Noninvasive Measurement Of Portal Venous Pressure Based On Three-dimensional Portal Venous Reconstruction

Background:Portal hypertension refers to a series of clinical manifestations caused by the increased pressure of the portal vein system.Viral hepatitis is the main cause of portal hypertension in China.Currently,the severity of portal hypertension is mainly assessed by hepatic venous pressure gradient(HVPG).When HVPG>is over 10mmHg,it may indicate the presence of esophageal and gastric varices.However,HVPG is an invasive operation with special requirements for operator technology and hospital equipment.Only a part of large-scale liver disease treatment centers are carried out in China,and patients often find it difficult to accept it.The existing non-invasive assessment methods are still mainly based on qualitative detection.Therefore,it is necessary to study the non-invasive assessment of portal venous pressure,which is also a scientific and clinical problem to be solved urgently in the treatment of portal venous hypertension.Objectives:1.To reconstruct a preliminary three-dimensional model of the portal venous system to measure the portal venous pressure.2.To explore the correlation between liver function grading(Child-Pugh)and portal venous pressure.Methods:Retrospective analysis was performed on patients who underwent transjugular intrahepatic portosystemic shunt(TIPS)diagnosed with portal hypertension in the second affiliated hospital of kunming medical university from May 201 6 to May 2018.The obtained imaging data were imported into the 3d software of medical image to reconstruct the 3d model of the portal vein,and the ANSYS software was imported to calculate the portal venous pressure by given boundary conditions,and to compare with the actual portal venous pressure.Results:1.Gender and liver function score:there were 17 males with mean liver function score 7.2353,standard deviation 1.25147;10 females with mean liver function score 6.60,standard deviation 1.17379.By Levene's test of homogeneity of variance,F=0.007,p 0.935>0.05,it can be concluded that there is no significant difference between the two populations.The T test results,t=0.038,V=25,P=0.970.At the level of 0.05,it showed no significant difference.2.Gender and actual portal venous pressure:there were 17 males,with an average value of 3788.1847 and a standard deviation of 1010.33207.There were 10 females with mean value of actual portal venous pressure was 3773.7700,and the standard deviation was 828.19005.After Levene's test of homogeneity of variance,F=0.194,P=0.664>0.05,it can be considered that the two populations have homogeneity of variance.The t-test results is,t=0.038,v=25,P=0.970,and the difference was not statistically significant at the level of=0.05.3.The correlation between liver function score and actual portal venous pressure was not statistically significant(r=-0.09474,P=0.6383>0.05).4.The mean value of actual portal venous pressure was 3782.85,and the standard deviation was 930.40.The mean value of predicted portal venous pressure was 4237.69,and the standard deviation was 1218.44.After paired t-test,t=-1.970,v=26,P=0.06,the difference was not statistically significant at the level of=0.05.5.After linear correlation analysis,r=0.402,P=0.038 and=0.05,it was considered that the predictive portal venous pressure was positively correlated with the actual dream venous pressure.Conclusions:1.In patients with portal hypertension,there was no significant correlation among portal vein pressure and liver function score(Child-Pugh).2.There was no statistical difference between the predicted portal venous pressure and the actual portal venous pressure,and there was a positive correlation.3.Non-invasive measurement of portal venous pressure based on three-dimensional portal venous reconstruction can be used for preliminary assessment of portal venous pressure in patients with portal hypertension.