Sickle Cell Disease: Continuous Arterial Spin-labeling Perfusion MR Imaging in Children

Cerebral blood flow (CBF) was measured with continuous arterial spin-labeling perfusion magnetic resonance (MR) imaging in 14 children with sickle cell disease and seven control subjects. Mean CBF values were higher in patients (P < .005) than in control subjects in all cerebral artery territories. Three patients had decreased CBF in right anterior and middle cerebral artery territories compared with CBF on the left, and one patient had a profound decrease in CBF in all three territories in the right hemisphere. Baseline CBF was significantly decreased in territories seen as unaffected on conventional MR images and MR angiograms in four children with sickle cell disease.

© RSNA, 2003

References

  • 1 Pavlakis SG, Prohovnik I, Piomelli S, De Vivo DC. Neurologic complications of sickle cell disease. Adv Pediatr 1989; 36:247-276. MedlineGoogle Scholar
  • 2 Portnoy BA, Herion JC. Neurological manifestations in sickle cell disease. Ann Intern Med 1972; 76:643-652. Crossref, MedlineGoogle Scholar
  • 3 Hindmarsh PC, Brozovic M, Brook CG, Davies SC. Incidence of overt and covert neurological damage in children with sickle cell disease. Postgrad Med J 1987; 63:751-753. Crossref, MedlineGoogle Scholar
  • 4 Adams RJ, Nichols FT, McKie V, et al. Cerebral infarction in sickle cell anemia. Neurology 1988; 38:1012-1017. Crossref, MedlineGoogle Scholar
  • 5 Huttenlocher PR, Moohr JW, Johns L, Brown FD. Cerebral blood flow in sickle cell cerebrovascular disease. Pediatrics 1984; 73:615-621. MedlineGoogle Scholar
  • 6 Malouf AJ, Jr, Hamrick-Turner JE, Doherty MC, Dhillon GS, Iyer RV, Smith MG. Implementation of the STOP protocol for stroke prevention in sickle cell anemia by using duplex power Doppler imaging. Radiology 2001; 219:359-365. LinkGoogle Scholar
  • 7 Wang WC, Gallagher DM, Pegelow CH, et al. Multicenter comparison of magnetic resonance imaging and transcranial Doppler ultrasonography in the evaluation of the central nervous system in children with sickle cell disease. J Pediatr Hematol Oncol 2000; 22:335-339. Crossref, MedlineGoogle Scholar
  • 8 Adams RJ, McKie VC, Hsu L, et al. Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography. N Engl J Med 1998; 339:5-11. Crossref, MedlineGoogle Scholar
  • 9 Seibert JJ, Glasier CM, Kirby RS, et al. Transcranial Doppler, MRA, and MRI as a screening examination for cerebrovascular disease in patients with sickle cell anemia: an 8-year study. Pediatr Radiol 1998; 28:138-142. Crossref, MedlineGoogle Scholar
  • 10 Adams RJ, McKie VC, Carl EM, et al. Long-term stroke risk in children with sickle cell disease screened with transcranial Doppler. Ann Neurol 1997; 42:699-704. Crossref, MedlineGoogle Scholar
  • 11 Verlhac S, Bernaudin F, Tortrat D, et al. Detection of cerebrovascular disease in patients with sickle cell disease using transcranial Doppler sonography: correlation with MRI, MRA and conventional angiography. Pediatr Radiol 1995; 25(suppl 1):S14-S19. Crossref, MedlineGoogle Scholar
  • 12 Siegel MJ, Luker GD, Glauser TA, DeBaun MR. Cerebral infarction in sickle cell disease: transcranial Doppler US versus neurologic examination. Radiology 1995; 197:191-194. LinkGoogle Scholar
  • 13 Seibert JJ, Miller SF, Kirby RS, et al. 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; 189:457-466. LinkGoogle Scholar
