Sickle cell disease: reference values and interhemispheric differences of nonimaging transcranial Doppler blood flow parameters.
Publication/Presentation Date
9-1-2011
Abstract
BACKGROUND AND PURPOSE: TCD screening is widely used to identify children with SCD at high risk of stroke. Those with high mean flow velocities in major brain arteries have increased risk of stroke. Thus, our aim was to establish reference values of interhemispheric differences and ratios of blood flow Doppler parameters in the tICA, MCA, and ACA as determined by conventional TCD in children with sickle cell anemia.
MATERIALS AND METHODS: Reference limits of blood flow parameters were established on the basis of a consecutive cohort of 56 children (mean age, 100 ± 40 months; range, 29-180 months; 30 females) free of neurologic deficits and intracranial stenosis detectable by MRA, with blood flow velocities < 170 cm/s by conventional TCD. Reference limits were estimated by using tolerance intervals, within which are included with a probability of .90 of all possible data values from 95% of a population.
RESULTS: Average peak systolic velocities were significantly higher in the right hemisphere in the MCA and ACA (185 ± 28 cm/s versus 179 ± 27 and 152 ± 30 cm/s versus 143 ± 34 cm/s respectively). Reference limits for left-to-right differences in the mean flow velocities were the following: -43 to 33 cm/s for the MCA; -49 to 38 cm/s for the ACA, and -38 to 34 cm/s for the tICA, respectively. Respective reference limits for left-to-right velocity ratios were the following: 0.72 to 1.25 cm/s for the MCA; 0.62 to 1.39 cm/s for the ACA, and 0.69 to 1.27 cm/s for the tICA. Flow velocities in major arteries were inversely related to age and Hct or Hgb.
CONCLUSIONS: The study provides reference intervals of TCD flow velocities and their interhemispheric differences and ratios that may be helpful in identification of intracranial arterial stenosis in children with SCD undergoing sonographic screening for stroke prevention.
Volume
32
Issue
8
First Page
1444
Last Page
1450
ISSN
1936-959X
Published In/Presented At
Arkuszewski, M., Krejza, J., Chen, R., Kwiatkowski, J. L., Ichord, R., Zimmerman, R., Ohene-Frempong, K., Desiderio, L., & Melhem, E. R. (2011). Sickle cell disease: reference values and interhemispheric differences of nonimaging transcranial Doppler blood flow parameters. AJNR. American journal of neuroradiology, 32(8), 1444–1450. https://doi.org/10.3174/ajnr.A2529
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
21700785
Department(s)
Department of Pediatrics
Document Type
Article