TY - JOUR
T1 - Non-Invasive Assessment of Intravascular Pressure Gradients
T2 - A Review of Current and Proposed Novel Methods
AU - Nguyen, Tin-Quoc
AU - Hansen, Kristoffer Lindskov
AU - Bechsgaard, Thor
AU - Lonn, Lars
AU - Jensen, Jørgen Arendt
AU - Nielsen, Michael Bachmann
N1 - This article belongs to the Special Issue Imaging-Based Diagnostics in Interventional Medicine
PY - 2019
Y1 - 2019
N2 - Invasive catheterization is associated with a low risk of serious complications. However, although it is the gold standard for measuring pressure gradients, it induces changes to blood flow and requires significant resources. Therefore, non-invasive alternatives are urgently needed. Pressure gradients are routinely estimated non-invasively in clinical settings using ultrasound and calculated with the simplified Bernoulli equation, a method with several limitations. A PubMed literature search on validation of non-invasive techniques was conducted, and studies were included if non-invasively estimated pressure gradients were compared with invasively measured pressure gradients in vivo. Pressure gradients were mainly estimated from velocities obtained with Doppler ultrasound or magnetic resonance imaging. Most studies used the simplified Bernoulli equation, but more recent studies have employed the expanded Bernoulli and Navier–Stokes equations. Overall, the studies reported good correlation between non-invasive estimation of pressure gradients and catheterization. Despite having strong correlations, several studies reported the non-invasive techniques to either overestimate or underestimate the invasive measurements, thus questioning the accuracy of the non-invasive methods. In conclusion, more advanced imaging techniques may be needed to overcome the shortcomings of current methods
AB - Invasive catheterization is associated with a low risk of serious complications. However, although it is the gold standard for measuring pressure gradients, it induces changes to blood flow and requires significant resources. Therefore, non-invasive alternatives are urgently needed. Pressure gradients are routinely estimated non-invasively in clinical settings using ultrasound and calculated with the simplified Bernoulli equation, a method with several limitations. A PubMed literature search on validation of non-invasive techniques was conducted, and studies were included if non-invasively estimated pressure gradients were compared with invasively measured pressure gradients in vivo. Pressure gradients were mainly estimated from velocities obtained with Doppler ultrasound or magnetic resonance imaging. Most studies used the simplified Bernoulli equation, but more recent studies have employed the expanded Bernoulli and Navier–Stokes equations. Overall, the studies reported good correlation between non-invasive estimation of pressure gradients and catheterization. Despite having strong correlations, several studies reported the non-invasive techniques to either overestimate or underestimate the invasive measurements, thus questioning the accuracy of the non-invasive methods. In conclusion, more advanced imaging techniques may be needed to overcome the shortcomings of current methods
KW - pressure gradient
KW - ultrasound
KW - magnetic resonance imaging
KW - intravascular catheterization
KW - review
U2 - 10.3390/diagnostics9010005
DO - 10.3390/diagnostics9010005
M3 - Review
C2 - 30597993
VL - 9
JO - Diagnostics
JF - Diagnostics
SN - 2075-4418
IS - 1
M1 - 5
ER -