Transcranial doppler ultrasonography in children with sickle cell anemia: Clinical and laboratory correlates for elevated blood flow velocities

2013 ◽  
Vol 42 (2) ◽  
pp. 89-95 ◽  
Author(s):  
IkeOluwa Lagunju ◽  
Olugbemiro Sodeinde ◽  
Biobele Brown ◽  
Felix Akinbami ◽  
Babatunde Adedokun
Keyword(s):  
Blood Flow ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Transcranial Doppler ◽  
Doppler Ultrasonography ◽  
Transcranial Doppler Ultrasonography ◽  
Elevated Blood ◽  
Blood Flow Velocities ◽  
Flow Velocities

Correlation Between Cerebral Blood Flow Velocities Measured By Magnetic Resonance and Transcranial Doppler Ultrasound in Children with Sickle Cell Anemia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2496-2496
Author(s):  
Monica L. Hulbert ◽  
Dustin K. Ragan ◽  
Hongyu An ◽  
Cihat Eldeniz ◽  
Geetika Khanna ◽  
...  
Keyword(s):  
Blood Flow ◽  
Magnetic Resonance ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Transcranial Doppler ◽  
Arterial Stenosis ◽  
Acquisition Time ◽  
Transfusion Therapy ◽  
Blood Flow Velocities ◽  
Flow Velocities

Abstract Background Transcranial Doppler (TCD) ultrasonography is the standard stroke screening test for children with sickle cell anemia (SCA). However, approximately 10% of children have inadequate ultrasonographic windows for a successful TCD study, and some clinical sites may lack the equipment or personnel to perform TCDs in children. Magnetic resonance imaging (MRI) techniques can also measure blood flow velocities and could substitute for TCD in these clinical scenarios. We tested the hypothesis that MRI-derived middle cerebral artery (MCA) blood flow velocities would correlate with TCD-derived MCA blood flow velocities in children with SCA. Methods Children age 6 years and up with SCA at their baseline state of health underwent TCD and MRI as part of a prospective clinical study. Imaging TCD of the bilateral MCAs to determine time-average mean of maximum blood flow velocities (TCD-CBFV) were performed using clinical ultrasound equipment. MRIs were performed at 3T without sedation. MRI cerebral time-averaged mean blood flow velocities (MR-CBFV) were measured in the MCAs using phase contrast sequences without cardiac cycle gating to shorten acquisition time and reduce ghosting artifacts. TCD- and MR-CBFV of each hemisphere were compared. Silent cerebral infarctions (SCIs) were categorized as present or absent in each hemisphere. Non-parametric tests were used with a level of significance of <0.05. Statistics were performed in SPSS version 21. Results Twenty hemispheres from 15 children had both TCD-CBFV and MR-CBFV measurements. Median age was 9 years (IQR 6.25-10). In these children, two hemispheres had unobtainable TCDs due to skull thickness, and eight hemispheres had MR-CBFV excluded due to patient motion or poor positioning. The median TCD-CBFV was 116 cm/sec (IQR 90.25-124) and none of the included hemispheres had arterial stenosis or TCD-CBFV in the conditional or abnormal range. Eight included hemispheres were from children receiving chronic blood transfusion therapy for primary or secondary stroke prevention. There was a linear relationship between TCD-CBFV and MR-CBFV (Spearman correlation, ρ=0.781, p<0.001, Figure) although MR-CBFV values were lower than TCD-CBFV values (median difference 32.6%, IQR 26.7-42.8). When evaluating only the children not receiving chronic transfusion therapy, MR-CBFV was significantly higher in 8 hemispheres without SCIs (median 80 cm/sec, IQR 77.8-87.8) than in 4 hemispheres with SCIs (median 60 cm/sec, IQR 44.6-72.3, p=0.004). In a multivariate model adjusting for age, MR-CBFV continued to be associated with presence of SCIs (p=0.036). There was no significant difference in TCD-CBFV when analyzed by SCI status (p=0.2), consistent with published studies of TCD-CBFV and SCIs. Conclusions In this small cohort of children with SCA, MR-CBFV correlated significantly with TCD-CBFV, but MR-CBFV values were approximately 30% lower than TCD-CBFV. This may be due to the method of acquiring MR-CBFV via non-gated methodology, which is known to produce lower blood flow velocity estimates. Further work is needed to determine a threshold for high-risk MR-CBFV values before this modality could be used as a substitute for TCD screening. Lower MR-CBFV was associated with SCIs, suggesting a potential role for MR-CBFV in predicting SCI risk. The relationship between MR-CBFV and SCIs should be explored further. Disclosures Hulbert: Pfizer, Inc.: Other: spouse employment. Fields:NeuroPhage Pharmaceuticals: Equity Ownership, Membership on an entity's Board of Directors or advisory committees.

