Transcranial color‐coded duplex sonography reliably identifies intracranial vasculopathy in adult patients with sickle cell disease

Edjlali, Myriam; Gobin-Metteil, Marie-Pierre; Mêlé, Nicolas; Maïer, Benjamin; Habibi, Anoosha; Kauv, Paul; Hosseini, Hassan; Mas, Jean‐Louis; Oppenheim, Catherine; Galactéros, Frédéric; Bartolucci, Pablo; Calvet, D.

doi:10.1002/ajh.26215

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…TCCD can also directly observe the lesion location, size and abnormal blood flow state of the vascular mass [ 16 , 17 ]. With the increase in the number of cerebrovascular disease patients, TCCD examination has been widely used in the clinical diagnosis of various diseases [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a prediction model for facilitating the clinical application of transcranial color-coded duplex ultrasonography

Duan,

Wang,

Wang

et al. 2024

BMC Med Imaging

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Background Transcranial color-coded duplex ultrasonography (TCCD) is an important diagnostic tool in the investigation of cerebrovascular diseases. TCCD is often hampered by the temporal window that ultrasound cannot penetrate. Rapidly determine whether ultrasound can penetrate the temporal window in order to determine whether to use other acoustic windows to complete the examination process. In this study, Skull thickness can be measured simultaneously during TCCD examination, which makes it possible to use skull thickness to rapidly determine whether the temporal window is penetrated by ultrasound. Methods This retrospective study included 301 patients with clinical symptoms of cerebrovascular diseases. These 301 patients were divided into an impenetrable temporal window (ITW) group and a penetrable temporal window group according to the results of the TCCD examination. Results The area under the receiver operating characteristic (ROC) curve (AUC) for skull thickness was 0.887 (cutoff value 1.045 cm). Following multivariate logistic regression, sex, age, and skull thickness were used to develop a nomogram. The AUC for the nomogram was 0.923 (cutoff value 0.407). Conclusions The skull thickness at the temporal window was measured by ultrasound, which was convenient and accurate. The probability of ITW in females was higher than that in males, and it increased with age. In this study, a prediction model incorporating sex, age and skull thickness could predict ITW probability well. If the patient’s temporal window was rapidly predicted as an ITW, other acoustic window examinations were used to complete the TCCD examination process to optimize the TCCD examination process of cerebrovascular diseases and facilitate the popularization of TCCD in clinical application.

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Section: Discussionmentioning

confidence: 99%

Development of a prediction model for facilitating the clinical application of transcranial color-coded duplex ultrasonography

Duan,

Wang,

Wang

et al. 2024

BMC Med Imaging

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“…Adult cerebral vasculopathy differs from children’s because the acceleration of velocities is always related to a stenosis visible on the MRI [ 16 ]. The situation is therefore equivalent to that of children with stenosis detected with TCD, but which is also visible on MRI.…”

Section: Discussionmentioning

confidence: 99%

Near-Infrared Spectroscopy Demonstrates the Benefit of Erythracytapheresis in Sickle Cell Disease Adult Patients with Cerebral Vasculopathy

Martino

Turki

Zouiti

et al. 2023

JCM

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Background: Cerebral vasculopathy can induce chronic cerebral hypoperfusion leading to stroke in patients with sickle cell disease (SCD) and is treated by blood exchange transfusion (BET). However, no prospective clinical study has demonstrated the benefit of BET in adults with SCD and cerebral vasculopathy. Near Infrared Spectroscopy (NIRS) is a recent non-invasive method complementary to Magnetic Resonance Imaging (MRI). We evaluated cerebral perfusion using NIRS during erythracytapheresis in patients with SCD with and without steno-occlusive arterial disease. Methods: We conducted a monocentric, prospective study in 16 adults with SCD undergoing erythracytapheresis in 2014. Among them, 10 had cerebral steno-occlusive arterial disease. NIRS measured the relative amounts of oxyhemoglobin (OxyHb), deoxyhemoglobin (DeoxyHb) and total hemoglobin (Total Hb) in brain tissue and in muscle. Results: In cerebral hemispheres associated with steno-occlusive arterial disease, we observed a significant increase of OxyHb and Total Hb during BET, without modification of DeoxyHb. Conclusion: Using NIRS during BET showed that BET improves cerebral perfusion in adult patients with SCD with cerebral vasculopathy.

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Determinants of cognitive dysfunction in adults with sickle cell–related stroke or suspected neurological morbidity

Messimeris,

Bismuth,

Provost

et al. 2024

Blood Advances

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The prognosis of sickle cell disease (SCD) in adults is determined primarily by damage to targeted organs such as the brain. Cognitive dysfunction in SCD is a common chronic neurological mani-festation but studies remain mostly descriptive in adults. The objective of this study was to better characterize the cognitive profile and the association between cognitive dysfunction and brain lesions. We included adult SCD patients referred for a neurological assessment. An adapted bat-tery of neuropsychological tests was used to assess cognitive deficits. Brain (white matter lesions or infarcts) or arterial (stenosis or occlusion) abnormalities were assessed using brain MRI/MRA and a cervical and transcranial Doppler ultrasound. The battery was completed in 96 patients. The cognitive profile was characterized by deficits in processing speed (58% (95% CI [48-68])), short-term memory (34% (95% CI [24-43])) and working memory (24% (95% CI [15-33])). Brain in-farcts were found in 56% of patients and intracranial vasculopathy in 49%. Twenty percent of pa-tients had no brain abnormalities. Processing speed dysfunction was associated with territorial in-farcts (OR 3.1, p=0.03) and education outside of France (OR 4.7, p=0.02). Short-term memory dysfunction was associated with territorial infarcts (OR 3.4, p=0.01) and a low educational level (OR 8.2, p=0.01). Working memory dysfunction was associated with a low educational level (OR 4.3, p=0.05) and vasculopathy (OR 3.7, p=0.03). Cognitive dysfunction appears to be a hallmark sign of SCD, particularly for adults with sickle cell related stroke or suspected neurological mor-bidity. Assessment of such dysfunction could be used in longitudinal follow up and clinical trials.

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Transcranial color‐coded duplex sonography reliably identifies intracranial vasculopathy in adult patients with sickle cell disease

Cited by 3 publications

References 37 publications

Development of a prediction model for facilitating the clinical application of transcranial color-coded duplex ultrasonography

Development of a prediction model for facilitating the clinical application of transcranial color-coded duplex ultrasonography

Near-Infrared Spectroscopy Demonstrates the Benefit of Erythracytapheresis in Sickle Cell Disease Adult Patients with Cerebral Vasculopathy

Determinants of cognitive dysfunction in adults with sickle cell–related stroke or suspected neurological morbidity

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