Stenosis or Hyperperfusion in Sickle Cell Disease – Ultrasound Assessment of Cerebral Blood Flow Volume
Abstract Increased blood flow velocity (BFV) in basal cerebral arteries measured by transcranial color-coded sonography (TCCS) is a stroke risk factor in sickle cell disease (SCD). Raised BFV may be caused by vessel narrowing or by hyperperfusion. In 44 SCD patients and 14 controls, intracranial art...
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| Veröffentlicht in: | Ultrasound in medicine & biology 2012-08, Vol.38 (8), p.1333-1338 |
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| description | Abstract Increased blood flow velocity (BFV) in basal cerebral arteries measured by transcranial color-coded sonography (TCCS) is a stroke risk factor in sickle cell disease (SCD). Raised BFV may be caused by vessel narrowing or by hyperperfusion. In 44 SCD patients and 14 controls, intracranial arterial BFVs and global cerebral blood flow (CBF) were analyzed by TCCS and extracranial duplex ultrasound, respectively. Magnetic resonance imaging and magnetic resonance angiography were performed in all patients with pathologic intracranial BFV rise. Intracranial BFVs and CBF in SCD were significantly higher than in controls. CBF in SCD correlated with BFV in all intracranial arteries and correlated inversely with age and hemoglobin values. Magnetic resonance angiography failed to demonstrate any stenosis in our SCD patients, thus raised intracranial BFVs must be interpreted as an anemia-dependent cerebral hyperperfusion. These findings suggest that the pathomechanism of stenosis-derived arterio-arterial embolism might be less relevant in SCD-related ischemic stroke, and other factors like small vessel disease or sickle cell–induced microvascular blood clotting have to be considered. |
| doi_str_mv | 10.1016/j.ultrasmedbio.2012.04.003 |
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Raised BFV may be caused by vessel narrowing or by hyperperfusion. In 44 SCD patients and 14 controls, intracranial arterial BFVs and global cerebral blood flow (CBF) were analyzed by TCCS and extracranial duplex ultrasound, respectively. Magnetic resonance imaging and magnetic resonance angiography were performed in all patients with pathologic intracranial BFV rise. Intracranial BFVs and CBF in SCD were significantly higher than in controls. CBF in SCD correlated with BFV in all intracranial arteries and correlated inversely with age and hemoglobin values. Magnetic resonance angiography failed to demonstrate any stenosis in our SCD patients, thus raised intracranial BFVs must be interpreted as an anemia-dependent cerebral hyperperfusion. These findings suggest that the pathomechanism of stenosis-derived arterio-arterial embolism might be less relevant in SCD-related ischemic stroke, and other factors like small vessel disease or sickle cell–induced microvascular blood clotting have to be considered.</description><identifier>ISSN: 0301-5629</identifier><identifier>EISSN: 1879-291X</identifier><identifier>DOI: 10.1016/j.ultrasmedbio.2012.04.003</identifier><identifier>PMID: 22698503</identifier><identifier>CODEN: USMBA3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Anemia, Sickle Cell - complications ; Anemia, Sickle Cell - diagnostic imaging ; Anemia, Sickle Cell - physiopathology ; Anemias. Hemoglobinopathies ; Biological and medical sciences ; Blood Flow Velocity ; Blood Volume ; Blood Volume Determination - methods ; Cerebral blood flow volume ; Cerebrovascular Circulation ; Cerebrovascular Disorders - diagnostic imaging ; Cerebrovascular Disorders - etiology ; Cerebrovascular Disorders - physiopathology ; Child ; Child, Preschool ; Constriction, Pathologic - diagnostic imaging ; Constriction, Pathologic - etiology ; Constriction, Pathologic - physiopathology ; Diseases of red blood cells ; Duplex sonography ; Echoencephalography - methods ; Female ; Hematologic and hematopoietic diseases ; Humans ; Hyperperfusion ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Radiology ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Reproducibility of Results ; Sensitivity and Specificity ; Sickle cell disease ; Transcranial color-coded sonography ; Young Adult</subject><ispartof>Ultrasound in medicine & biology, 2012-08, Vol.38 (8), p.1333-1338</ispartof><rights>World Federation for Ultrasound in Medicine & Biology</rights><rights>2012 World Federation for Ultrasound in Medicine & Biology</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. 