value is found out;

the segment setting end is used for carrying out segment division on blood vessels on the video frame;

and the segment weight database stores the weight data of the blood vessel segments, and generates scores by calling the weight data through the division of the segment set ends on the blood vessels.

Preferably, the blood vessel labeling device further comprises a labeling module, wherein the labeling module labels the blood vessel into a gray scale image from high to low according to the change of the width of the blood vessel.

Preferably, the set threshold is a mean value of the percentage of change in the width of the blood vessel.

The invention has the advantages that:

when the heart is mobilized, because cause the short-term jam behind the vascular pathological change, cause the pressure that blocks up the rear to reduce sharply, vasodilatation is not enough, adopts image processing's mode to confirm that the vasodilatation width fixes a position the pathological change blood vessel, combines the segment to cut apart, can calculate the total score of cardiac muscle fast, avoids complicated and extensive computational process, makes the score more accurate.

Drawings

Fig. 1 is a drawing of 3 regions delineated by 3 anatomical landmarks of the left ventricular surface.

Fig. 2, 3 and 4 show 6 types of right coronary artery dominant patterns.

Fig. 5, 6, and 7 show different lengths of anterior descending branches (abc) and different sizes of diagonal branches (def).

Fig. 8 and 9 are depictions of coronary vessel segments.

Fig. 10, 11, and 12 show the assignment of coronary vessel weighting factors.

Fig. 13 shows the lesion score in a situation where correction is required. The upper row is occlusive lesions and the lower row is non-occlusive lesions.

Fig. 14 is a conventional score generation example.

Fig. 15 is an example of score generation after lesion correction.

Detailed Description

The invention is further illustrated with reference to the following figures and examples:

the 17-segment myocardial scoring system comprises:

the frame capturing end is used for capturing video frames of the dynamic contrast video; the coronary angiography video is guided into a frame capturing end, and single frame images in the video are separated one by the frame capturing end.

An image processing module, extracting the blood vessel boundary and the heart boundary in the dynamic contrast image according to the video frame captured by the frame capturing end, extracting the edge by adopting a common Matlab edge detection operator in the image processing such as canny, sobel and the like according to the blood vessel boundary and the extracted maximum edge is the heart boundary, intercepting the fluctuation of the heart size when the heart is shifted each time, intercepting the video frame between the wave crest and the wave trough, extracting the edge again, filtering out the continuous edge (namely the heart boundary) at the outermost layer after filtering, leaving the continuous blood vessel boundary, the blood vessel boundary forms a blood vessel for scoring segments, the heart boundary is used for determining the regular waveform of the heart beating, according to the regular waveform, when the minimum volume of the heart is reached, sampling the blood vessel on the video frame of the dynamic contrast image at the moment according to the equal interval, and the width line of the sampling is vertical to the extending central axis of the blood vessel, recording the track of the blood vessel boundary where the width is located, comparing the width with the blood vessel width at the same position in the video frame between the minimum volume and the maximum volume of the heart, and finding out the position record of the blood vessel with the expansion ratio of the blood vessel width lower than a set threshold value;

the segment setting end is used for carrying out segment division on blood vessels on the video frame; the following naming mode and segment segmentation are adopted by manually marking each segment:

54 coronary circulation types

The coronary circulation system is divided into 6 types according to the blood supply range of the right coronary artery:

zero post-reduction (PDA zero): the left heart receives blood only from the left coronary system, and the right coronary system does not supply blood to the left heart, as it is known as the left dominant type (fig. 2 a).

Unique post descending (PDA only): the right coronary system only sends out the posterior descending branch to walk in the posterior ventricular sulcus to supply blood for the posterior ventricular septum. The lower diaphragm surface of the left ventricle is entirely fed by the left circumflex (fig. 2 b).

Small right coronary artery type (small RCA): the right coronary system sends out the posterior descending branch and also sends out the posterior lateral branch to supply a part of the inferior diaphragm. The remaining diaphragm surface is supplied with blood from the posterior collateral branch originating from the left circumflex (fig. 3 c).

