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Updated: Aug 21, 2026
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Transcranial Doppler correlation with cerebral angiography in sickle cell disease
R J Adams1, F T Nichols, R Figueroa
1Department of Neurology, Medical College of Georgia, Augusta 30912.
Insights
Transcranial Doppler (TCD) effectively detects intracranial arterial disease in sickle cell disease patients, aiding stroke prevention. Screening with TCD, including a transorbital approach, is highly sensitive and specific.
Area of Science:
- Neurology
- Vascular Medicine
- Pediatric Hematology
Background:
- Sickle cell disease (SCD) frequently causes intracranial arterial narrowing or occlusions.
- Cerebral infarction is a major complication of SCD.
- Early detection of intracranial vasculopathy is crucial for primary stroke prevention in SCD.
Purpose of the Study:
- To evaluate the sensitivity and specificity of transcranial Doppler (TCD) for detecting significant intracranial arterial lesions in SCD patients.
- To compare TCD findings with cerebral angiography.
- To assess the utility of TCD as a noninvasive screening tool for stroke risk in SCD.
Main Methods:
- A cohort of 33 young, symptomatic SCD patients underwent both TCD and cerebral angiography.
- TCD examinations included transtemporal and transorbital approaches.
- Significant lesions were defined as ≥50% lumen diameter reduction.
Main Results:
- TCD demonstrated high sensitivity (90%) and specificity (100%) in detecting significant intracranial arterial abnormalities.
- Abnormalities were detected in 26 of 29 patients by TCD.
- The transorbital examination identified lesions in two patients with otherwise normal studies.
Conclusions:
- Transcranial Doppler is a sensitive and specific tool for identifying vasculopathy in sickle cell disease.
- Routine screening for SCD patients should incorporate TCD with both transtemporal and transorbital approaches.
- TCD can facilitate noninvasive screening for stroke risk in SCD.
Background And Purpose:
Cerebral infarction in sickle cell disease is associated with arterial narrowing or occlusions of intracranial arteries. Primary stroke prevention would be feasible if a noninvasive screening test could be developed to detect intracranial disease in patients before symptoms develop.
Methods:
To determine the sensitivity and specificity of transcranial Doppler in detecting significant (greater than or equal to 50% lumen diameter reduction) intracranial arterial lesions, we compared transcranial Doppler and cerebral angiography in a primarily young, symptomatic group of 33 patients (18 males and 15 females) with sickle cell disease.
Results:
From a total of 34 examinations, transcranial Doppler detected significant abnormalities in 26 of 29 (sensitivity 90%, specificity 100%). Five were normal by both techniques. The transorbital examination detected abnormalities in two patients whose studies were otherwise unremarkable.
Conclusions:
Transcranial Doppler is sensitive and specific for the detection of arterial vasculopathy of sickle cell disease. Screening should include a transorbital examination of the distal internal carotid artery as well as examination using the transtemporal approach.
