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Clinically significant portal hypertension (CSPH) is a severe complication ofchronic liver disease associated with cirrhosis, which is diagnosed by themeasurement of hepatic venous pressure gradient (HVPG). However, HVPGmeasurement is invasive and therefore difficult to be widely applied inclinical routines. There is no currently available technique to measure HVPGnoninvasively. Computational fluid dynamics (CFD) has been used for noninvasivemeasurement of vascular pressure gradient in the intracranial and coronaryarteries. However, it has been scarcely employed in the hepatic vessel systemdue to the difficulties in reconstructing precise vascular anatomies andsetting appropriate boundary conditions. Several computer tomography andultrasound based studies have verified the effectiveness of virtual HVPG(vHVPG) by directly connecting the portal veins and hepatic veins before CFDsimulations. We apply the latest techniques of phase-contrast magneticresonance imaging (PC-MRI) and DIXON to obtain the velocity and vesselanatomies at the same time. Besides, we improve the CFD pipeline in regards tothe construction of vessel connections and reduction of calculation time. Theproposed method shows high accuracy in the CSPH diagnosis in a study containingten healthy volunteers and five patients. The MRI-based noninvasive HVPGmeasurement is promising in the clinical application of CSPH diagnosis.

Non-invasive Assessment of Hepatic Venous Pressure Gradient (HVPG) Based on MR Flow Imaging and Computational Fluid Dynamics