Literature DB >> 19401577

Sickle cell disease: ratio of blood flow velocity of intracranial to extracranial cerebral arteries--initial experience.

Mikolaj A Pawlak1, Jaroslaw Krejza, Wojciech Rudzinski, Janet L Kwiatkowski, Rebecca Ichord, Abbas F Jawad, Maciej Tomaszewski, Elias R Melhem.   

Abstract

PURPOSE: To establish reference values of the ratios of flow velocity in the middle cerebral artery (V(MCA)) and the terminal portion of the internal carotid artery (V(tICA)) to flow velocity in the extracranial portion of internal carotid artery (V(ICA)) in children with sickle cell disease (SCD).
MATERIALS AND METHODS: Institutional ethics committee approval and parental informed consent were obtained for this prospective HIPAA-compliant study. Sixty-eight children (38 female; mean age, 7.7 years +/- 3.3; range, 2-14 years) with HbSS genotype, without neurologic deficits and no history of stroke, were enrolled. Final study population comprised 56 (mean age 8.0 +/- 3.3 years, 26 females) children who underwent magnetic resonance (MR) angiography, which excluded intracranial arterial narrowing, transcranial color-coded duplex ultrasonography (US), and carotid US to determine V(MCA)/V(ICA) and V(tICA)/V(ICA) ratios from angle-corrected and uncorrected velocities. Tolerance interval estimates were used to calculate reference ranges and linear regression was used to quantify associations of Doppler parameters with age adjusted for hemoglobin and hematocrit.
RESULTS: Reference ranges in centimeters per second for mean angle-corrected V(MCA) on the left and right sides were 62-198 and 69-153; those for V(tICA) were 30-196 and 36-175; and those for V(ICA) were 18-116 and 15-95, respectively. Reference ranges for mean angle-corrected V(MCA)/V(ICA) ratio on the left and right sides were 1.2-4.0 and 0.4-3.4 and those for V(tICA)/V(IC)(A) ratio were 0.5-2.9 and 0.5-2.7, respectively. V(MCA), V(tICA), and V(tICA)/V(ICA) ratio were not age dependent, contrary to V(ICA) and V(MCA)/V(ICA) ratio, after controlling for hematocrit and hemoglobin.
CONCLUSION: The study provides reference limits for V(MCA), V(tICA), V(ICA), and velocity ratios obtained from children with SCD.

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Year:  2009        PMID: 19401577      PMCID: PMC2674554          DOI: 10.1148/radiol.2512071180

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  35 in total

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10.  Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography.

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4.  Low micromolar intravascular cell-free hemoglobin concentration affects vascular NO bioavailability in sickle cell disease: a computational analysis.

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