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Cerebral perfusion characteristics show differences in younger vs. older children with sickle cell anaemia: results from a multiple inflow time arterial spin labelling study

Kirkham, FJ; Kawadler, JM; Clark, CA; Hales, PW; Cox, TS; Barker, S; (2018) Cerebral perfusion characteristics show differences in younger vs. older children with sickle cell anaemia: results from a multiple inflow time arterial spin labelling study. NMR in Biomedicine , 31 (6) 10.1002/nbm.3915. Green open access

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Abstract

Sickle cell anaemia (SCA) is associated with chronic anaemia and oxygen desaturation, which elevate cerebral blood flow (CBF) and increase 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 characterise 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, CBF was negatively correlated with blood oxygen content 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/100g/min, SCI-: mean=72.71ml/100g/min; F=4.28, p=0.04) but this no longer reached significance when 2 children with abnormal transcranial Doppler and one with HbSC 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

Type: Article
Title: Cerebral perfusion characteristics show differences in younger vs. older children with sickle cell anaemia: results from a multiple inflow time arterial spin labelling study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/nbm.3915
Publisher version: http://doi.org/10.1002/nbm.3915
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Sickle cell anemia; cerebral hemodynamics; cerebral circulation; cerebral blood flow; arterial spin labelling; posterior circulation.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10043654
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