2005
DOI: 10.1007/s00247-005-1417-7
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Abstract: Cerebral infarction is a major cause of morbidity and mortality in children with sickle cell disease. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. Transcranial Doppler (TCD) has been shown to be a noninvasive, reliable, inexpensive method of identifying children at highest risk for cerebral infarction. The pros and cons of imaging and non-imaging TCD techniques are discussed. The protocol for the stroke prevention trial in sickle cell anemia (STOP), including… Show more

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Cited by 41 publications
(30 citation statements)
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“…With angle correction, the operator can correct for the difference in angle between the course of the artery and the ultrasound beam to provide angle-corrected measurements of velocity [151,152]. To adhere as closely as possible to the original STOP criteria, which used nonimaging TCD, angle correction may not be recommended as there are no large studies establishing appropriate thresholds for intervention [153]. Additionally, studies have shown that with rigorous protocols, TCDi without angle correction may be equivalent to standard TCD [154,155] However, some studies suggest that TCDi velocities without angle correction can be 10-15% lower than standard nonimaging TCD [51,156]; therefore, a lower cutoff of 185 cm/s is often used to define an abnormal study [157].…”
Section: Reviewmentioning
confidence: 99%
“…With angle correction, the operator can correct for the difference in angle between the course of the artery and the ultrasound beam to provide angle-corrected measurements of velocity [151,152]. To adhere as closely as possible to the original STOP criteria, which used nonimaging TCD, angle correction may not be recommended as there are no large studies establishing appropriate thresholds for intervention [153]. Additionally, studies have shown that with rigorous protocols, TCDi without angle correction may be equivalent to standard TCD [154,155] However, some studies suggest that TCDi velocities without angle correction can be 10-15% lower than standard nonimaging TCD [51,156]; therefore, a lower cutoff of 185 cm/s is often used to define an abnormal study [157].…”
Section: Reviewmentioning
confidence: 99%
“…The ±10--5% variation in velocity illustrated by the limits of agreement was attributed to physiological variation, which is probably due largely to variation in pCO 2 levels. A review of the literature demonstrated different reported degrees of velocity underestimation by imaging TCD using the same TCD systems, supporting the absence of a systematic difference between techniques attributable to manufacturer type [2][3][4][5][6][7]. To reproduce the non-imaging TCD technique, which successfully predicted stroke risk in SCD [1], the transducer orientation must be adjusted at each sampling point to achieve the highest audible Doppler frequency, which will equate to the smallest Doppler angle.…”
Section: Discussionmentioning
confidence: 98%
“…There was initial caution in the substitution of imaging TCD in the sickle surveillance programme, particularly in view of the reported differences in velocities acquired by the two TCD techniques [4,5]. A number of elegant studies have been undertaken to establish the variance between the techniques, and adjustments to imaging TCD diagnostic thresholds have been advised [6,7].…”
Section: Introductionmentioning
confidence: 99%
“…The examination is performed with the patient in the supine position. Two acoustic windows are used: the temporal and the suboccipital [3,5,[7][8][9].…”
Section: Techniquementioning
confidence: 99%
“…Introducing an inappropriate angle correction would result in overestimation of flow velocities. The tracing is assumed to be obtained at an optimal angle of 0° [1,8].…”
Section: Techniquementioning
confidence: 99%