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Publications

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 25 citations

PubMed: 32281458 DOI: 10.1177/0271678X20913123

Reduced oxygen extraction efficiency in sickle cell anemia patients with evidence of cerebral capillary shunting.

J Cereb Blood Flow Metab 41(3):546-560

Authors: Meher R Juttukonda, Manus J Donahue, Spencer L Waddle, Larry T Davis, Chelsea A Lee, Niral J Patel, Sumit Pruthi, Adetola A Kassim, Lori C Jordan

Affiliations

  • Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
  • Department of Radiology, Harvard Medical School, Boston, MA, USA.
  • Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.

Abstract

Arterial spin labeling (ASL) magnetic resonance imaging (MRI) utilizes arterial blood water as an endogenous contrast agent to provide a quantitative measure of cerebral blood flow (CBF). Recently, hyperintense signal within dural venous sinuses in ASL images of sickle cell anemia (SCA) patients has been shown to be consistent with elevated flow velocities and may indicate capillary shunting and reduced oxygen extraction. Here, we performed oxygen extraction fraction (OEF) and CBF measurements in adults (cumulative  = 114) with ( = 69) and without ( = 45) SCA to test the hypothesis that hyperintense venous ASL signal is associated with reduced OEF. Higher categorical scores of shunting on ASL MRI were associated with lower OEF in participants with silent cerebral infarcts or white matter hyperintensities ( = 0.003), but not in those without lesions ( = 0.551). These findings indicate that venous hyperintense signal in ASL images in SCA patients may represent a marker of capillary-level disturbances in oxygen exchange efficiency and small vessel pathology.

MeSH

Anemia, Sickle Cell, Cerebrovascular Circulation, Cells, Blood, Capillaries

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