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Raised BFV may be caused by vessel narrowing or by hyperperfusion. In 44 SCD patients and 14 controls, intracranial arterial BFVs and global cerebral blood flow (CBF) were analyzed by TCCS and extracranial duplex ultrasound, respectively. Magnetic resonance imaging and magnetic resonance angiography were performed in all patients with pathologic intracranial BFV rise. Intracranial BFVs and CBF in SCD were significantly higher than in controls. CBF in SCD correlated with BFV in all intracranial arteries and correlated inversely with age and hemoglobin values. Magnetic resonance angiography failed to demonstrate any stenosis in our SCD patients, thus raised intracranial BFVs must be interpreted as an anemia-dependent cerebral hyperperfusion. These findings suggest that the pathomechanism of stenosis-derived arterio-arterial embolism might be less relevant in SCD-related ischemic stroke, and other factors like small vessel disease or sickle cell–induced microvascular blood clotting have to be considered.</description><subject>Adolescent</subject><subject>Anemia, Sickle Cell - complications</subject><subject>Anemia, Sickle Cell - diagnostic imaging</subject><subject>Anemia, Sickle Cell - physiopathology</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Blood Volume</subject><subject>Blood Volume Determination - methods</subject><subject>Cerebral blood flow volume</subject><subject>Cerebrovascular Circulation</subject><subject>Cerebrovascular Disorders - diagnostic imaging</subject><subject>Cerebrovascular Disorders - etiology</subject><subject>Cerebrovascular Disorders - physiopathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Constriction, Pathologic - diagnostic imaging</subject><subject>Constriction, Pathologic - etiology</subject><subject>Constriction, Pathologic - physiopathology</subject><subject>Diseases of red blood cells</subject><subject>Duplex sonography</subject><subject>Echoencephalography - methods</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Hyperperfusion</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Radiology</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Sickle cell disease</subject><subject>Transcranial color-coded sonography</subject><subject>Young Adult</subject><issn>0301-5629</issn><issn>1879-291X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNks2KFDEQgBtR3NnVV5AgCF5mrCTd6Y4HYZ11XWHBw7jiLaTT1ZDZTGdMdStz23fwDX0SM874gychUId89fdRRfGUw4IDVy_WiymMydIGu9bHhQAuFlAuAOS9YsabWs-F5p_uFzOQwOeVEvqkOCVaA0CtZP2wOBFC6aYCOSv8asQhkicWE7vabTHl10_k48D8wFbe3QZkSwyBXXhCS8i-331jNz8HiNPQsXMipDzLMLLYZzJhm2xgr0OMHbsM8Sv7GMO0wUfFg94GwsfHeFbcXL75sLyaX79_-255fj13parGeWcF15VoupqrjnNoLdZYKifqXqKESkhZd1rJXlaN7bnWttStsKKRVknI4ax4fqi7TfHzhDSajSeXF7ADxokMByGFriTojL48oC5FooS92Sa_sWmXIbNXbdbmb9Vmr9pAabLqnPzk2Gdq8_fv1F9uM_DsCFhyNvTJDs7TH05xBXWjMndx4DBb-eIxGXIeB4edT-hG00X_f_O8-qeMC37wufMt7pDWcUpD9m64oZxjVvvj2N8GFwCCV1L-AGxQuQk</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Doepp, Florian</creator><creator>Kebelmann-Betzing, Christian</creator><creator>Kivi, Anatol</creator><creator>Schreiber, Stephan J</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Stenosis or Hyperperfusion in Sickle Cell Disease – Ultrasound Assessment of Cerebral Blood Flow Volume</title><author>Doepp, Florian ; Kebelmann-Betzing, Christian ; Kivi, Anatol ; Schreiber, Stephan J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-da219528d716d110bae7e46c27f3e3052337d963f358af199a49b2a283a630283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Anemia, Sickle Cell - complications</topic><topic>Anemia, Sickle Cell - diagnostic