Trans-stenotic pressure drop estimation from PC-MRI and ultrasound imaging velocimetry using a modified Bernoulli equation
摘要
Accurate non-invasive estimation of trans-stenotic pressure drops remains a challenge. In clinical practice, pressure drops are often estimated from velocity measurements using Bernoulli-based formulas, but these simplified relations do not explicitly account for how pressure losses change with the flow regime. Here, we introduce a modified Bernoulli (MB) formulation that incorporates regime-dependent pressure losses through a Reynolds-number-dependent loss coefficient. Steady in-vitro experiments were performed in an idealized stenosis model over physiologically relevant flow rates (0.65–3.9 L/min), combining direct pressure measurements with ultrasound imaging velocimetry (UIV) and phase-contrast magnetic resonance imaging (PC-MRI) to measure velocities. The MB model was calibrated from the measured pressure drops and then evaluated against the simplified Bernoulli (SB) and extended Bernoulli (EB) formulations. Over the tested flow regime, MB agreed best with the measurements (typically within about ±10% ). SB and EB showed larger biases, with errors of roughly 10–55% (SB) and -15 to 25%−(EB), and overestimated the pressure drop in the clinically relevant range. We additionally quantified the effect of PC-MRI in-plane pixel size on MRI-based pressure estimates. Coarse in-plane pixel size of 1.33 mm, corresponding to only approximately 3–4 pixels across the 3.3 mm throat radius of the 6.6 mm stenosis throat, led to systematic underestimation of flow rate and bulk velocity (about − 34 to − 44%) and, consequently, of the MB-predicted pressure drop (about − 52 to − 62%). In contrast, the peak throat velocity was substantially less sensitive to pixel size, resulting in smaller estimation errors (about − 13 to − 18.7%) when used as input for the MB. Overall, the results demonstrate that accounting for flow-regime-dependent loss mechanisms enhances pressure drop estimation, and that sufficient sampling of the stenotic throat is crucial for MRI-based flow rate and pressure drop estimation. In addition, peak-velocity-based MB pressure drop estimations are less sensitive to pixel size.