Common right coronary artery type (average RCA): the right coronary system sends out the posterior descending branch and the postperfusion compartment of the posterior collateral and the entire inferior diaphragmatic surface (fig. 3 d).

Large right coronary artery type (large RCA): the right coronary system sends a small blunt edge branch to perfuse a small blunt edge of the left heart, in addition to the posterior descending branch and the postperfusion septal and whole inferior diaphragm surface. This part of the blunt left heart is originally supplied with blood from the circumflex (FIG. 4 e).

Extra large right coronary artery type (super RCA): the right coronary system sends out a relatively large blunt-limbed branch to perfuse a relatively large portion of the blunt edge of the left heart, in addition to the posterior descending branch and the postperfusion septal and entire inferior diaphragmatic surface. This part of the blunt left heart is originally supplied by the circumflex (FIG. 4 f).

According to the blood supply range of anterior descending branch (excluding diagonal branch), the coronary circulation system is classified into type 3: short (fig. 5a), normal (fig. 5b) and long (fig. 6c) anterior descending 3 types; according to the blood supply range of diagonal branches, the coronary circulation system is divided into 3 types: the small (fig. 6d), medium (fig. 7e) and large (fig. 7f) diagonal branch 3 types, totaling 54 coronary circulation types, the 17-segment myocardial scoring system will use these 54 coronary circulation types to reflect the huge variation of coronary tree among individuals.

In our scoring system, the definitions of the series of segments 16, 7, 9, 12, 14, and the series of segments 11,13, and 15 have been modified from the conventional definitions. The definition of each coronary segment in the present scoring system is set forth in detail below.

Referring to fig. 8 and 9, the coronary tree segments are named

Seg 1. RCA proximal the right coronary opening to half of the sharp edge of the heart.

Seg 2. RCA Mid, end of first segment to sharp edge of heart.

Seg 3. RCA Distal, the beginning of the sharp edge to descending branch of the heart, usually running in the right posterior ventricular groove.

Seg 4 PDA from RCA, posterior descending branch originating from the right coronal, running in the posterior interventricular sulcus.

Seg 16. originates from the main branch of the right coronal posterior collateral branch: beginning with the posterior descending branch, it runs in the left posterior ventricular sulcus and gives out a branch supplying blood to the left ventricular diaphragm.

In the right dominant form, the left cardiac diaphragm is usually supplied with blood from 1-2 posterior side branches originating from the right crown. The 1 posterior collateral branch is usually larger and is called seg 16&. If the 2 posterior branches are equally large, they are designated seg 16a and 16b, respectively. If the posterior collateral branches of 2 branches are not equally large, the large 1 branch is named seg 16X, and the small 1 branch is named seg 16S.

Seg 16a. originates from the equally large (compared to the other posterior side branch) posterior side branch of Seg 16.

Seg 16b. originates from the equally large (compared to the other posterior side branch) posterior side branch of Seg 16.

Seg 16x. originates from the larger posterior side branch of Seg 16, independent of the site of emission.

Seg 16s. originates from the smaller posterior side branch of Seg 16, independent of the location of the emission.

Seg 16&. originates from only one large posterior side branch of Seg 16.

Seg 16c. originate in the blunt limbus branch of Seg 16, perfusing a portion of the blunt limbus.

Seg 5, bifurcation from the left coronary ostia to the anterior descending and circumflex branches.

Seg6 LAD proximal, the first proximal primary transseptal segment and including the primary transseptal opening.

Seg 7, LAD mid (mid anterior descending branch) starting from the first main septum and ending with the anterior descending branch angled at the right anterior oblique position. If the angulation is not significant, it ends at the midpoint of the first main septal crossing branch to the apex of the heart.

The anterior descending branch usually originates from the proximal segment or the middle segment (seg 6 or 7) by 1-2 diagonal branches. It is usually larger when only one diagonal branch is issued, named seg 9&. If the two diagonal branches are equally large, they are named seg 9a and seg 9b, respectively. If two diagonal branches are not equal in size, the larger branch is named seg 9X, and the smaller branch is named seg 9S. The larger diagonal branch is sent from seg 6.

