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

IF 2 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Trials Pub Date : 2025-05-21 DOI:10.1186/s13063-025-08818-6

Lei Zheng, Guangbo Wu, Jiayun Lin, Hongjie Li, Chihao Zhang, Zhifeng Zhao, Min Chen, Zhenghao Wu, Guqing Luo, Qiang Fan, Xiaoliang Qi, Haizhong Huo, Longci Sun, Meng Luo

{"title":"A novel noninvasive assessment of portal pressure from computational biofluid mechanics in patients with portal hypertension.","authors":"Lei Zheng, Guangbo Wu, Jiayun Lin, Hongjie Li, Chihao Zhang, Zhifeng Zhao, Min Chen, Zhenghao Wu, Guqing Luo, Qiang Fan, Xiaoliang Qi, Haizhong Huo, Longci Sun, Meng Luo","doi":"10.1186/s13063-025-08818-6","DOIUrl":null,"url":null,"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.","PeriodicalId":23333,"journal":{"name":"Trials","volume":"26 1","pages":"167"},"PeriodicalIF":2.0000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093596/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Trials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13063-025-08818-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

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.

查看原文本刊更多论文

从计算生物流体力学对门静脉高压症患者门静脉压力的一种新的无创评估。

背景与目的：介绍并评估一种基于生物流体力学的门静脉高压手术患者门静脉压力测量新方法。方法：本研究是一项多中心回顾性研究，对接受手术并测量游离门静脉压力（FPP）的患者进行研究。纳入118例，因多普勒超声检查失败或结果不佳而排除21例，共筛查97例。我们利用患者的CT图像、门静脉系统的多普勒超声结果、血液密度和粘度重建门静脉系统，模拟门静脉系统内部血流。根据患者的物理性质、几何形状和边界条件，利用FLUENT软件求解Navier-Stokes方程，计算虚拟自由门静脉压力（vFPP）。最后，采用Bland-Altman一致限、类内相关系数（ICC）和Lin’s一致性相关系数来评价vFPP和FPP之间的数值相关性。结果：所有入组患者均行手术，术中测量患者FPP，平均FPP为22.8±3.3 mmHg（范围：13-33 mmHg）。同时，根据计算生物流体力学计算所有患者的vFPP。然后，我们进一步探讨在整个人群中vFPP和FPP之间是否存在密切的关系。Bland-Altman一致限分析，差异均值为- 0.1569 (95% CI: - 0.4305 ~ 0.1167)；一致性下限：- 2.8176(95%置信区间：- 3.2868至- 2.3484)；一致性上限：2.5038 （95% CI: 2.0346 ~ 2.9730）。ICC为0.9215 （95% CI: 0.8848 ~ 0.9468）。此外，林氏一致性相关系数显示vFPP与FPP之间的数值相关性为0.9205 （95% CI: 0.8840 ~ 0.9459）。这些结果证实了我们的vFPP模型可以准确预测患者的FPP。结论：计算生物流体力学计算的患者vFPP与门静脉高压症患者FPP有显著相关性，为外科患者门静脉压力评估提供了一种新颖、无创、准确的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Trials 医学-医学：研究与实验

CiteScore

3.80

自引率

4.00%

发文量

966

审稿时长

6 months

期刊介绍： Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.