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Blood, 1 July 2006, Vol. 108, No. 1, pp. 379-381. Prepublished online as a Blood First Edition Paper on March 14, 2006; DOI 10.1182/blood-2005-10-4029.
RED CELLS Inverse correlation between cerebral blood flow measured by continuous arterial spin-labeling (CASL) MRI and neurocognitive function in children with sickle cell anemia (SCA)From the Division of Pediatric Hematology, Department of Pediatrics, the Neurocirculatory Physiology Laboratory, and the Departments of Radiology, Neurology, Anesthesia, and Critical Care Medicine, Johns Hopkins University School of Medicine; and the Department of Developmental and Cognitive Neurology and the F. M. Kirby Center for Functional Imaging, Kennedy-Krieger Institute, Baltimore, MD.
Overt stroke, clinically "silent" cerebral infarct, and neurocognitive impairment are frequent complications of sickle cell anemia (SCA). Current imaging techniques have limited sensitivity and specificity to identify children at risk for neurocognitive impairment. We prospectively evaluated 24 children with SCA with a neurologic exam, complete blood count, transcranial Doppler ultrasound (TCD), measurement of intelligence quotient (IQ), and magnetic resonance imaging (MRI) with measurement of cerebral blood flow (CBF) using continuous arterial spin-labeling (CASL) MRI. Average CBF to gray matter was 112 ± 36 mL/100 g/min. We identified a strong inverse relationship between performance IQ and CBF (-1.5 points per 10 mL/100 g/min increase in CBF, P = .013). Elevated steady-state white blood cell count (
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