Cerebrovascular disease in symptomatic and asymptomatic patients with sickle cell anemia: screening with duplex transcranial Doppler US--correlation with MR imaging and MR angiography.

Abstract

The authors evaluated the role of transcranial Doppler ultrasonography (US) in patients with sickle cell disease (SCD) and cerebrovascular disease. Twenty-one patients with SCD and stroke (aged 3-22 years; mean age at stroke, 9 years) were evaluated with magnetic resonance (MR) imaging and duplex transcranial Doppler US with a 2-MHz transducer. Nineteen patients also underwent MR angiography. Forty-six asymptomatic patients with SCD were also evaluated with Doppler US, MR imaging, and MR angiography. The following transcranial Doppler US findings were correlated with cerebrovascular disease in patients with SCD: (a) maximum velocity in the ophthalmic artery (OA) of more than 35 cm/sec; (b) mean velocity in the middle cerebral artery (MCA) of more than 170 cm/sec; (c) resistive index in the OA of less than 50; (d) velocity in the OA greater than that of the ipsilateral MCA; and (e) maximum velocity in the posterior cerebral, vertebral, or basilar arteries greater than the maximum velocity in the MCA. Transcranial Doppler US scanning has great potential as an inexpensive, easily performed screening procedure for cerebrovascular disease in patients with SCD.