Neuroimaging findings in sickle cell disease

Thust, Stefanie; Burke, Carol A.; Siddiqui, Anam

doi:10.1259/bjr.20130699

Cited by 43 publications

(21 citation statements)

References 39 publications

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“…The terminal ICA, proximal ACA, and MCA were the most affected by vasculopathy detected by MRA, in keeping with previously published data. 35 Stenosis has previously been reported to be rare in the posterior circulation 36 and was not seen in our data. The exact cause of vasculopathy is unclear, but it is probably mediated by endothelial injury with adhesion of abnormal cellular elements, which eventually results in damage of the muscularis.…”

Section: Mricontrasting

confidence: 54%

“…The exact cause of vasculopathy is unclear, but it is probably mediated by endothelial injury with adhesion of abnormal cellular elements, which eventually results in damage of the muscularis. 35 It is very important to prevent or reverse vasculopathy in asymptomatic patients before vascular occlusion, but few studies have examined whether previous exposures to complications are important via the use of longitudinal laboratory data. Reticulocyte percentage is an independent predictor of cerebrovascular disease in children with SCD.…”

Section: Mrimentioning

confidence: 99%

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Cerebral Infarcts and Vasculopathy in Tanzanian Children With Sickle Cell Anemia

Jacob

Saunders

Sangeda

et al. 2020

Pediatric Neurology

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Background: Cerebral infarcts and vasculopathy in neurologically asymptomatic children with sickle cell anemia (SCA) have received little attention in African settings. This study aimed to establish the prevalence of silent cerebral infarcts (SCI) and vasculopathy and determine associations with exposure to chronic hemolysis, anemia, and hypoxia. Methods: We prospectively studied 224 children with SCA with transcranial Doppler (TCD), and magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). Regressions were undertaken with contemporaneous hemoglobin, reticulocyte count, mean prior hemoglobin, oxygen content, reticulocyte count, and indirect bilirubin. Results: Prevalence of SCI was 27% (61 of 224); cerebral blood flow velocity was abnormal (>200 cm/s) in three and conditional (>170<200 cm/s) in one. Vasculopathy grades 2 (stenosis) and 3 (occlusion) occurred in 16 (7%) and two (1%), respectively; none had grade 4 (moyamoya). SCI was associated with vasculopathy on MRA (odds ratio 2.68; 95% confidence intervals [95% CI] 1.32 to 5.46; P ¼ 0.007) and mean prior indirect bilirubin (odds ratio 1.02, 95% CI 1.00 to 1.03, P ¼ 0.024; n ¼ 83) but not age, sex, nonnormal TCD, or contemporaneous hemoglobin. Vasculopathy was associated with mean prior values for hemoglobin (odds ratio 0.33, 95% CI 0.16 to 0.69, P ¼ 0.003; n ¼ 87), oxygen content (odds ratio 0.43, 95% CI 0.25 to 0.74, P ¼ 0.003), reticulocytes (odds ratio 1.20, 95% CI 1.01-1.42, P ¼ 0.041; n ¼ 77), and indirect bilirubin (odds ratio 1.02, 95% CI 1.01 to 1.04, P ¼ 0.009). Conclusions: SCI and vasculopathy on MRA are common in neurologically asymptomatic children with SCA living in Africa, even when TCD is normal. Children with vasculopathy on MRA are at increased risk of SCI. Longitudinal exposure to anemia, hypoxia, and hemolysis appear to be risk factors for vasculopathy.

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Section: Mricontrasting

confidence: 54%

Section: Mrimentioning

confidence: 99%

Cerebral Infarcts and Vasculopathy in Tanzanian Children With Sickle Cell Anemia

Jacob

Saunders

Sangeda

et al. 2020

Pediatric Neurology

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“…Children and adolescents with SCD are susceptible to mini-silent strokes that can impact brain structure and function and may contribute to chronic pain and cognitive dysfunction ( 43 – 47 ). Children with SCD compared to HCs have been found to have less GM in the DMN ( 48 ), ERN and SMN ( 49 ), as well as greater RS-FC in the DMN, a finding associated with lower cognitive performance ( 50 ).…”

Section: Introductionmentioning

confidence: 99%

Chronic pain in children: structural and resting-state functional brain imaging within a developmental perspective

et al. 2019

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Chronic pain is a major public health problem in the United States costing $635 billion annually. Hospitalizations for chronic pain in childhood have increased almost tenfold in the last decade, without breakthroughs in novel treatment strategies. Findings from brain imaging studies using structural and resting-state fMRI could potentially help personalize treatment to address this costly and prevalent health problem by identifying the underlying brain pathways that contribute, facilitate, and maintain chronic pain. The aim of this review is to synthesize structural and resting-state network pathology identified by recent brain imaging studies in pediatric chronic pain populations and discuss the potential impact of chronic pain on cortical development. Sex-differences, as well as treatment effects on these cortical alterations associated with symptom changes, are also summarized. This area of research is still in its infancy with currently limited evidence available from a small number of studies, some of which suffer from limitations such as small sample size and suboptimal methodology. The identification of brain signatures of chronic pain in children may help to develop new pathways for future research as well as treatment strategies.

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“…FLAIR sequence is one of the most reliable conventional MRI acquisition techniques for assessing the presence of SCI. [ 10 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

Conventional and advanced brain MR imaging in patients with sickle cell anemia

Issar¹,

Nehra²,

Singh³

et al. 2018

Indian Journal of Radiology and Imaging

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Background:Sickle cell disease (SCD) is an autosomal recessive hemolytic disorder; its cerebrovascular complications include silent cerebral ischemia, infarct, and brain atrophy. Conventional magnetic resonance imaging (MRI) often underestimates the extent of injury. Diffusion tensor imaging (DTI) can demonstrate and quantify microstructural brain changes in SCD cases having normal routine MRI.Objective:To identify various neurological abnormalities in asymptomatic sickle cell patients using routine MRI and to evaluate the microstructure of various regions of the brain using DTI.Materials and Methods:A prospective, randomized case–control study was conducted over a period of 2 years. A total of 58 cases of SCD and 56 age- and sex-matched controls were included. Routine MRI and DTI were performed in both the groups following a standard protocol. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated in certain pre-defined regions. Primary data were analyzed using MS excel version 17. Analysis of variance test was performed and statistical significance was set at P < 0.05.Results:Thirty regions of interest with 60 variables were included in the final analysis. Patients with SCD showed statistically significant reduced FA values, increased ADC values, or both, clustered in several brain areas, including pons, cerebral peduncle, corpus callosum, frontal, temporal, parietal white matter, centrum semiovale, periventricular areas, basal ganglia, and left thalamus (P < 0.05).Conclusion:DTI is a promising method for characterizing microstructural changes, when conventional MRI is normal.

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Neuroimaging findings in sickle cell disease

Cited by 43 publications

References 39 publications

Cerebral Infarcts and Vasculopathy in Tanzanian Children With Sickle Cell Anemia

Cerebral Infarcts and Vasculopathy in Tanzanian Children With Sickle Cell Anemia

Chronic pain in children: structural and resting-state functional brain imaging within a developmental perspective

Conventional and advanced brain MR imaging in patients with sickle cell anemia

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