Brain Magnetic Resonance Imaging Abnormalities in Adult Patients With Sickle Cell Disease Correlation With Transcranial Doppler Findings

Brain Magnetic Resonance Imaging Abnormalities in Adult Patients With Sickle Cell Disease Correlation With Transcranial Doppler Findings

Author Silva, Gisele Sampaio Autor UNIFESP Google Scholar
Vicari, Perla Autor UNIFESP Google Scholar
Figueiredo, Maria Stella Autor UNIFESP Google Scholar
Carrete Junior, Henrique Autor UNIFESP Google Scholar
Idagawa, Marcos Hideki Autor UNIFESP Google Scholar
Massaro, Ayrton Roberto Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Ctr Diagnost Fleury
Abstract Background and Purpose-Brain imaging abnormalities were reported in up to 44% of children with sickle cell disease (SCD). the prevalence of neuroimaging abnormalities in adult patients with SCD and their relationship to transcranial Doppler is still unclear. Our objectives were to study the frequency of MRI and MR angiography abnormalities in adults with SCD and to define what transcranial Doppler velocities are associated with intracranial stenoses detected by MR angiography.Methods-We examined all adult patients (>16 years) with SCD followed in the hematology outpatient clinic at our university hospital with MRI, MR angiography, and transcranial Doppler.Results-We evaluated 50 patients. the overall prevalence of MRI abnormalities was 60%. Abnormal MRI findings were more frequent when vessel tortuosity or stenoses were present on MR angiography (P<0.01). Patients with intracranial stenoses had significantly higher time-averaged maximum mean velocities (P=0.01). A time-averaged maximum mean velocity of 123.5 cm/s allowed the diagnosis of middle cerebral artery or internal carotid artery intracranial stenosis with sensitivity of 100% and specificity of 73% with an area under the receiver operator characteristic curve of 0.91 (CI, 0.79 to 1.00).Conclusions-The frequency of brain imaging abnormalities detected by MRI/MR angiography in adults with SCD was higher than that described for children. Transcranial Doppler velocities in adult patients with intracranial stenoses were lower than those described for the pediatric population with SCD. (Stroke. 2009; 40: 2408-2412.)
Keywords magnetic resonance imaging
sickle cell anemia
stroke
transcranial Doppler ultrasonography
Language English
Date 2009-07-01
Published in Stroke. Philadelphia: Lippincott Williams & Wilkins, v. 40, n. 7, p. 2408-2412, 2009.
ISSN 0039-2499 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 2408-2412
Origin http://dx.doi.org/10.1161/STROKEAHA.108.537415
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000267467900021
URI http://repositorio.unifesp.br/handle/11600/31620

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