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Flow Resistance Analysis of Clinically Significant Portal Hypertension in Patients with Liver Cirrhosis

Yizhe Wang1, Luxiang Zhao2, Zhuozhao Zheng1

  • 1Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University, Beijing 102218, China.

Canadian Journal of Gastroenterology & Hepatology
|October 6, 2022
PubMed

Insights

Flow resistance analysis is a more sensitive noninvasive method for detecting clinically significant portal hypertension (CSPH) in cirrhosis patients compared to vessel size measurements. Early detection of CSPH is crucial for reducing mortality.

Area of Science:

  • Medical Imaging
  • Hepatology
  • Cardiovascular Fluid Dynamics

Background:

  • Clinically significant portal hypertension (CSPH) due to cirrhosis is a fatal condition requiring early detection.
  • Current diagnostic methods for CSPH have limitations in sensitivity.

Purpose of the Study:

  • To propose and evaluate an image-based flow resistance analysis for detecting CSPH.
  • To compare the sensitivity of flow resistance analysis with traditional vessel size measurements in CSPH detection.

Main Methods:

  • Utilized three-dimensional image construction technology and computational fluid dynamics (CFD).
  • Performed flow resistance analysis on nine cirrhosis patients with CSPH and ten healthy controls.
  • Measured portal vein system flow resistance and cross-sectional area.

Main Results:

  • CSPH patients exhibited significantly lower portal vein system flow resistance (0.97 ± 0.11 Pa/(mL/s)) compared to controls (1.80 ± 0.40 Pa/(mL/s), P = 0.028).
  • Main portal vein dilation was observed in CSPH patients, but cross-sectional area enlargement was not statistically significant (P = 0.39).
  • Flow resistance analysis demonstrated higher sensitivity for CSPH detection than vessel size measurement.

Conclusions:

  • Image-based flow resistance analysis is a sensitive noninvasive method for detecting CSPH in cirrhosis patients.
  • Flow resistance analysis can serve as a valuable supplementary tool for early CSPH detection.
  • This approach may aid in reducing mortality rates associated with CSPH.

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