Analysis of simulated hemodynamic parameters of Budd-Chiari syndrome with perforated membrane of inferior vena cava before and after interventional therapy / 中华肝胆外科杂志

ABSTRACT

Objective To establish a three-dimensional (3D) model of the diaphragm type of Budd-Chiari syndrome (BCS) with perforated membrane,to analyze changes of hemodynamic parameters pre and post percutaneous transluminal angioplasty (PTA) and to analyze any possibly related mechanical factors for postoperative recurrence in BCS.Methods The data on enhanced MRI from patients suffering from BCS with perforated diaphragm of inferior vena cava were reconstructed into a 3D model Computational fluid dynamics (CFD) were applied for numerical simulation based on the model,and the results were expressed as cloud images.Results The total number of model units of the finite element model for preoperative inferior vena cava stenosis was 16 422,and the total number of nodes was 48 170.The total number of model units for postoperative inferior vena cava was 16 539,and the total number of nodes was 51 339.Hemodynamic patterns of the lesion areas were effectively reflected in the 3D flow dynamic model for BCS.By comparing the hemodynamic parameters before and after interventional therapy,the data indicated that there was a gradual decline in wall pressure from the telecentric side.The largest blood flow velocity as well as wall shear stress were observed in the stenotic area of inferior vena cava.Both a large postoperative vascular central velocity and a low increase in local pressure predicted occurrence of vascular restenosis.Conclusions The establishment of a 3D fluid model of inferior vena cava revealed that there were mechanical changes in the location of the lesion.Variations in blood flow patterns exert a far-reaching influence on distribution of hemodynamic parameters,including local blood flow velocity,vascular wall pressure and shear stress.All these might be related to recurrence of BCS after interventional therapy.