Seg 9a. first diagonal arms of equal size from Seg6 or 7.

Seg 9b. equi-large second diagonal legs from Seg6 or 7.

Seg 9x. originates from the larger diagonal branch of Seg6 or 7, regardless of its originating location.

Seg 9s. originates from the smaller diagonal branch of Seg6 or 7, regardless of its originating location.

Seg 9&. usually originates from Seg6 with only 1 large diagonal branch.

Seg 7&. only send out the middle section of the forward descending branch of one large diagonal branch.

Seg 7x. send out the mid-forward descending branch of the larger diagonal branch.

Seg 7s. send out the middle of the anterior descending branch of the smaller diagonal branch.

Seg 7e. send out the mid-forward descending branch of the equal large diagonal branch.

Seg 7. without mid-forward descending branch from diagonal branches. The only large diagonal branch is usually from seg 6.

Seg 8 LAD disk (forward descending far leg): starting from the end of the previous segment, ending at or bypassing the apex of the heart, and running in the anterior interventricular sulcus, which is the terminal part of the anterior descending branch.

Seg 11. Proximal LCX (circumflex Proximal segment): the branch trunk revolves, starting from the left trunk and ending at the blunt edge of the heart.

The circumflex branches usually give out 1-2 blunt limbal branches. The only 1 blunt edge is usually larger and is named seg 12&. If the 2 blunt-edged branches are equally large, they are designated seg 12a and 12b, respectively. If the 2 blunt edge branches are not equal in size, the larger one is named as 12X, and the smaller one is named as 12S.

Seg 12a, the 1 st blunt, equally large limbus branch emanating from the circumflex, which runs at the blunt edge of the heart.

Seg 12b, the 2 nd blunt arm of equal size, emanating from the circumflex arm, which runs at the blunt edge of the heart.

Seg 12X. the larger blunt limbus from the circumflex, which runs at the blunt edge of the heart, regardless of the location of its emergence.

Seg 12s. the smaller blunt limbus from the circumflex, runs over the blunt limbus of the heart, regardless of the location of its emergence.

Seg 12&. only one large blunt edge branch emanates from the gyrus and runs at the blunt edge of the heart, regardless of its location of emanation.

Seg interx. larger middle branch, equivalent to Seg 12X.

Seg inters. smaller middle leg, equivalent to Seg 12S.

Seg intere. smaller middle leg, corresponding to Seg 12a or 12b.

Seg inter &. only one large blunt limbus, equivalent to Seg 12&, perfuse the blunt edge of the heart. A circumflex branch is independently sent out from the trunk and runs in the left rear chamber ditch.

Seg 13. LCX disk (cyclotomic distance segment): starting at the blunt edge of the heart and running along the left posterior atrioventricular groove. In the right dominant version, its size is usually smaller or missing, while in the left dominant version, its size is usually larger.

In the left dominant form, the left ventricular diaphragm is usually supplied with blood from 1-2 posterior branches originating from LCX. The only 1 large posterior side branch was named seg 14 &. If the 2 posterior branches are equally large, they are designated as 14a and 14b, respectively. If the 2 side branches are not equally large, the larger branch is designated 14X and the smaller branch is designated 14S.

Seg 14a equal size first posterior branch from Seg 13.

Seg 14b an equally large second posterior branch from Seg 13.

Seg 14X originated from the larger posterior side branch of Seg 13, regardless of the location of its emission.

Seg 14S, from the smaller posterior side branch of Seg 13, regardless of the location of its emission.

Seg 14 &. the only large posterior branch from Seg 13, regardless of its location of emission.

Seg 15, posterior descending branch. The most distant section of the circumflex from seg 13, which runs in the posterior interventricular sulcus, perfuses the posterior septum.

And determining the weight of the lesion of the segment according to the height of the width percentage of the blood vessels in the marked segment relative to a set threshold value, and adding the factors of the segments to generate a score.

