Detection of cerebrovascular disease in patients with sickle cell disease using transcranial Doppler sonography: correlation with MRI, MRA and conventional angiography.
A prospective study of 58 patients with sickle cell disease (SCD) by transcranial Doppler sonography (TCD) included both MRI and MRA in patients over 7 years of age and those with abnormal TCD. Arteriography was performed in cases where a stenosis was suspected on TCD. Middle cerebral artery (MCA) and basilar artery (BA) velocities were significantly higher in the sickle cell hemoglobin SS group than in the hemoglobin SC group. Patients with a MCA mean velocity of over 1.90 m/s had stenoses found by arteriography. Patients with unilaterally undetectable MCA flow had experienced a stroke and MCA thrombosis was confirmed at MRA and arteriography. We concluded that TCD is valuable in detecting arterial stenosis in SCD and will lead to consideration of these patients for intensive therapy, such as bone marrow transplantation (BMT) or transfusion regimes.
Verlhac
S
S
Service de Radiologie, Centre Hospitalier Intercommunal, 40, avenue de Verdun, F-94010 Creteil Cedex, France.
Bernaudin
F
F
Tortrat
D
D
Brugieres
P
P
Mage
K
K
Gaston
A
A
Reinert
P
P
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006450:Hemoglobin SC Disease / Q000150:complications*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D017585:Ultrasonography, Doppler, Transcranial