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Published online before print March 27, 2003, 10.1148/radiol.2272020903
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Sickle Cell Disease: Continuous Arterial Spin-labeling Perfusion MR Imaging in Children1

Kader K. Oguz, MD, Xavier Golay, PhD, Francesca B. Pizzini, MD, Catherine A. Freer, MS, Nevada Winrow, PhD, Rebecca Ichord, MD, James F. Casella, MD, Peter C. M. van Zijl, PhD and Elias R. Melhem, MD

1 From the Depts of Radiology and Radiological Sciences (K.K.O., X.G., F.B.P., N.W., P.C.M.v.Z., E.R.M.) and Pediatrics, Div of Pediatric Hematology (C.A.F., J.F.C.), Johns Hopkins Med Insts, Baltimore, Md; F. M. Kirby Research Ctr for Functional Brain Imaging, Kennedy-Krieger Inst, Baltimore, Md (K.K.O., X.G., F.B.P., P.C.M.v.Z., E.R.M.); and Dept of Pediatrics and Neurology, Children’s Hosp of Philadelphia and Univ of Pennsylvania (R.I.). Received Jul 24, 2002; revision requested Sep 26; revision received Oct 11; accepted Dec 10. Supported by NIH grant R21-0035-01. Address correspondence to E.R.M., Dept of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (e-mail: emelhem@rad.upen.edu).



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  		Figure 1. Transverse whole-brain CBF maps in an 11-year-old neurologically asymptomatic girl with SCD. CBF maps generated with CASL perfusion MR images (5,000/36) demonstrate good differentiation between gray and white matter, with elevated CBF in gray matter (129 mL/min/100 g) and no apparent asymmetry in CBF between left and right hemispheres.

 


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  		Figure 2. SCD in a 7-year-old neurologically asymptomatic boy (patient 1 in the Table). A, B, Consecutive transverse fast fluid-attenuated inversion-recovery MR images (11,000/140/2,725) at the level of the lateral ventricles and corona radiata demonstrate two small high-signal-intensity lesions (arrows) in white matter of both frontal lobes. C-E, Coronal targeted maximum intensity projections from three-dimensional time-of-flight MR angiogram (37/3.2, 25° flip angle) of the circle of Willis demonstrate no abnormalities.

 


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  		Figure 3. Bar graph demonstrates significant increase in total and territorial CBF in children with SCD (black bars) as compared with CBF in control subjects (gray bars). ACA = anterior cerebral artery, MCA = middle cerebral artery, PCA = posterior cerebral artery.

 


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  		Figure 4. Transverse whole-brain CBF maps in a 9-year-old neurologically asymptomatic girl with SCD (patient 4 in the Table). CBF maps generated with CASL perfusion MR images (5,000/36) demonstrate definite decrease in CBF in gray matter of the right cerebral hemispheres in comparison with that on the left for all three vascular territories.

 




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