Background

This study aimed to adopt computational fluid dynamics to simulate the blood flow dynamics in inferior vena cava stenosis based on time-dependent patient-specific models of Budd-Chiari syndrome as well as a normal model. It could offer valuable references for a retrospective insight into the underlying mechanisms of Budd-Chiari syndrome pathogenesis as well as more accurate evaluation of postoperative efficacy.

Methods

Three-dimensional inferior vena cava models of Budd-Chiari syndrome patient-specific (preoperative and postoperative) and normal morphology model were reconstructed as per magnetic resonance images using Simpleware. Moreover, computational fluid dynamics of time-resolved inferior vena cava blood flow were simulated using actual patient-specific measurements to reflect time-dependent flow rates.

Findings

The assessment of the preoperative model revealed the dramatic variations of hemodynamic parameters of the stenotic inferior vena cava. Moreover, the comparison of the preoperative and postoperative models with the normal model as benchmark showed that postoperative hemodynamic parameters were markedly ameliorated via stenting, with the attenuation of overall velocity and wall shear stress, and the increase of pressure. However, the comparative analysis of the patient-specific simulations revealed that some postoperative hemodynamic profiles still bore some resemblance to the preoperative ones, indicating potential risks of restenosis.

Interpretation

Computational fluid dynamics simulation of time-resolved blood flow could reveal the tight correlation between the hemodynamic characteristics and the pathological mechanisms of inferior vena cava stenosis. Furthermore, such time-resolved hemodynamic profiles could provide a quantitative approach to diagnosis, operative regimen and postoperative evaluation of Budd-Chiari syndrome with inferior vena cava stenosis.

中文翻译：

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Budd-Chiari综合征合并下腔静脉狭窄的时间分辨血流的计算流体动力学模拟及其对术后疗效评估的意义

背景

这项研究旨在采用计算流体动力学来模拟下腔静脉狭窄的血流动力学，该模型基于与时间有关的Budd-Chiari综合征患者特定模型以及正常模型。它可以为宝贵的参考资料，以回顾性了解Budd-Chiari综合征发病机理的基础机制，以及更准确地评估术后疗效。

方法

使用Simpleware根据磁共振图像重建Budd-Chiari综合征患者特有的三维下腔静脉模型（术前和术后）和正常形态模型。此外，使用实际的患者特定测量值来模拟时间分辨下腔静脉血流的计算流体动力学，以反映时间依赖性流速。

发现

术前模型的评估揭示了狭窄下腔静脉血流动力学参数的巨大变化。此外，将术前和术后模型与正常模型作为基准进行比较，结果表明，通过置入支架可以显着改善术后血液动力学参数，同时降低整体速度和壁切应力，并增加压力。然而，对患者特定模拟的比较分析显示，一些术后血流动力学特征仍然与术前相似，表明存在再狭窄的潜在风险。

解释

时间分辨血流的计算流体动力学模拟可以揭示下腔静脉狭窄的血液动力学特征与病理机制之间的紧密相关性。此外，这种时间分辨的血流动力学特征可以为定量诊断下腔静脉狭窄的Budd-Chiari综合征提供诊断，手术方案和术后评估的定量方法。