imaging</topic><topic>Anemia, Sickle Cell - physiopathology</topic><topic>Anemias. Hemoglobinopathies</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Blood Volume</topic><topic>Blood Volume Determination - methods</topic><topic>Cerebral blood flow volume</topic><topic>Cerebrovascular Circulation</topic><topic>Cerebrovascular Disorders - diagnostic imaging</topic><topic>Cerebrovascular Disorders - etiology</topic><topic>Cerebrovascular Disorders - physiopathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Constriction, Pathologic - diagnostic imaging</topic><topic>Constriction, Pathologic - etiology</topic><topic>Constriction, Pathologic - physiopathology</topic><topic>Diseases of red blood cells</topic><topic>Duplex sonography</topic><topic>Echoencephalography - methods</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Hyperperfusion</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Radiology</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Sickle cell disease</topic><topic>Transcranial color-coded sonography</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doepp, Florian</creatorcontrib><creatorcontrib>Kebelmann-Betzing, Christian</creatorcontrib><creatorcontrib>Kivi, Anatol</creatorcontrib><creatorcontrib>Schreiber, Stephan J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in medicine & biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doepp, Florian</au><au>Kebelmann-Betzing, Christian</au><au>Kivi, Anatol</au><au>Schreiber, Stephan J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stenosis or Hyperperfusion in Sickle Cell Disease – Ultrasound Assessment of Cerebral Blood Flow Volume</atitle><jtitle>Ultrasound in medicine & biology</jtitle><addtitle>Ultrasound Med Biol</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>38</volume><issue>8</issue><spage>1333</spage><epage>1338</epage><pages>1333-1338</pages><issn>0301-5629</issn><eissn>1879-291X</eissn><coden>USMBA3</coden><abstract>Abstract Increased blood flow velocity (BFV) in basal cerebral arteries measured by transcranial color-coded sonography (TCCS) is a stroke risk factor in sickle cell disease (SCD). Raised BFV may be caused by vessel narrowing or by hyperperfusion. In 44 SCD patients and 14 controls, intracranial arterial BFVs and global cerebral blood flow (CBF) were analyzed by TCCS and extracranial duplex ultrasound, respectively. Magnetic resonance imaging and magnetic resonance angiography were performed in all patients with pathologic intracranial BFV rise. Intracranial BFVs and CBF in SCD were significantly higher than in controls. CBF in SCD correlated with BFV in all intracranial arteries and correlated inversely with age and hemoglobin values. Magnetic resonance angiography failed to demonstrate any stenosis in our SCD patients, thus raised intracranial BFVs must be interpreted as an anemia-dependent cerebral hyperperfusion. 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| subjects | Adolescent Anemia, Sickle Cell - complications Anemia, Sickle Cell - diagnostic imaging Anemia, Sickle Cell - physiopathology Anemias. Hemoglobinopathies Biological and medical sciences Blood Flow Velocity Blood Volume Blood Volume Determination - methods Cerebral blood flow volume Cerebrovascular Circulation Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - etiology Cerebrovascular Disorders - physiopathology Child Child, Preschool Constriction, Pathologic - diagnostic imaging Constriction, Pathologic - etiology Constriction, Pathologic - physiopathology Diseases of red blood cells Duplex sonography Echoencephalography - methods Female Hematologic and hematopoietic diseases Humans Hyperperfusion Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Radiology Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Reproducibility of Results Sensitivity and Specificity Sickle cell disease Transcranial color-coded sonography Young Adult |
| title | Stenosis or Hyperperfusion in Sickle Cell Disease – Ultrasound Assessment of Cerebral Blood Flow Volume |
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