Cerebrovascular disease in symptomatic and asymptomatic patients with sickle cell anemia: screening with duplex transcranial Doppler US--correlation with MR imaging and MR angiography

Radiology. 1993 Nov;189(2):457-66. doi: 10.1148/radiology.189.2.8105505.

Abstract

Purpose: The authors evaluated the role of transcranial Doppler ultrasonography (US) in patients with sickle cell disease (SCD) and cerebrovascular disease.

Materials and methods: Twenty-one patients with SCD and stroke (aged 3-22 years; mean age at stroke, 9 years) were evaluated with magnetic resonance (MR) imaging and duplex transcranial Doppler US with a 2-MHz transducer. Nineteen patients also underwent MR angiography. Forty-six asymptomatic patients with SCD were also evaluated with Doppler US, MR imaging, and MR angiography.

Results: The following transcranial Doppler US findings were correlated with cerebrovascular disease in patients with SCD: (a) maximum velocity in the ophthalmic artery (OA) of more than 35 cm/sec; (b) mean velocity in the middle cerebral artery (MCA) of more than 170 cm/sec; (c) resistive index in the OA of less than 50; (d) velocity in the OA greater than that of the ipsilateral MCA; and (e) maximum velocity in the posterior cerebral, vertebral, or basilar arteries greater than the maximum velocity in the MCA.

Conclusion: Transcranial Doppler US scanning has great potential as an inexpensive, easily performed screening procedure for cerebrovascular disease in patients with SCD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Sickle Cell / complications*
  • Angiography
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / diagnostic imaging
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / pathology
  • Cerebral Angiography
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / pathology
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / diagnostic imaging
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / diagnosis*
  • Cerebrovascular Disorders / diagnostic imaging*
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Prospective Studies
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Transcranial*
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / pathology