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Screening for Stroke in Sickle Cell Anemia: Comparison of Transcranial Doppler Imaging and Nonimaging US Techniques¹

¹ From the Department of Radiology, Children’s Health Care of Atlanta at Scottish Rite, 1001 Johnson Ferry Rd NE, Atlanta, GA 30342. Received February 27, 2001; revision requested April 2; final revision received September 14; accepted September 20. Funding for purchase of Nicolet Companion EME Transcranial Doppler machine was provided by the Children’s Health Care of Atlanta Foundation. Address correspondence to A.S.N. (e-mail: ariane.neish@choa.org).

PURPOSE: To determine whether criteria for screening patients with sickle cell anemia for stroke established with a nonimaging transcranial Doppler ultrasonographic (US) technique are applicable to studies performed with a transcranial Doppler US imaging technique.

MATERIALS AND METHODS: One hundred sixty-eight examinations in 66 children were performed for sickle cell stroke screening. Children were examined with nonimaging and imaging transcranial Doppler US techniques on the same day, for a total of 84 paired examinations. The time-averaged maximum mean velocity (V_mean) and resistive index (RI) were calculated in the middle cerebral arteries, bifurcations of the distal internal carotid arteries, distal internal carotid arteries, anterior cerebral arteries, posterior cerebral arteries, and basilar arteries. The maximum systolic velocity (V_max) was evaluated in the distal internal carotid arteries and middle cerebral arteries. V_mean, V_max, and RI measurements were subjected to repeated-measures multivariate analysis of covariance, and the Pearson product moment correlation was used for middle cerebral artery velocity, age, and hemoglobin.

RESULTS: V_mean measurements obtained with nonimaging and imaging techniques varied substantially for the bifurcation of the distal internal carotid artery, the posterior cerebral artery, and the basilar artery. Substantial differences were found in RIs for every vessel. Examination time was shorter with the nonimaging technique.

CONCLUSION: V_mean measurements in the middle cerebral artery, distal internal carotid artery, and anterior cerebral artery did not vary substantially between nonimaging and imaging transcranial Doppler US. RI data did not yield comparable measurements.

© RSNA, 2002

Index terms: Brain, infarction, 17.78, 10.651 • Brain, US, 17.12989, 17.12983 • Sickle cell disease (SS, SC), 17.651, 10.651 • Ultrasound (US), comparative studies, 17.12989, 17.12983 • Ultrasound (US), Doppler studies, 17.12989, 17.12983

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