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Journal Article Ppublish 40 citations

PubMed: 27231223 DOI: 10.3174/ajnr.A4793

In Vivo T1 of Blood Measurements in Children with Sickle Cell Disease Improve Cerebral Blood Flow Quantification from Arterial Spin-Labeling MRI.

AJNR Am J Neuroradiol 37(9):1727-32

Authors: L Václavů, V van der Land, D F R Heijtel, M J P van Osch, M H Cnossen, C B L M Majoie, A Bush, J C Wood, K J Fijnvandraat, H J M M Mutsaerts, A J Nederveen

Affiliations

  • From the Department of Radiology (L.V. D.F.R.H. C.B.L.M.M. H.J.M.M.M. A.J.N.), Academic Medical Center, Amsterdam, the Netherlands.
  • Department of Pediatric Hematology (V.v.d.L. K.J.F.), Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands.
  • From the Department of Radiology (L.V. D.F.R.H. C.B.L.M.M. H.J.M.M.M. A.J.N.), Academic Medical Center, Amsterdam, the Netherlands.
  • C.J. Gorter Center for High Field MRI (M.J.P.v.O.), Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
  • Department of Pediatric Hematology (M.H.C.), Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
  • Department of Biomedical Engineering (A.B.), Viterbi School of Engineering, University of Southern California, Los Angeles, California.
  • Department of Pediatrics (J.C.W.), Children's Hospital Los Angeles, Los Angeles, California.
  • From the Department of Radiology (L.V. D.F.R.H. C.B.L.M.M. H.J.M.M.M. A.J.N.), Academic Medical Center, Amsterdam, the Netherlands Sunnybrook Research Institute (H.J.M.M.M.), Toronto, Ontario, Canada.

Abstract

BACKGROUND AND PURPOSE

Children with sickle cell disease have low hematocrit and elevated CBF, the latter of which can be assessed with arterial spin-labeling MR imaging. Quantitative CBF values are obtained by using an estimation of the longitudinal relaxation time of blood (T1blood). Because T1blood depends on hematocrit in healthy individuals, we investigated the importance of measuring T1blood in vivo with MR imaging versus calculating it from hematocrit or assuming an adult fixed value recommended by the literature, hypothesizing that measured T1blood would be the most suited for CBF quantification in children with sickle cell disease.

MATERIALS AND METHODS

Four approaches for T1blood estimation were investigated in 39 patients with sickle cell disease and subsequently used in the CBF quantification from arterial spin-labeling MR imaging. First, we used 1650 ms as recommended by the literature (T1blood-fixed); second, T1blood calculated from hematocrit measured in patients (T1blood-hematocrit); third, T1blood measured in vivo with a Look-Locker MR imaging sequence (T1blood-measured); and finally, a mean value from T1blood measured in this study in children with sickle cell disease (T1blood-sickle cell disease). Quantitative flow measurements acquired with phase-contrast MR imaging served as reference values for CBF.

RESULTS

T1blood-measured (1818 ± 107 ms) was higher than the literature recommended value of 1650 ms, was significantly lower than T1blood-hematocrit (2058 ± 123 ms, P < .001), and, most interesting, did not correlate with hematocrit measurements. Use of either T1blood-measured or T1blood-sickle cell disease provided the best agreement on CBF between arterial-spin labeling and phase-contrast MR imaging reference values.

CONCLUSIONS

This work advocates the use of patient-specific measured T1blood or a standardized value (1818 ms) in the quantification of CBF from arterial spin-labeling in children with SCD.

MeSH

Hematocrit, Cells, Research Design, Blood, Anemia, Sickle Cell, Blood Circulation, Child, Radionuclide Imaging

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