European journal of radiology · 2026
Computational fluid dynamics for severity assessment of arterial occlusive diseases.
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Li Weihao, Tan Yiheng, van der Doef Hubert P J, Willems Tineke, Bertoglio Cristóbal, Bokkers Reinoud P H
Аннотация
OBJECTIVES: This scoping review aims to examine the methodological considerations and clinical applications of computational fluid dynamics (CFD) in arterial occlusive diseases spanning the carotid, peripheral, renal, and aortic segments.
METHODS: MEDLINE, CENTRAL, and Embase were searched for studies applying CFD to arterial occlusive diseases (except for coronary and intracranial segments). Studies with more than 5 patients and clinical outcome data were included. Data on CFD techniques, hemodynamic parameters, and clinical correlations were extracted.
RESULTS: From 1,925 identified studies, 34 were included. Blood flow measurements were obtained primarily using Doppler ultrasound (n = 17) and phase-contrast MRI (n = 10). Twenty-four studies specified inlet velocity profiles, with parabolic (n = 11), Womersley (n = 10), and plug (n = 3) patterns. Transient (pulsatile) flow (n = 18) was more frequently modeled than steady flow (n = 9). In carotid artery disease (n = 23), high wall shear stress (WSS) and oscillatory shear index (OSI) predicted plaque vulnerability and restenosis, with high WSS linked to ulceration and low WSS to plaque growth. In peripheral artery disease (n = 6), low time-averaged WSS (TAWSS) and high OSI predicted restenosis, particularly in curved segments. CFD-derived pressure gradients achieved up to 95% diagnostic accuracy for iliac stenosis. For renal artery stenosis (n = 3), high peak WSS and velocity indicated critical cases, and in aortic diseases (n = 2), elevated TAWSS and OSI highlighted post-repair risks.
CONCLUSIONS: CFD offers detailed hemodynamic assessment that correlates with diagnostic accuracy, disease progression, treatment strategies and outcomes. Future research should prioritize standardization of CFD protocols, improved inlet data acquisition, reduced computational burden, and robust clinical validation.
METHODS: MEDLINE, CENTRAL, and Embase were searched for studies applying CFD to arterial occlusive diseases (except for coronary and intracranial segments). Studies with more than 5 patients and clinical outcome data were included. Data on CFD techniques, hemodynamic parameters, and clinical correlations were extracted.
RESULTS: From 1,925 identified studies, 34 were included. Blood flow measurements were obtained primarily using Doppler ultrasound (n = 17) and phase-contrast MRI (n = 10). Twenty-four studies specified inlet velocity profiles, with parabolic (n = 11), Womersley (n = 10), and plug (n = 3) patterns. Transient (pulsatile) flow (n = 18) was more frequently modeled than steady flow (n = 9). In carotid artery disease (n = 23), high wall shear stress (WSS) and oscillatory shear index (OSI) predicted plaque vulnerability and restenosis, with high WSS linked to ulceration and low WSS to plaque growth. In peripheral artery disease (n = 6), low time-averaged WSS (TAWSS) and high OSI predicted restenosis, particularly in curved segments. CFD-derived pressure gradients achieved up to 95% diagnostic accuracy for iliac stenosis. For renal artery stenosis (n = 3), high peak WSS and velocity indicated critical cases, and in aortic diseases (n = 2), elevated TAWSS and OSI highlighted post-repair risks.
CONCLUSIONS: CFD offers detailed hemodynamic assessment that correlates with diagnostic accuracy, disease progression, treatment strategies and outcomes. Future research should prioritize standardization of CFD protocols, improved inlet data acquisition, reduced computational burden, and robust clinical validation.