scholarly journals Transcranial doppler ultrasonography (TCD) in infants with sickle cell anemia: Baseline data from the BABY HUG trial

2009 ◽  
pp. n/a-n/a ◽  
Author(s):  
Steven G. Pavlakis ◽  
Renée C. Rees ◽  
Xiangke Huang ◽  
R. Clark Brown ◽  
James F. Casella ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Transcranial Doppler ◽  
Doppler Ultrasonography ◽  
Baseline Data ◽  
Transcranial Doppler Ultrasonography

scholarly journals Implementation of a Process for Initial Transcranial Doppler Ultrasonography in Children With Sickle Cell Anemia

2016 ◽  
Vol 51 (1) ◽  
pp. S10-S16 ◽  
Author(s):  
Lori E. Crosby ◽  
Naomi E. Joffe ◽  
Blair Davis ◽  
Charles T. Quinn ◽  
Lisa Shook ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Transcranial Doppler ◽  
Doppler Ultrasonography ◽  
Transcranial Doppler Ultrasonography

scholarly journals Effects of Ascorbic Acid Intake on the Intima-Media Thickness and Blood Flow Velocities of the Carotid Artery in Patients With Sickle Cell Anemia

2011 ◽  
Vol 27 (5) ◽  
pp. 214-219
Author(s):  
Omodele A. Olowoyeye ◽  
Smith I. Jaja ◽  
Michael O. Kehinde ◽  
Gbolahan O. Awosanya ◽  
Nicholas K. Irurhe ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ascorbic Acid ◽  
Carotid Artery ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Intima Media Thickness ◽  
Acid Intake ◽  
Media Thickness ◽  
Blood Flow Velocities ◽  
Flow Velocities

scholarly journals Pattern of cerebral blood flow velocity using transcranial Doppler ultrasonography in children with sickle cell disorder in Lagos State, Nigeria

2017 ◽  
Vol 9 (1) ◽  
pp. e2017050 ◽  
Author(s):  
Motunrayo Oluwabukola Adekunle
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Sickle Cell ◽  
Transcranial Doppler ◽  
Doppler Ultrasonography ◽  
Cerebral Blood Flow Velocity ◽  
Neurological Complication ◽  
Routine Screening ◽  
Transcranial Doppler Ultrasonography ◽  
Cell Disorder

Cerebrovascular accident (CVA) is a common devastating neurological complication of sickle cell disorder (SCD) with a high recurrent and mortality rate. The Stroke Prevention Trial in Sickle Cell Anaemia study (STOP) recommends routine screening with transcranial Doppler ultrasonography in children aged two to sixteen years with SCD. The present study assessed cerebral blood flow velocities of children with SCD in accordance with the recommendation of routine screening by the STOP study.Methods: Transcranial Doppler ultrasonography was done for children with SCD that attended Sickle Cell Foundation, Nigeria between July and November 2015.Results: In all, 388 subjects were screened within the study period (360 HbSS and 28 HbSC). The prevalence of abnormal Time-Averaged Maximum Mean Velocity (TAMMV) of at least 200cm/second was 10.8%: this was seen solely in HbSS subjects. The mean Time-averaged mean of the maximum (TAMM) velocity were 163 ± 25cm/sec, 162±30cm/sec and 150 ± 30cm/sec for children less than five years, five to ten years and eleven to sixteen years respectively.Conclusion: The prevalence of abnormal TAMM velocity is high in children with HbSS. The need for availability of and accessibility to transcranial Doppler screening is emphasized.

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