HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2281020600v1 228/1/208    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Steen, R. G. Articles by Helton, K. J. Search for Related Content PubMed PubMed Citation Articles by Steen, R. G. Articles by Helton, K. J.

Prospective Brain Imaging Evaluation of Children with Sickle Cell Trait: Initial Observations¹

¹ From the Departments of Diagnostic Imaging (R.G.S., G.M.H., K.B., J.W.L., K.J.H.), Epidemiology and Biostatistics (X.X.), and Hematology (W.C.W.), St Jude Children’s Research Hospital, 332 N Lauderdale St, Memphis, TN 38105-2794; and Departments of Pediatrics (R.G.S., W.C.W.) and Radiology (R.G.S, J.W.L., K.J.H.), University of Tennessee School of Medicine, Memphis. Received May 20, 2002; revision requested July 16; final revision received October 9; accepted November 5. Supported by the American Lebanese Syrian Associated Charities (ALSAC). R.G.S. supported by grant HL 60022 from the National Institutes of Health. Address correspondence to R.G.S. (e-mail: grant.steen@stjude.org).

PURPOSE: To determine whether sickle cell trait (hemoglobin AS) is associated with abnormalities in the brain of asymptomatic children.

MATERIALS AND METHODS: Magnetic resonance (MR) imaging and MR angiography were performed prospectively in 26 siblings (eight girls, 18 boys; mean age, 10.5 years) of patients with sickle cell disease. Two neuroradiologists, blinded as to whether a child had hemoglobin AS or AA, reviewed images obtained in siblings. With MR imaging, lacunae, loss of white matter volume, encephalomalacia, or leukoencephalopathy was identified. With MR angiography, arterial stenosis, occlusion, or tortuosity was identified. Images with definite or possible abnormalities were mixed with randomly selected images and were referred to a third neuroradiologist for a completely blinded review. In cases in which all neuroradiologists concurred, a score was assigned that indicated the sibling had an abnormality. MR angiographic findings were assigned a score for tortuosity with a new quantitative scale.

RESULTS: Among 26 siblings screened, 21 children had sickle cell trait. Among these 21 children, two had mild abnormalities at MR imaging (sample prevalence rate, 10% [95% CI: 1%, 29%]), and four had arterial tortuosity (sample prevalence rate, 19% [95% CI: 5%, 42%]). When children with sickle cell trait were compared with 31 control subjects without the trait, arterial tortuosity was significantly more common in children with sickle cell trait (P = .014). Among children with sickle cell trait, percentage of hemoglobin S was significantly greater in children who had tortuosity than percentage of hemoglobin S in children who had normal blood vessels at MR angiography (P < .03).

CONCLUSION: Findings suggest that greater percentage of hemoglobin S is associated with mild vasculopathy. This vasculopathy may explain some of the excess risk of stroke among African Americans.

© RSNA, 2003

Index terms: Brain, MR, 17.121411 • Cerebral angiography, 17.12142 • Children, central nervous system • Magnetic resonance (MR), vascular studies, 17.12142 • Sickle cell disease (SS, SC), 10.651, 17.651

This article has been cited by other articles:

				M. R. Golomb and H. J. Fullerton Kinky vessels and double joints: useful clues for childhood stroke? Neurology, July 25, 2006; 67(2): 199 - 200. [Full Text] [PDF]

				M. R. Golomb Sickle Cell Trait Is a Risk Factor for Early Stroke Arch Neurol, November 1, 2005; 62(11): 1778 - 1779. [Full Text] [PDF]

				R. G. Steen, C. Fineberg-Buchner, G. Hankins, L. Weiss, A. Prifitera, and R. K. Mulhern Cognitive Deficits in Children With Sickle Cell Disease J Child Neurol, February 1, 2005; 20(2): 102 - 107. [Abstract] [PDF]