Perfusion magnetic resonance abnormalities in patients with sickle cell disease

Kirkham, Fenella J., Calamante, Fernando, Bynevelt, Michael, Gadian, David G., Evans, Jane P.M., Cox, Timothy C. and Connolly, Alan (2001) Perfusion magnetic resonance abnormalities in patients with sickle cell disease. Annals of Neurology, 49, (4), 477-485. (doi:10.1002/ana.97).


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Neurological complications are common in sickle cell disease (SCD). However, it is often difficult to relate the clinical presentation to conventional neuroimaging, because subclinical infarction is common and stroke has been described in the absence of large-vessel disease. We studied 48 patients with SCD aged 4-34 (median 13) years with T2-weighted, diffusion and perfusion magnetic resonance imaging (MRI) and with MR angiography. Forty-four underwent transcranial Doppler (TCD). Abnormalities on perfusion imaging were seen in 25 cases, 24 of whom had been symptomatic. The remaining patient had evidence of executive dysfunction and reduced perfusion in the frontal lobes. The perfusion abnormality was larger than the area of infarction in 9 patients and was seen in an arterial distribution with no infarction in a further 9. In 3 patients with transient ischemic attacks, perfusion abnormalities were demonstrated in the absence of any other neuroimaging abnormalities, and perfusion changes were seen in 3 others despite normal MR angiography and TCD. Perfusion abnormalities are associated with neurological symptoms in patients with SCD, whether or not MRI, MR angiography, and TCD are abnormal. It is likely that this technique will guide management in individual patients

Item Type: Article
Digital Object Identifier (DOI): doi:10.1002/ana.97
ISSNs: 0364-5134 (print)
Related URLs:
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions : University Structure - Pre August 2011 > School of Medicine > Clinical Neurosciences
ePrint ID: 40641
Accepted Date and Publication Date:
Date Deposited: 07 Jul 2006
Last Modified: 31 Mar 2016 12:11

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