1. Detectability of white matter cerebral blood flow using arterial spin labeling MRI in patients with sickle cell disease: Relevance of flow territory, bolus arrival time, and hematocrit.
- Author
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Richerson WT, Aumann M, Song AK, Eisma JJ, Davis S, Milner L, Garza M, Taylor Davis L, Martin D, Jordan LC, and Donahue MJ
- Abstract
Sickle cell disease (SCD) is the most common genetic blood disorder, characterized by red cell hemolysis, anemia, and corresponding increased compensatory cerebral blood flow (CBF). SCD patients are at high risk for cerebral infarcts and CBF quantification is likely critical to assess infarct risk. Infarcts primarily localize to white matter (WM), yet arterial spin labeling (ASL) MRI, the most common non-invasive CBF approach, has poor WM CBF sensitivity owing to low WM CBF and long WM bolus arrival time (BAT). We hypothesize that anemia, and associated cerebral hyperemia, in SCD leads to improved WM detection with ASL. We performed 3-Tesla multi-delay pulsed ASL in SCD (n = 35; age = 30.5 ± 8.3 years) and control (n = 15; age = 28.7 ± 4.5 years) participants and applied t-tests at each inversion time within different flow territories, and determined which regions were significantly above noise floor (criteria: one-sided p < 0.05). Total WM CBF-weighted signal was primarily detectable outside of borderzone regions in SCD (CBF = 17.7 [range = 12.9-25.0] mL/100 g/min), but was largely unphysiological in control (CBF = 8.1 [range = 7.6-9.9)] mL/100 g/min) participants. WM BAT was reduced in SCD versus control participants (ΔBAT = 37 [range = 46-70] ms) and BAT directly correlated with hematocrit (Spearman's-ρ = 0.62; p < 0.001). Findings support the feasibility of WM CBF quantification using ASL in SCD participants for appropriately parameterized protocols., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MJD receives research related support from the National Institutes of Health (NINDS, NCI, NIA, NCCIH, NINR, and NHLBI), Philips Healthcare, Pfizer Inc and is a paid consultant for Graphite Bio, Pfizer Inc, Global Blood Therapeutics, Woolsey Pharmaceuticals, Alterity Pharmaceuticals, and LymphaTouch. He is a paid advisory board member for Pfizer Inc, Novartis and bluebird bio and is the CEO of Biosight Inc which operates as a clinical research organization. These agreements have been approved by Vanderbilt University Medical Center in accordance with its conflict of interest policy.
- Published
- 2024
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