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Perfusion magnetic resonance abnormalities in patients with sickle cell disease

Perfusion magnetic resonance abnormalities in patients with sickle cell disease
Perfusion magnetic resonance abnormalities in patients with sickle cell disease
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
0364-5134
477-485
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Calamante, Fernando
63d493e7-04b6-4147-8353-5f487b994cab
Bynevelt, Michael
b193cce3-8cf6-4b82-ab0a-6bb739b6fa29
Gadian, David G.
2b0e526e-9bd0-4173-b5cd-ee32c8f66c57
Evans, Jane P.M.
012f896d-f0c8-40fd-b871-e62bc982e30d
Cox, Timothy C.
f53c3285-98ba-44b0-9967-50a0e9a8d37b
Connolly, Alan
0eb32b57-e2b6-474a-b435-2977dbef5354
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Calamante, Fernando
63d493e7-04b6-4147-8353-5f487b994cab
Bynevelt, Michael
b193cce3-8cf6-4b82-ab0a-6bb739b6fa29
Gadian, David G.
2b0e526e-9bd0-4173-b5cd-ee32c8f66c57
Evans, Jane P.M.
012f896d-f0c8-40fd-b871-e62bc982e30d
Cox, Timothy C.
f53c3285-98ba-44b0-9967-50a0e9a8d37b
Connolly, Alan
0eb32b57-e2b6-474a-b435-2977dbef5354

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).

Record type: Article

Abstract

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

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Published date: 2001

Identifiers

Local EPrints ID: 40641
URI: http://eprints.soton.ac.uk/id/eprint/40641
ISSN: 0364-5134
PURE UUID: 435782e6-ffa8-47d3-9236-ac36628e3635
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 07 Jul 2006
Last modified: 16 Mar 2024 03:22

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Contributors

Author: Fernando Calamante
Author: Michael Bynevelt
Author: David G. Gadian
Author: Jane P.M. Evans
Author: Timothy C. Cox
Author: Alan Connolly

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