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Multicenter Study
. 2025 May 21;26(1):167.
doi: 10.1186/s13063-025-08818-6.

A novel noninvasive assessment of portal pressure from computational biofluid mechanics in patients with portal hypertension

Lei Zheng #  1 , Guangbo Wu #  1 , Jiayun Lin #  1 , Hongjie Li  1 , Chihao Zhang  1 , Zhifeng Zhao  1 , Min Chen  1 , Zhenghao Wu  1 , Guqing Luo  1 , Qiang Fan  1 , Xiaoliang Qi  1 , Haizhong Huo  2 , Longci Sun  3 , Meng Luo  4
Affiliations
Multicenter Study

A novel noninvasive assessment of portal pressure from computational biofluid mechanics in patients with portal hypertension

Lei Zheng et al. Trials. .

Abstract

Background and aims: To introduce and assess a novel method for portal pressure measurement based on biofluid mechanics in portal hypertensive patients undergoing surgery.

Methods: The research was a multi-center, retrospective study, conducted on patients who underwent surgery and measurement of free portal pressure (FPP). There were 118 patients included and 21 patients excluded due to the failure or poor results of Doppler ultrasound, and 97 patients were screened. We used patients' CT images, Doppler ultrasound results of the portal system, blood density and viscosity to reconstruct their portal system and simulate its internal blood flow. According to the patient's physical property, geometry, and boundary conditions, the Navier-Stokes equations were solved by FLUENT software, and virtual free portal pressure (vFPP) was calculated. Finally, the Bland-Altman Limits of Agreement, intraclass correlation coefficient (ICC), and the Lin's concordance correlation coefficient were performed to evaluate the numerical correlation between the vFPP and FPP.

Results: All patients enrolled in this study underwent the surgery, and the FPP of patients was measured during the surgery, with a mean FPP of 22.8 ± 3.3 mmHg (range: 13-33 mmHg). Meanwhile, according to computational biofluid mechanics, all patients' vFPP was calculated. Then, we further explored whether there was a close relationship between vFPP and FPP in the whole population. For the analysis of Bland-Altman Limits of Agreement, the mean value of difference was - 0.1569 (95% CI: - 0.4305 to 0.1167); lower limit of agreement: - 2.8176 (95% CI: - 3.2868 to - 2.3484); upper limit of agreement: 2.5038 (95% CI: 2.0346 to 2.9730). The ICC was 0.9215 (95% CI: 0.8848 to 0.9468). Furthermore, the Lin's concordance correlation coefficient showed a numerical correlation between the vFPP and FPP, which was 0.9205 (95% CI: 0.8840 to 0.9459). All these results confirmed that our vFPP model could provide an accurate prediction of FPP in patients.

Conclusions: The vFPP of patients calculated by computational biofluid mechanics was significantly correlated with the FPP of portal hypertensive patients, which would be a novel, non-invasive, and accurate method for the assessment of portal pressure in surgical patients.

Keywords: Computational biofluid mechanics; Free portal pressure; Portal hypertension.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study conformed to the Helsinki declaration. Ethics approval and written informed consent were obtained. Furthermore, the present research was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR-DDD-17012700). The study was submitted and approved by the Ethical Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, China (Approval No: SH9H-2021-A233-SB, SH9H-2021-TK116-1, SH9H-2019-A201-2, and SH9H-2021-T451-2). Consent for publication: All authors have approved the manuscript and agree with its submission to Trials. Competing interests: No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript and all authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Study procedure. FPP, free portal pressure
Fig. 2
Fig. 2
An example of the simulation model of a portal venous system. A The geometry of the simulation model. B The body meshes of the simulation model. C The blood flow velocity (m/s) of the portal vein and its branches
Fig. 3
Fig. 3
An example of the blood pressure (Pa) of the portal vein and its branches
Fig. 4
Fig. 4
The numeric correlation between vFPP and FPP. A Bland–Altman Limits of Agreement analysis. B Intraclass correlation coefficient. C Lin’s concordance correlation coefficient. FPP, free portal pressure; vFPP, virtual free portal pressure
See this image and copyright information in PMC

References

    1. Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet. 2014;383(9930):1749–61. - DOI - PubMed
    1. Qi X, Berzigotti A, Cardenas A, et al. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018;3(10):708–19. - DOI - PubMed
    1. Procopet B, Tantau M, Bureau C. Are there any alternative methods to hepatic venous pressure gradient in portal hypertension assessment? Journal of gastrointestinal and liver diseases : JGLD. 2013;22(1):73–8. - PubMed
    1. Gana JC, Serrano CA, Ling SC. Angiogenesis and portal-systemic collaterals in portal hypertension. Ann Hepatol. 2016;15(3):303–13. - DOI - PubMed
    1. Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology (Baltimore, MD). 2017;65(1):310–35. - DOI - PubMed

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