  • 14 Adams RJ, Nichols FT, Figueroa R, McKie V, Lott T. Transcranial Doppler correlation with cerebral angiography in sickle cell disease. Stroke 1992; 23:1073-1077. Crossref, MedlineGoogle Scholar
  • 15 Adams R, McKie V, Nichols F, et al. The use of transcranial ultrasonography to predict stroke in sickle cell disease. N Engl J Med 1992; 326:605-610. Crossref, MedlineGoogle Scholar
  • 16 Adams RJ, Nichols FT, III, Aaslid R, et al. Cerebral vessel stenosis in sickle cell disease: criteria for detection by transcranial Doppler. Am J Pediatr Hematol Oncol 1990; 12:277-282. Crossref, MedlineGoogle Scholar
  • 17 Pavlakis SG, Bello J, Prohovnik I, et al. Brain infarction in sickle cell anemia: magnetic resonance imaging correlates. Ann Neurol 1988; 23:125-130. Crossref, MedlineGoogle Scholar
  • 18 Moser FG, Miller ST, Bello JA, et al. The spectrum of brain MR abnormalities in sickle cell disease: a report from the cooperative study of sickle cell disease. AJNR Am J Neuroradiol 1996; 17:965-972. MedlineGoogle Scholar
  • 19 Pegelow CH, Wang W, Granger S, et al. Silent infarcts in children with sickle cell anemia and abnormal cerebral artery velocity. Arch Neurol 2001; 58:2017-2021. Crossref, MedlineGoogle Scholar
  • 20 Brown RT, Davis PC, Lambert R, Hsu L, Hopkins K, Eckman J. Neurocognitive functioning and magnetic resonance imaging in children with sickle cell disease. J Pediatr Psychol 2000; 25:503-513. Crossref, MedlineGoogle Scholar
  • 21 DeBaun MR, Schatz J, Siegel MJ, et al. Cognitive screening examinations for silent cerebral infarcts in sickle cell disease. Neurology 1998; 50:1678-1682. Crossref, MedlineGoogle Scholar
  • 22 Schatz J, Brown RT, Pascual JM, Hsu L, DeBaun MR. Poor school and cognitive functioning with silent cerebral infarcts and sickle cell disease. Neurology 2001; 56:1109-1111. Crossref, MedlineGoogle Scholar
  • 23 Powars DR, Conti PS, Wong WY, et al. Cerebral vasculopathy in sickle cell anemia: diagnostic contribution of positron emission tomography. Blood 1999; 93:71-79. MedlineGoogle Scholar
  • 24 Rodgers GP, Clark CM, Larson SM, et al. Brain glucose metabolism in neurologically normal patients with sickle cell disease. Arch Neurol 1988; 45:78-82. Crossref, MedlineGoogle Scholar
  • 25 Reed W, Jagust W, Al-Mateen M, Vichinsky E. Role of positron emission tomography in determining the extent of CNS ischemia in patients with sickle cell disease. Am J Hematol 1999; 60:268-272. Crossref, MedlineGoogle Scholar
  • 26 Tzika AA, Massoth RJ, Ball WS, et al. Cerebral perfusion in children: detection with dynamic contrast-enhanced T2*-weighted MR images. Pediatr Radiol 1993; 187:449-458. Google Scholar
  • 27 Kirkham FJ, Calamante F, Bynevelt M, et al. Perfusion magnetic resonance abnormalities in patients with sickle cell disease. Ann Neurol 2001; 49:477-485. Crossref, MedlineGoogle Scholar
  • 28 Herold S, Brozovic M, Gibbs J, et al. Measurement of regional cerebral blood flow, blood volume and oxygen metabolism in patients with sickle cell disease using positron emission tomography. Stroke 1986; 17:692-698. Crossref, MedlineGoogle Scholar
  • 29 Numaguchi Y, Haller JS, Humbert JR, et al. Cerebral blood flow mapping using stable xenon-enhanced CT in sickle cell cerebrovascular disease. Neuroradiology 1990; 32:289-295. Crossref, MedlineGoogle Scholar
