Sickle Cell Disease: Reference Values and Interhemispheric Differences of Nonimaging Transcranial Doppler Blood Flow Parameters

Arkuszewski, Michał; Krejza, Jarosław; Chen, R.; Kwiatkowski, Janet L.; Ichord, Rebecca; Zimmerman, Robert A.; Ohene‐Frempong, Kwaku; Desiderio, Lisa; Melhem, Elias R.

doi:10.3174/ajnr.a2529

Cited by 20 publications

(12 citation statements)

References 44 publications

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“…Vein of Galen malformation is a congenital cerebrovascular disease that primarily affects infants and young children and has been shown to cause abnormal cardiac and cerebral flow . Sickle cell disease has also been shown to be associated with abnormal cerebral blood flow and velocities in children . In addition, congenital heart disease has a significant impact on cerebral blood flow and brain development as a result of flow disturbances from cardiac abnormality .…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Sickle cell disease has also been shown to be associated with abnormal cerebral blood flow and velocities in children. 38,39 In addition, congenital heart disease has a significant impact on cerebral blood flow and brain development as a result of flow disturbances from cardiac abnormality. 3 Consequently, determination of normal values of cerebral and cardiac flow parameters, particularly considering the effects of age, can be of significant benefit in treatment planning and outcome evaluation in the management of these diseases.…”

Section: Discussionmentioning

confidence: 99%

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Age‐Related Changes of Normal Cerebral and Cardiac Blood Flow in Children and Adults Aged 7 Months to 61 Years

Honarmand

Schnell

et al. 2016

JAHA

123

107

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BackgroundCerebral and cardiac blood flow are important to the pathophysiology and development of cerebro‐ and cardiovascular diseases. The purpose of this study was to investigate the age dependence of normal cerebral and cardiac hemodynamics in children and adults over a broad range of ages.Methods and ResultsOverall, 52 children (aged 0.6–17.2 years) and 30 adults (aged 19.2–60.7 years) without cerebro‐ and cardiovascular diseases were included in this study. Intracranial 4‐dimensional flow and cardiac 2‐dimensional phase‐contrast magnetic resonance imaging were performed for all participants to measure flow parameters in the major intracranial vessels and aorta. Total cerebral blood flow (TCBF), cardiac and cerebral indexes, brain volume, and global cerebral perfusion (TCBF/brain volume) were evaluated. Flow analysis revealed that TCBF increased significantly from age 7 months to 6 years (P<0.001) and declined thereafter (P<0.001). Both cardiac and cerebral indices declined with age (P<0.001). The ratio of TCBF to ascending aortic flow declined rapidly until age 18 years (P<0.001) and remained relatively stable thereafter. Age‐related changes of cerebral vascular peak velocities exhibited a trend similar to TCBF. By comparison, aortic peak velocities maintained relatively high levels in children and declined with age in adults (P<0.001). TCBF significantly correlated with brain volume in adults (P=0.005) and in 2 pediatric subgroups, aged <7 years (P<0.001) and 7 to 18 years (P=0.039).ConclusionsCerebral and cardiac flow parameters are highly associated with age. The findings collectively highlight the importance of age‐matched control data for the characterization of intracranial and cardiac hemodynamics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age‐Related Changes of Normal Cerebral and Cardiac Blood Flow in Children and Adults Aged 7 Months to 61 Years

Honarmand

Schnell

et al. 2016

JAHA

123

107

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“…3 Additionally, microvascular tissue perfusion, or CBF, is also increased in patients with SCD 4,5 ; which is related to low hematocrit (Hct). 6,7 CBF measurements are instrumental in understanding the pathophysiology of impaired perfusion in the occurrence of silent cerebral infarcts in SCD.…”

mentioning

confidence: 99%

In Vivo T1 of Blood Measurements in Children with Sickle Cell Disease Improve Cerebral Blood Flow Quantification from Arterial Spin-Labeling MRI

Václavů

Land

Heijtel

et al. 2016

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Children with sickle cell disease have low hematocrit and elevated CBF, the latter of which can be assessed with arterial spin-labeling MR imaging. Quantitative CBF values are obtained by using an estimation of the longitudinal relaxation time of blood (T1 blood ). Because T1 blood depends on hematocrit in healthy individuals, we investigated the importance of measuring T1 blood in vivo with MR imaging versus calculating it from hematocrit or assuming an adult fixed value recommended by the literature, hypothesizing that measured T1 blood would be the most suited for CBF quantification in children with sickle cell disease.

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“…Studies either do not report the prevalence of inadequate TCDs[11, 19, 20], or report finding no inadequate scans[21, 22], although precise criteria for defining inadequate are usually not given. In the STOP study, 5.4% of initial TCD scans on 1934 children, aged 2–16 years, were recorded as inadequate[23].…”

Section: Discussionmentioning

confidence: 99%

The significance of inadequate transcranial Doppler studies in children with sickle cell disease

et al. 2017

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Sickle cell disease (SCD) is a common cause of cerebrovascular disease in childhood. Primary stroke prevention is effective using transcranial Doppler (TCD) scans to measure intracranial blood velocities, and regular blood transfusions or hydroxycarbamide when these are abnormal. Inadequate TCD scans occur when it is not possible to measure velocities in all the main arteries. We have investigated the prevalence and significance of this in a retrospective audit of 3915 TCD scans in 1191 children, performed between 2008 and 2015. 79% scans were normal, 6.4% conditional, 2.8% abnormal and 12% inadequate. 21.6% of 1191 patients had an inadequate scan at least once. The median age of first inadequate scan was 3.3 years (0.7–19.4), with a U-shaped frequency distribution with age: 28% aged 2–3 years, 3.5% age 10 years, 25% age 16 years. In young children reduced compliance was the main reason for inadequate TCDs, whereas in older children it was due to a poor temporal ultrasound window. The prevalence of inadequate TCD was 8% in the main Vascular Laboratory at King’s College Hospital and significantly higher at 16% in the outreach clinics (P<0.0001), probably due to the use of a portable ultrasound machine. Inadequate TCD scans were not associated with underlying cerebrovascular disease.

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Sickle Cell Disease: Reference Values and Interhemispheric Differences of Nonimaging Transcranial Doppler Blood Flow Parameters

Cited by 20 publications

References 44 publications

Age‐Related Changes of Normal Cerebral and Cardiac Blood Flow in Children and Adults Aged 7 Months to 61 Years

Age‐Related Changes of Normal Cerebral and Cardiac Blood Flow in Children and Adults Aged 7 Months to 61 Years

In Vivo T1 of Blood Measurements in Children with Sickle Cell Disease Improve Cerebral Blood Flow Quantification from Arterial Spin-Labeling MRI

The significance of inadequate transcranial Doppler studies in children with sickle cell disease

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