title: Transcranial Doppler and brain MRI in children with sickle cell disease and high hemoglobin F levels.
abstract: OBJECTIVE
  While overt stroke and silent brain infarcts (SBI) are uncommon among Kuwaiti patients with sickle cell disease (SCD), there have been no previous transcranial Doppler (TCD) studies in this population. The main objective of this study is to determine TCD velocities in a group of Kuwaiti children with SCD and correlate same with brain magnetic resonance imaging (MRI) and angiography (MRA) findings.
  
  
  METHODS
  Forty-three steady-state, pediatric patients with SCD aged 10.1 ± 3.9 years (21 SS, 19 Sβ(0)Thal, and 3 SD) were studied. Twenty-six age-matched, normal siblings of the patients served as controls. TCD was performed using a General Electric (GE), Vivid 3 equipment and MRI/MRA with a GE Signa Excite HD 1.5 Tesla magnet. Complete blood count was with an electronic counter and Hb quantitation with cation-exchange high performance liquid chromatography (HPLC).
  
  
  RESULTS
  The mean time-averaged mean of the maximum velocity (TAMV) was significantly higher in the SCD group than the controls, but was normal (<170 cm/second) in all. The mean values were comparable among the SS and Sβ(0)thal groups. Five (11.1%) patients had SBI and all were between 12 and 16 years of age. There was no significant difference of TAMV in this group compared to those without infarcts. No patient showed evidence of stenosis or any other abnormalities in the circle of Willis vessels.
  
  
  CONCLUSIONS
  The mild phenotype among Kuwaiti patients with SCD is reflected in normal TCD velocities and a low prevalence of SBI in children with the disease.
authors.affiliation: Faculty of Allied Health Sciences, Department of Radiologic Sciences, Kuwait University, Safat, Kuwait.
authors.forename: Akram
authors.initials: A
authors.lastname: Asbeutah
authors.forename: Renu
authors.initials: R
authors.lastname: Gupta
authors.forename: Osama
authors.initials: O
authors.lastname: Al-Saeid
authors.forename: Sam
authors.initials: S
authors.lastname: Ashebu
authors.forename: Sundus
authors.initials: S
authors.lastname: Al-Sharida
authors.forename: Ali
authors.initials: A
authors.lastname: Mullah-Ali
authors.forename: Nada Yousef
authors.initials: NY
authors.lastname: Mustafa
authors.forename: Adekunle
authors.initials: A
authors.lastname: Adekile
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D005319:Fetal Hemoglobin
keywords: Kuwait Arabs; magnetic resonance imaging; sickle cell disease; silent brain infarcts; stroke; transcranial Doppler