Magnetic resonance imaging/angiography and transcranial Doppler velocities in sickle cell anemia: results from the SWiTCH trial

Authors

K. J. Helton
R. J. Adams
K. L. Kesler
A. Lockhart
B. Aygun, Zucker School of Medicine at Hofstra/Northwell
C. Driscoll
M. M. Heeney
S. M. Jackson
L. Krishnamurti
R. E. Ware
+3 additional authors

Publication Date

2014

Journal Title

Blood

Abstract

The Stroke With Transfusions Changing to Hydroxyurea (SWiTCH) trial compared standard (transfusions/chelation) to alternative (hydroxyurea/phlebotomy) treatment to prevent recurrent stroke and manage iron overload in children chronically transfused over 7 years before enrollment. Standardized brain magnetic resonance imaging/magnetic resonance angiography (MRA) and transcranial Doppler (TCD) exams were performed at entry and exit, with a central blinded review. A novel MRA vasculopathy grading scale demonstrated frequent severe baseline left/right vessel stenosis (53%/41% >/=Grade 4); 31% had no vessel stenosis on either side. Baseline parenchymal injury was prevalent (85%/79% subcortical, 53%/37% cortical, 50%/35% subcortical and cortical). Most children had low or uninterpretable baseline middle cerebral artery TCD velocities, which were associated with worse stenoses (incidence risk ratio [IRR] = 5.1, P

Volume Number

124

Issue Number

6

Pages

891-8

Document Type

Article

EPub Date

2014/06/11

Status

Faculty

Facility

School of Medicine

Primary Department

General Pediatrics

PMID

24914136

DOI

10.1182/blood-2013-12-545186