The segment weight database stores the weight data of the blood vessel segments, the weight data are called by dividing the blood vessel through the segment set end to generate scores, and the weight data and the weight calculation adopt the following rules:

computation and derivation of coronary tree weight factors

The derivation of the coronary tree weight factors is based on the following rules:

1) competitive blood supply rules for 3 regions;

the left ventricular surface clearly presents 3 anatomical landmarks: anterior interventricular sulcus, posterior interventricular sulcus and blunt edge. These 3 anatomical landmarks constantly divide the left heart into 3 regions: bays, including front and rear bays (fig. 1 c); diagonal strut-blunt edge zone, including front wall and side walls, but not crossing the blunt edge boundary (fig. 1 a); lower diaphragm face (fig. 1 b). Accordingly, there are 3 vessels running relatively constantly along these anatomical landmarks: the left anterior descending branch (12), the posterior descending branch, and the blunt limbic branch, although the coronary vessel tree varies greatly between individuals.

Competitive blood supply laws

The compartment is supplied with blood competitively by the anterior descending branch (excluding the diagonal branch) and the posterior descending branch (usually without the major branch). A long anterior descending branch will decrease the blood supply to the posterior descending branch and vice versa. The diagonal-blunt edge region is supplied with blood competitively by the diagonal branch and the blunt edge branch. A large diagonal branch will reduce the extent of blood supply to the blunt edge branch and vice versa. The inferior diaphragmatic surface is competitively fed by the posterior collateral branches originating from the left or right corona. A large right corona would reduce the circumflex blood supply range and vice versa.

2) The sum of the sub-vessel flows equals the main vessel flow rule;

3) and (4) calculating an unknown weight factor rule according to the key known anchoring value.

Referring to fig. 10-12, the total coronary weighting factor was constant at 17.0, the diagonal branch-blunt edge region vessel weighting factor was constant at 8.0, the septal vessel weighting factor was constant at 6.0, and the inferior diaphragmatic vessel weighting factor was constant at 3.0 for all 54 coronary circulation types. In the RCA general right dominant type, the weight factors of the LAD at the far section are 1.0, 2.0 and 3.0 in sequence according to the different lengths of the LAD; the diagonal branch weight factors are different according to the diagonal branch size and are sequentially 2.0, 3.0 and 4.0; the LCX weighting factors are 6.0, 5.0 and 2.0 according to the competitive blood supply rule of diagonal branch-blunt edge region. When the diagonal branch size and the LAD length are the same, the RCA weighting factors are increased by 1.5 step by step according to the order from PDA only to super RCA type. Based on the above-mentioned anchoring values, the weighting factors for the 54 types of coronary trees can be derived. The vessels are identical, but the weighting factors are different, reflecting the difference in the number of left ventricular segments perfused by the vessel between individuals.

Distribution of coronary vessel weighting factors for patients with common dominant, diagonal and anterior descending branches (average RCA dominant circulation with intermediate diagonals and average LAD)

Referring to the column labeled light in fig. 11, in the patient with common preponderance, diagonal and anterior descending, the right coronal section supplies blood to the inferior septal and inferior diaphragmatic regions for a total of 5 segments with a weighting factor of 5.0. The anterior descending branch (except the diagonal branch) supplies blood to the anterior septal and apical segments, and the total number is 4 segments; the diagonal branch feeds the anterior wall for a total of 3 segments. Thus, the antegrade (including diagonal) branches total 7 segment blood supplies with a weighting factor of 7.0. The circumflex branch feeds the remaining 5 segments with a weighting factor of 5.0. The total score amounted to 17.0, corresponding to 17 segments of the left ventricular myocardium.

