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MRI detection of brain abnormality in sickle cell disease

MRI detection of brain abnormality in sickle cell disease
MRI detection of brain abnormality in sickle cell disease
Introduction: Over the past decades, neuroimaging studies have clarified that a significant proportion of patients with sickle cell disease (SCD) have functionally significant brain abnormalities. Clinically, structural magnetic resonance imaging (MRI) sequences (T2, FLAIR, diffusion-weighted imaging) have been used by radiologists to diagnose chronic and acute cerebral infarction (both overt and clinically silent), while magnetic resonance angiography and venography have been used to diagnose arteriopathy and venous thrombosis. In research settings, imaging scientists are increasingly applying quantitative techniques to shine further light on underlying mechanisms.

Areas covered: From a June 2020 PubMed search of ‘magnetic’ or ‘MRI’ and ‘sickle’ over the previous 5 years, we selected manuscripts on T1-based morphometric analysis, diffusion tensor imaging, arterial spin labeling, T2-oximetry, quantitative susceptibility, and connectivity.

Expert Opinion: Quantitative MRI techniques are identifying structural and hemodynamic biomarkers associated with risk of neurological and neurocognitive complications. A growing body of evidence suggests that these biomarkers are sensitive to change with treatments, such as blood transfusion and hydroxyurea, indicating that they may hold promise as endpoints in future randomized clinical trials of novel approaches including hemoglobin F upregulation, reduction of polymerization, and gene therapy. With further validation, such techniques may eventually also improve neurological and neurocognitive risk stratification in this vulnerable population.
Sickle cell, mri, neuroimaging, neuroradiology, biomarkers
1747-4086
473-491
Stotesbury, Hanne
1104423d-f215-4585-bb50-29b7fdd6c518
Kawadler, Jamie Michelle
07330bca-ab5f-43fb-a96f-e8beff1cfa1c
Saunders, Dawn Elizabeth
e0013b4d-31f9-45ca-be5e-67ff4eb9449b
Kirkham, Fenella Jane
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Stotesbury, Hanne
1104423d-f215-4585-bb50-29b7fdd6c518
Kawadler, Jamie Michelle
07330bca-ab5f-43fb-a96f-e8beff1cfa1c
Saunders, Dawn Elizabeth
e0013b4d-31f9-45ca-be5e-67ff4eb9449b
Kirkham, Fenella Jane
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58

Stotesbury, Hanne, Kawadler, Jamie Michelle, Saunders, Dawn Elizabeth and Kirkham, Fenella Jane (2021) MRI detection of brain abnormality in sickle cell disease. Expert Review of Hematology, 14 (5), 473-491. (doi:10.1080/17474086.2021.1893687).

Record type: Review

Abstract

Introduction: Over the past decades, neuroimaging studies have clarified that a significant proportion of patients with sickle cell disease (SCD) have functionally significant brain abnormalities. Clinically, structural magnetic resonance imaging (MRI) sequences (T2, FLAIR, diffusion-weighted imaging) have been used by radiologists to diagnose chronic and acute cerebral infarction (both overt and clinically silent), while magnetic resonance angiography and venography have been used to diagnose arteriopathy and venous thrombosis. In research settings, imaging scientists are increasingly applying quantitative techniques to shine further light on underlying mechanisms.

Areas covered: From a June 2020 PubMed search of ‘magnetic’ or ‘MRI’ and ‘sickle’ over the previous 5 years, we selected manuscripts on T1-based morphometric analysis, diffusion tensor imaging, arterial spin labeling, T2-oximetry, quantitative susceptibility, and connectivity.

Expert Opinion: Quantitative MRI techniques are identifying structural and hemodynamic biomarkers associated with risk of neurological and neurocognitive complications. A growing body of evidence suggests that these biomarkers are sensitive to change with treatments, such as blood transfusion and hydroxyurea, indicating that they may hold promise as endpoints in future randomized clinical trials of novel approaches including hemoglobin F upregulation, reduction of polymerization, and gene therapy. With further validation, such techniques may eventually also improve neurological and neurocognitive risk stratification in this vulnerable population.

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Accepted/In Press date: 22 February 2021
e-pub ahead of print date: 7 June 2021
Keywords: Sickle cell, mri, neuroimaging, neuroradiology, biomarkers

Identifiers

Local EPrints ID: 470165
URI: http://eprints.soton.ac.uk/id/eprint/470165
ISSN: 1747-4086
PURE UUID: 6476dfd9-7395-49f4-8375-e7e9526a23fd
ORCID for Fenella Jane Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

Catalogue record

Date deposited: 04 Oct 2022 16:38
Last modified: 17 Mar 2024 02:53

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Contributors

Author: Hanne Stotesbury
Author: Jamie Michelle Kawadler
Author: Dawn Elizabeth Saunders

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