A numerical study of hepatic artery flow for prediction of congenital biliary atresia

Biliary atresia (BA) is the most severe life-threatening and quickly developed hepatobiliary disease in infants which will lead to destructive inflammatory process of both intra-hepatic and extra-hepatic bile ducts. Currently, the common diagnosis method is Ultrasonography (US). However, its sensitivity commonly arrived at the range of 70% to 80%. Here, we investigated a patient with BA, Patient 1, and a normal patient, Patient 2, were used as control. There is no much difference from the US results of two patients. Due to close relationship between the occurrence and development of BA and the hemodynamic changes, two three-dimensional (3D) hepatic arteries (HA) with splenic artery (SA) models were constructed from Computed Tomography (CT) images, and the simulation of computational fluid dynamics (CFD) was performed to evaluate the hemodynamic outcomes of HA and SA. Pressure, wall shear stress (WSS) and streamlines were calculated to estimate and compare the results of two models. By the analysis, we clearly found that the value of total pressure of HA in Patient 1 was much higher and uneven than that of HA in Patient 2. WSS distribution of Patient 1 is higher and uneven. The blood flow in HA of Patient 1 was more turbulent and complex than in HA of the normal patient. These hemodynamic abnormalities parameters were more sensitive than US, which may be able to provide a prediction of BA for clinicians. And CFD can be a potential noninvasive tool for early diagnosis of BA.