Specifically, in the common right dominant and diagonal branches, the distal anterior descending branch (digital LAD) supplies blood to 1 apical septal segment and 1 apical segment, totaling 2 segments, and the weighting factor is 2.0. Mid-anterior descending (mid LAD), if no diagonal branches are issued, will supply blood to the precordial septum, apical septum and apical segments, totaling 3 segments with a weighting factor of 3.0. If mid-way descending branch (mid LAD) issues diagonal branches, the weighting factors will be 6.0, 5.0 and 4.5 respectively according to the weights of the diagonal branches. The weight factor for the proximal descending (proximal LAD) is constant at 7.0 regardless of the position of the diagonal branch. The posterior descending branch (PDA) supplies blood for the next 2 segments of interval, with a weighting factor of 2.0. The posterior side branch of 1-2 feeds the inferior wall for 3 segments, which is weighted 3.0. If the 2 posterior collateral vessels are not equally large, the larger 1 is weighted at 2.0 and the smaller 1 is weighted at 1.0. If 2 posterior branches are equally large, each branch is weighted 1.5. There are only 1 large posterior branch, feeding the inferior wall 3 segments, with a weighting factor of 3.0. The sum of the posterior descending branch (PDA) and posterior branch weights is 5.0, which is also the distal segment right coronal (distalRCA) weight. The gyral branches emit 1-2 blunt edge branches with equal or unequal sizes. The only large blunt-edged branch that is issued is the 5 segment-fed blood, which has a weight factor of 5.0. If the 2 blunt edge branches are not equal, the greater 1 branch is weighted 3.0 and the lesser 1 branch is weighted 2.0. If 2 blunt-edged branches are equally large, each branch has a weight of 2.5. Seg inter series (Seg inter X, S, E & and &) represent different sizes of intermediate branches, with weighting factors corresponding to Seg 12 series (Seg 12X, 12S, 12a, 12b & 12 &).

The weight factor of the same blood vessel which changes continuously among different individuals reflects the continuous change of the segment number of the myocardial segments supplied by the blood vessel. But in the 54 coronary circulation types, the overall weight factor was constant at 17.0.

In our designed 17-segment myocardial scoring system, the importance of a vessel depends on the number of myocardial segments supplied by the vessel rather than the vessel itself. In all 54 coronary circulation types, the weight factor assignment for a vessel is based on the number of myocardial segments perfused by that vessel.

The degree of stenosis of the vessel is also taken into account when deriving the 17-segment myocardial model scoring system. The integral is the product of the vessel weight factor and the stenosis degree (equation 1). If the vessel is completely occluded, the weighting factor is multiplied by 5. If the vessel diameter is narrowed by 50-99%, the weighting factor is multiplied by 2, and then the integration obtained by the vessel segments is added to obtain the total coronary integral (21). An integral of 0 indicates that the coronary tree is not stenotic. The higher the integral, the more severe the stenosis.

S=W×D (1)

Wherein S is a 17-segment model score;

w is the weighting factor of the blood vessel;

d is the degree of stenosis of the vessel.

Definition of lesions

More than 50% of the diameter stenosis was visualized as a lesion (vessel diameter greater than 1.5 mm). In the present scoring system, only 2 types of lesions are considered: occlusive (100% stenosis) and non-occlusive (50-99% diameter stenosis).

Lesion scoring

In the present system, all lesions should be scored. The maximum number of lesions per patient was set to 12 and each lesion was labeled with a corresponding number from 1 to 12. Non-occlusive lesions accumulated over 2 adjacent segments with no major side branches, and only segments with >1/2 lesion length were scored. If the non-occlusive lesion is affected by 2 adjacent segments and there are main branches, the scoring correction should be performed with reference to the condition listed in the "lesion scoring correction" if these branches are judged to be in the same segment.

Lesion score correction

Lesion scores were modified for the following cases:

occlusive lesions

Major branch occlusive lesions of the same segment, with normal major branches (fig. 13a), lesion scores are modified by equation 2 because the major branch weights already include the major branch weights, but in fact, the major branches are not affected.

S =subtotal score -W intact SBs×5; (2)

Wherein, intact SBs refer to all normal side branches.

The main branch obliterative lesion of the same segment, with the main branch (fig. 13b), lesion score is modified according to equation 3, since the main branch is obliterative lesion (multiplication factor of 5.0) and the main branch is non-obliterative lesion (multiplication factor of 2.0), with different stenosis severity.