  • 30 Alsop D, Detre J. Reduced transit time sensitivity in noninvasive magnetic resonance imaging of human cerebral blood flow. J Cereb Blood Flow Metab 1996; 16:1236-1249. Crossref, MedlineGoogle Scholar
  • 31 Alsop D, Detre J. Multisection cerebral blood flow MR imaging with continuous arterial spin labeling. Radiology 1998; 208:410-416. LinkGoogle Scholar
  • 32 van Gelderen P, de Vleeschouwer MH, DesPres D, Pekar J, van Zijl PC, Moonen CT. Water diffusion and acute stroke. Magn Reson Med 1994; 31:154-163. Crossref, MedlineGoogle Scholar
  • 33 Woods RP, Mazziotta JC, Cherry SR. MRI-PET registration with automated algorithm. J Comput Assist Tomogr 1993; 4:536-546. Google Scholar
  • 34 Tatu L, Moulin T, Bogousslavsky J, Duvernoy H. Arterial territories of the human brain: cerebral hemispheres. Neurology 1998; 50:1699-1708. Crossref, MedlineGoogle Scholar
  • 35 Kirkham FJ, Hewes DK, Prengler M, Wade A, Lane R, Evans JP. Nocturnal hypoxaemia and central-nervous-system events in sickle-cell disease. Lancet 2001; 357:1656-1659. Crossref, MedlineGoogle Scholar
  • 36 Prohovnik I, Pavlakis SG, Piomelli S, et al. Cerebral hyperemia, stroke, and transfusion in sickle cell disease. Neurology 1989; 39:344-348. Crossref, MedlineGoogle Scholar
  • 37 Massik J, Tang YL, Hudak ML, et al. Effect of hematocrit on cerebral blood flow with induced polycythemia. J Appl Physiol 1987; 62:1090-1096. Crossref, MedlineGoogle Scholar
  • 38 Hudak ML, Tang YL, Massik J, et al. Base-line O2 extraction influences cerebral blood flow response to hematocrit. Am J Physiol 1988; 254(1 pt 2):H156-H162. MedlineGoogle Scholar
  • 39 Hughes JG, Diggs LW, Gillespie CE. The involvement of the nervous system in sickle cell anemia. J Pediatr 1940; 17:166-184. CrossrefGoogle Scholar
  • 40 Schoning M, Hartig B. Age dependence of total cerebral blood flow volume from childhood to adulthood. J Cereb Blood Flow Metab 1996; 16:827-833. Crossref, MedlineGoogle Scholar
  • 41 Takahashi T, Shirane R, Sato S, Yoshimato T. Developmental changes of cerebral blood flow and oxygen metabolism in children. AJNR Am J Neuroradiol 1999; 20:917-922. MedlineGoogle Scholar
  • 42 Steen RG, Langston JW, Ogg RJ, Xiong X, Ye Z, Wang WC. Diffuse T1 reduction in gray matter of sickle cell disease patients: evidence of selective vulnerability to damage? Magn Reson Imaging 1999; 17:503-515. Crossref, MedlineGoogle Scholar
  • 43 Frackowiak RS, Lenzi GL, Jones T, Heather JD. Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure, and normal values. J Comput Assist Tomogr 1980; 4:727-736. Crossref, MedlineGoogle Scholar
  • 44 Pantano P, Baron JC, Lebrun Grandie P, Duquesnoy N, Bousser MG, Comar D. Regional cerebral blood flow and oxygen consumption in human aging. Stroke 1984; 15:635-641. Crossref, MedlineGoogle Scholar
  • 45 Roberts DA, Rizi R, Lenkinski RE, Leigh JS, Jr. Magnetic resonance imaging of the brain: blood partition coefficient for water: application to spin-tagging measurement of perfusion. J Magn Reson Imaging 1996; 6:363-366. Crossref, MedlineGoogle Scholar
  • 46 Ye FQ, Mattay VS, Jezzard P, Frank JA, Weinberger DR, McLaughlin AC. Correction for vascular artifacts in cerebral blood flow values measured by using arterial spin tagging techniques. Magn Reson Med 1997; 37:226-235. Crossref, MedlineGoogle Scholar

Article History

Published in print: May 2003