arXiv:2602.16000physics.med-phcs.LG2026-02

用AI和物理约束加速冠脉狭窄功能评估,更准更快更可靠。

Imaging-Derived Coronary Fractional Flow Reserve: Advances in Physics-Based, Machine Learning, and Physics-Informed Methods

  • 结合物理规律与深度学习,提升模型泛化能力。
  • 新方法实现无导丝、快速计算,30秒内完成评估。
  • 适合心血管影像医生和算法研发者参考。

影像衍生冠状动脉血流分数(FFR)正从传统计算流体动力学(CFD)转向机器学习(ML)、深度学习(DL)及物理信息学习方法,实现无导丝、快速且可扩展的功能性评估。本文综述了基于冠状动脉造影和CT的FFR进展,重点介绍物理信息神经网络(PINNs)和神经算子(PINOs)等新兴技术。ML/DL方法显著提升了自动化水平和计算速度,可从解剖特征或造影动态预测压力与FFR。但其真实表现受多中心数据异质性、图像质量差异和采集协议影响,存在泛化能力不稳定问题。物理信息学习通过引入守恒律与边界条件一致性,增强模型鲁棒性,减少对密集标注的依赖,同时保持快速推理。近期评估趋势强调校准、不确定性量化与质量控制门控等部署指标的重要性,确保临床应用安全。未来方向需通过前瞻性多中心验证与标准化评估,推动技术广泛安全落地。

原文摘要 · Abstract (English)

Purpose of Review Imaging derived fractional flow reserve (FFR) is rapidly evolving beyond conventional computational fluid dynamics (CFD) based pipelines toward machine learning (ML), deep learning (DL), and physics informed approaches that enable fast, wire free, and scalable functional assessment of coronary artery stenosis. This review synthesizes recent advances in computed tomography (CT)- and angiography-based FFR measurement, with particular emphasis on emerging physics-informed neural networks and neural operators (PINNs and PINOs), as well as key considerations for their clinical translation. Recent Findings ML/DL approaches have markedly improved automation and computational speed, enabling prediction of pressure and FFR from anatomical descriptors or angiographic contrast dynamics. However, their real-world performance and generalizability can remain variable and sensitive to domain shift, due to multi-center heterogeneity, interpretability challenges, and differences in acquisition protocols and image quality. Physics informed learning introduces conservation structure and boundary condition consistency into model training, improving generalizability and reducing dependence on dense supervision while maintaining rapid inference. Recent evaluation trends increasingly highlight deployment oriented metrics, including calibration, uncertainty quantification, and quality control gatekeeping, as essential for safe clinical use. Summary The field is converging toward imaging derived FFR methods that are faster, more automated, and more reliable. While ML/DL offers substantial efficiency gains, physics informed frameworks such as PINNs and PINOs may provide a more robust balance between speed and physical consistency. Prospective multi center validation and standardized evaluation will be critical to support broad and safe clinical adoption.

医学影像机器学习物理信息冠心病

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