Characterization of Turbulence and Pressure Gradients in Venous Sinus Stenosis: A Phantom Study using 4D Flow MRI with ICOSA6 Encoding and vWERP-t

Motivation: Pulsatile tinnitus is related to changes in venous sinus hemodynamics. However, non-invasive quantification of turbulence and resulting irreversible pressure loss remains scarce. Goal(s): To non-invasively measure turbulence-driven pressure gradients in venous sinus stenosis. Approach: Pressure gradients were measured in a patient-specific flow phantom of venous sinus stenosis using 4D Flow MRI with ICOSA6 encoding in combination with the virtual work-energy relative pressure method (vWERP-t) and validated against catheter-based manometry. Results: The inclusion of turbulent dissipation had distinct impact on estimated relative pressures. vWERP-t derived pressures agreed with reference manometry but results directly depended on resolution and flow rate. Impact: This work demonstrates the feasibility of measuring turbulence-driven pressure gradients in venous sinus flows non-invasively, laying the groundwork for future in-vivo studies to investigate the relationship between pulsatile tinnitus and venous sinus hemodynamics.