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Diagnostics 2019, 9(1), 5;

Non-Invasive Assessment of Intravascular Pressure Gradients: A Review of Current and Proposed Novel Methods

Department of Diagnostic Radiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
Department of Radiology, Odense University Hospital Svendborg Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark
Center for Fast Ultrasound Imaging, DTU Elektro, Technical University of Denmark, Ørsteds Plads Building 349, 2800 Lyngby, Denmark
Author to whom correspondence should be addressed.
Received: 29 October 2018 / Revised: 21 December 2018 / Accepted: 26 December 2018 / Published: 29 December 2018
(This article belongs to the Special Issue Imaging-Based Diagnostics in Interventional Medicine)
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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. View Full-Text
Keywords: pressure gradient; ultrasound; magnetic resonance imaging; intravascular catheterization; review pressure gradient; ultrasound; magnetic resonance imaging; intravascular catheterization; review

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Nguyen, T.-Q.; Hansen, K.L.; Bechsgaard, T.; Lönn, L.; Jensen, J.A.; Nielsen, M.B. Non-Invasive Assessment of Intravascular Pressure Gradients: A Review of Current and Proposed Novel Methods. Diagnostics 2019, 9, 5.

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