The application of computational fluid dynamics in hepatic portal vein haemodynamics research: a narrative review

The diagnosis and treatment of many liver diseases are related to the assessment of the hepatic portal vein (PV). Noninvasive methods (medical imaging) and invasive methods (hepatic vein catheterization) are commonly used to analyse the haemodynamic information of the PV. In recent years, computational fluid dynamics (CFD) has emerged as a transformative tool in haemodynamics research, revolutionizing the understanding of blood flow behaviour, especially in various artery systems. The purpose of this review is the following: (I) introduce clinicians to CFD as a novel tool and describe its role in PV assessment; and (II) for clinicians and researchers who already use CFD, outline the progress in the application of CFD to the PV.

The English-language literature published from 1987 (when the first study supporting the study's aim appeared) to 2024 was selected for inclusion in a narrative review.

This narrative review commences with an overview of principles of CFD and methods in PV studies, which involve model establishment, grid partitioning, boundary condition formulation, and error analysis. The focus then shifts to CFD's impact on the examination of the PV under different conditions such as portal hypertension in liver cirrhosis, PV thrombosis, post-transjugular intrahepatic portosystemic shunt (TIPS) procedure, and evaluation of the PV after liver transplantation. Finally, challenges and future directions about the CFD application in PV are outlined.

CFD has potential application value in PV haemodynamics, but of the few studies available, most involve only small samples. Therefore, more research is needed to clarify the feasibility and reliability of this new tool.