三维重建结合有限元分析测定门静脉 高压症患者门静脉压力的临床价值

Clinical value of portal venous pressure based on three dimensional reconstruction model of portal vein combined with finite element analysis in patients with portal hypertension

目的分析利用CT影像资料建立门静脉系统三维模型,结合有限元分析检测门静脉高压症患者门静脉压力的临床价值。方法回顾分析2016年5月至2018年5月连续在昆明医科大学第二附属医院诊断为门静脉高压症的27例患者资料,其中男性17例,女性10例,年龄范围34-77岁,平均年龄56岁。27例患者均接受经颈静脉肝内门体分流术(TIPS),手术期间测量门静脉压力值。将患者CT影像资料导入医学三维软件,重建门静脉三维模型,并导入ANSYS有限元分析软件,结合计算所得边界条件,计算门静脉压力预测值。采用Pearson相关分析门静脉压力实际测量值与软件预测值的相关性。结果27例门静脉高压症患者TIPS支架置入前门静脉压力实际测量值(3783±930)Pa,预测值为(4238±1218)Pa,两者比较差异无统计学意义(P>0.05)。门静脉压力预测值与实际测量值呈正相关(r=0.402,95%CI:0.026~0.678,P<0.05)。结论门静脉高压症患者基于CT三维重建和有限元分析所测得门静脉压力值可在一定程度提示实际门静脉压力水平。

Objective To study the clinical value of three-dimensional CT reconstruction model of portal venous system combined with finite element analysis to measure portal venous pressure in patients with portal hypertension.Methods A retrospective study was conducted on 27 patients who were diagnosed to have portal hypertension at the Second Affiliated Hospital of Kunming Medical University from May 2016 to May 2018.There were 17 males and 10 females,with ages ranging from 34 to 77 years(mean 56 years).All these patients underwent transjugular intrahepatic portal venous shunt(TIPS)during which the portal venous pressure was measured.The imaging data was imported into the three-dimensional software of medical imaging to reconstruct the three dimensional model of portal vein,and the finite element analysis software of ANSYS was used to calculate the portal venous pressure by calculation with given boundary conditions.Pearson correlation was used to analyze the correlation between the actual measurement of portal venous pressure and the predicted value.Results The actual measured value of portal vein pressure before TIPS in 27 patients with portal hypertension was(3783±930)Pa,and the predicted value was(4238±1218)Pa.There was no significant difference(P>0.05).The predicted value of portal venous pressure was positively correlated with the actual measured value(r=0.402,95%CI:0.026-0.678,P<0.05).Conclusion Non-invasive measurement of portal venous pressure based on three-dimensional portal venous reconstruction combined with finite element analysis correlated with actual portal venous pressure in patients with portal hypertension.