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MR and CT investigation of cerebrovascular disease in sickle cell patients
Insights
Magnetic Resonance (MR) imaging can detect stroke complications in sickle cell disease patients. This noninvasive method identifies vessel abnormalities and white matter lesions, aiding in risk assessment for stroke.
Area of Science:
- Neurology
- Radiology
- Hematology
Background:
- Stroke is a frequent complication in sickle cell disease patients.
- Previous diagnostic methods for identifying stroke risk factors relied on invasive angiography.
Purpose of the Study:
- To evaluate Magnetic Resonance (MR) imaging's effectiveness in visualizing large vessel vasculopathy in sickle cell disease patients.
- To determine the incidence of asymptomatic abnormalities in sickle cell disease patients without a history of stroke.
Main Methods:
- Compared MR and CT findings in 10 sickle cell disease patients with stroke history versus 10 without.
- Assessed visualization of major intracranial arteries and identified vessel occlusions or stenosis.
- Evaluated detection of infarctions and white matter lesions.
Main Results:
- MR imaging successfully visualized major intracranial arteries, revealing three cases of occlusion and three of stenosis.
- Infarctions were better delineated by MR compared to CT.
- High-signal white matter lesions were observed in seven patients with stroke and two without.
Conclusions:
- Cranial MR imaging is a valuable noninvasive tool for detecting cerebrovascular complications in sickle cell disease.
- Further research using MR imaging is warranted to identify patients at risk for stroke.
- MR imaging can reveal asymptomatic abnormalities, aiding in early intervention strategies.
Abstract:
Stroke is a common complication of sickle cell disease. Using MR and CT, we studied 10 patients with sickle cell disease and a history of stroke and compared these findings with those of 10 sickle cell patients without stroke. The purpose was to determine if MR could visualize the large vessel vasculopathy previously seen on angiography and to estimate the incidence of asymptomatic abnormalities in the nonstroke group. MR consistently demonstrated the major intracranial arteries and showed three cases with occlusion and three with stenosis of either the internal carotid or middle cerebral arteries. Infarctions were better delineated on MR but were also seen on CT. Seven cases with and two without stroke had high-signal white matter lesions on MR. Further research using cranial MR to develop noninvasive means of identifying sickle cell patients at risk for stroke is warranted.