S= subtotal score-W SBs*5-W involved SBs*5+W involved SBs *2; (3)

Where SBs refer to all normal or abnormal side branches. Involved SBs refer only to the affected edge legs.

Major branch occlusive lesion of the same segment, another lesion (> 1 lesion) is present in the major branch (fig. 13 c), the lesion score is modified according to equation 4 because the major branch weight already includes the major branch weight, and the major branch weight is mistakenly treated as an occlusive lesion by the program (multiplication factor of 5.0). In fact, the main branch disease becomes an independent disease and should be scored separately (multiplication factor of 2.0).

S = subtotal score-W diseased SBs×5; (4)

Non-occlusive lesions

Major branch non-occlusive lesions of the same segment, with the major branch normal and emanating earlier than the lesion (fig. 13 d), the major branch lesion score is modified according to equation 5 because the major branch weight already includes the major side branch weight, which is not affected.

S =subtotal score-W intact SBs×2; (5)

Major non-occlusive lesions of the same segment, with involvement of the major side branch (1 lesion) and the side branch giving out earlier than major lesion (fig. 13 e), major lesion score is modified according to equation 6, while the involved major side branch does not need to be scored, since the involved side branch weight is already included in the major branch.

S=subtotal score-W involved SBs×2; (6)

Major non-occlusive lesions of the same segment, with lesions in both major collateral branches (> 1 lesion) and with collateral branches giving off earlier than major lesions (fig. 13 f), the major branch lesion score is modified according to equation 7 because the major branch weight already includes the major branch weight, which must be scored as an independent lesion.

S= subtotal score - W diseased SBs×2; (7)

Wherein S is the corrected score of the lesion segment,

subtotal score is a conventional score for the lesion,

WSBs are the primary branch weights.

Intact SBs refer to primary side branches normal,

involved SBs refer to the involvement of the major side branch, but should be considered as 1 lesion along with the main branch lesion,

the disease SBs indicate that there is a lesion in the main collateral branch, and independent of the main branch lesion.

In summary, in the same segment, all major side branches (> 1.5mm in diameter), whenever they are issued earlier than the main branch lesions, whether normal, affected or independent, the software score may overestimate the severity of the lesion due to the presence of the side branch, and therefore the side branch weight should be deducted, thus modifying the score.

Preferably, the blood vessel monitoring device further comprises a marking module, wherein the marking module marks the blood vessel into a gray-scale image from high to low according to the variable width of the blood vessel, so that the lesion degree of the lesion part can be observed manually.

Scoring example:

referring to fig. 14, an example of a conventional score. In large RCA, short LAD and common diagonal branch circulation types, occlusive lesions are routinely scored (upper row white arrows). In the extra-large RCA, common LAD length and common diagonal branch circulation type, non-occlusive lesions were routinely scored (lower row white arrows).

Referring to fig. 14, in the normal LAD and major diagonal branch circulation type, major occlusive lesions in the same segment, and the main branches involved (upper row white arrows), the lesion score is modified according to equation 3: 50-2 by 5(9a) -2 by 5(seg 9b) +2 by 2(seg 9b) =24 in the left dominant, short LAD and large diagonal branch circulation type, the main branch is non-occlusive, normal and early in the lesion in the same segment (white arrow in the lower panel), the main lesion score is modified as in equation 5: 14-4 x 2(seg 9&) =6.

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like that fall within the spirit and principle of the present invention are intended to be included therein.

Claims

1. A 17-segment myocardial scoring system, comprising:

the method comprises the following steps: the frame capturing end is used for capturing video frames of the dynamic contrast video;

2. The 17-segment myocardial scoring system of claim 1, wherein: the blood vessel width detection device further comprises a marking module, and the marking module marks the blood vessel into a gray-scale image from high to low according to the height of the change of the blood vessel width.

3. The 17-segment myocardial scoring system of claim 1, wherein: the set threshold is the mean of the percentage change in vessel width.