Comparison of transcranial color Doppler imaging (TCDI) and transcranial Doppler (TCD) in children with sickle-cell anemia
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Updated: Aug 8, 2026
Assessment of Cerebral Lateralization in Children using Functional Transcranial Doppler Ultrasound (fTCD)
Published on: September 27, 2010
A M Jones1, J J Seibert, F T Nichols
1Department of Neurology, Medical College of Georgia, Augusta 30912, USA. Jones_Anne@email.msn.com
Insights
This study correlated transcranial Doppler imaging (TCDI) velocities with the gold standard transcranial Doppler (TCD) in children with sickle cell disease. Modified TCDI protocols improved velocity correlation, aiding stroke risk assessment.
Area of Science:
- Pediatric Neurology
- Vascular Ultrasound
- Sickle Cell Disease Management
Background:
- Transcranial Doppler (TCD) identifies stroke risk in children with sickle cell disease.
- National Institutes of Health (NIH) recommends TCD screening and blood transfusions based on the STOP trial (1997).
- Correlation of newer TCD imaging (TCDI) modalities with the established TCD is needed for treatment decisions.
Purpose of the Study:
- To correlate transcranial arterial time-averaged mean velocities from Acuson TCDI with the gold standard Nicolet TCD.
- To inform treatment decisions for sickle cell disease patients based on STOP trial criteria.
Main Methods:
- 29 children (3-16 years) with sickle cell disease underwent scanning with both Acuson TCDI and Nicolet TCD.
- A scanning protocol based on the STOP trial was used, with independent readings.
- Velocity differences were analyzed before and after TCDI protocol modifications.
Main Results:
- Acuson TCDI generally yielded lower velocities than Nicolet TCD for corresponding arterial segments.
- Modifying the TCDI protocol reduced the velocity difference, decreasing it from 15% to 10% for the middle cerebral artery.
Conclusions:
- Acuson TCDI measurements are modestly lower than those from the Nicolet TCD.
- Protocol adjustments can improve the correlation between TCDI and TCD, supporting TCDI's role in stroke risk screening for sickle cell disease.
Background:
Transcranial Doppler (TCD) has been demonstrated to identify those at highest risk of stroke among children with sickle-cell disease. Based on a randomized clinical trial [Stroke Prevention in Sickle-Cell Anemia Trial (STOP)], which ended in 1997, the National Heart Lung and Blood Division of NIH has recommended TCD screening and chronic blood transfusion based on Nicolet TC 2000 dedicated Doppler (TCD). Studies performed using TCD imaging modalities need to be correlated to that used in the clinical trial to provide information for treatment decisions when screening with TCDI.
Objective:
To correlate transcranial arterial time-averaged mean velocities obtained from an Acuson Transcranial Doppler Imaging to those obtained using the TCD as the gold standard for treatment decisions based on STOP.
Materials And Methods:
A total of 29 children with sickle-cell disease, age 3-16 years, were studied at one of two scanning sessions using both techniques and a scanning protocol based on that used in STOP performed and read independently. The average difference in the measured velocities for each arterial segment was tested to determine difference from zero. Differences were compared before and after modifications to the TCDI technique were made to mimic the STOP protocol more closely.
Results:
TCDI velocities were generally lower than TCD velocities for the same segment, but the difference was reduced (from 15 % to 10% for the middle cerebral artery) by modifications to the TCDI protocol.
Conclusions:
Measurements using the Acuson system are modestly lower than those obtained with dedicated Doppler using the Nicolet TCD.
