Change over Time of Transcranial Doppler Cerebral Blood Flow Velocity and the Relationship with Turbulence on Magnetic Resonance Angiography in Patients with Sickle Cell Anemia

• Published in: Blood 2005-11, Vol.106 (11), p.3799-3799
• Main Authors: Kotecha, Krishna, Prengler, Mara, Saunders, Dawn E., Hewes, Deborah K.M., Kirkham, Fenella J., Paul, Telfer
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V106.11.3799.3799

Cerebrovascular disease (CVD) involving the circle of Willis and documented using time-averaged maximum velocity (TAMM) on transcranial Doppler (TCD) and on magnetic resonance angiography (MRA), is common in sickle cell anemia (SCA). Few studies have examined the natural history of CVD. The relationship between TAMM and MRA turbulence is also unclear. We aimed to examine time trends in TAMM and any relationship with clinical stroke and silent infarction (SI) on MRI. We also wanted to determine (a) the degree of MRA turbulence associated with TCD V>200 cm/sec (b) the TCD signature of MRA occlusion and (c) the proportion of patients with no TCD signal who did not have MRA occlusion. TCD was performed in a cohort of 169 patients with highest TAMM measured in either internal carotid/middle cerebral artery recorded (time point 1). Studies were categorised as follows: 0=normal TAMM, 1=170–200cm/sec (conditional TAMM), 2=>200cm/sec, 3=200cm/sec; 3 had not been screened for SCD neonatally. 11 (7%) patients had abnormally low TAMM