Cerebral perfusion characteristics show differences in younger versus older children with sickle cell anaemia: Results from a multiple‐inflow‐time arterial spin labelling study. (30th March 2018)

• Record Type: Journal Article
• Authors: Kawadler, Jamie M.; Hales, Patrick W.; Barker, Simon; Cox, Timothy C. S.; Kirkham, Fenella J.; Clark, Chris A.
• Is Part Of: NMR in biomedicine. Volume 31:Number 6(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-03-30
• Subjects: arterial spin labelling -- cerebral blood flow -- cerebral circulation -- cerebral haemodynamics -- posterior circulation -- sickle cell anaemia; Nuclear magnetic resonance -- Periodicals; Magnetic Resonance Spectroscopy -- Periodicals; 574
• DOI: 10.1002/nbm.3915
• Languages: English
• ISSNs: 0952-3480

Abstract

Abstract : Sickle cell anaemia (SCA) is associated with chronic anaemia and oxygen desaturation, which elevate cerebral blood flow (CBF) and increase the risk of neurocognitive complications. Arterial spin labelling (ASL) provides a methodology for measuring CBF non‐invasively; however, ASL techniques using only a single inflow time are not sufficient to fully characterize abnormal haemodynamic behaviour in SCA. This study investigated haemodynamic parameters from a multi‐inflow‐time ASL acquisition in younger (8–12 years) and older (13–18 years) children with SCA with and without silent cerebral infarction (SCI+/−) ( n = 20 and 19 respectively, 6 and 4 SCI+ respectively) and healthy controls ( n = 9 and 7 respectively). Compared with controls, CBF was elevated globally in both groups of patients. In the younger SCA patients, blood oxygen content was negatively correlated with CBF in the middle and posterior cerebral artery territories and significantly positively correlated with bolus arrival time (BAT) in the anterior and middle cerebral artery territories. In older children, SCA patients had significantly shorter BAT than healthy controls and there was a significant negative correlation between CBF and oxygen content only in the territory of the posterior cerebral artery, with a trend for a correlation in the anterior cerebral artery but no relationship for the middle cerebral artery territory. In the younger group, SCI+ patients had significantly higher CBF in the posterior cerebral artery territory (SCI+ mean = 92.78 ml/100 g/min; SCI− mean = 72.71 ml/100 g/min; F = 4.28, p = 0.04), but this no longer reached significance when two children with abnormal transcranial Doppler and one with haemoglobin SC disease were excluded, and there were no significant differences between patients with and without SCI in the older children. With age, there appears to be increasing disparity between patients and controls in terms of the relationship between CBF and oxygen content in the anterior circulation, potentially predicting the risk of acute and chronic compromise of brain tissue. Abstract : Sickle cell disease (SCD) is associated with chronic anaemia and oxygen desaturation, which elevates cerebral blood flow (CBF) and increases risk of stroke. In a multi–inflow time ASL acquisition in children with SCD and healthy controls, CBF was elevated globally in SCD patients; in younger children, CBF was negatively correlated with blood oxygen content. In older children, SCD patients had significantly shorter bolus arrival times. This may indicate increasing disparity between patients and controls during development, related to longer‐standing burden of disease.