Transcranial Doppler examination in patients with sickle cell anemia

Yıl 2025, Cilt: 50 Sayı: 3, 761 - 769

Seda Nida Karaküçük , Süreyya Soyupak , Hatice İlgen Şaşmaz , Gülşah Seydaoğlu

https://doi.org/10.17826/cumj.1671978

Öz

Purpose: This study aimed to evaluate cerebral blood flow velocities using transcranial Doppler in children with sickle cell anemia, compared to healthy controls, in order to assess stroke risk among sickle cell patients.
Materials and Methods: A total of 80 children participated in this prospective study, which included 40 children with sickle cell anemia (16 girls, 24 boys) and a control group of 40 healthy children (22 girls, 18 boys). The age range of participants was from 3 to 20 years. Cerebral blood flow measurements were performed using a transcranial Doppler (TCD) ultrasonography through the transtemporal and occipital acoustic windows. Time-averaged maximum mean velocity (TAMMV), Resistive Index (RI) and Pulsation Index (PI) of the Middle Cerebral Artery (MCA), Anterior Cerebral Artery (ACA), Posterior Cerebral Artery (PCA), vertebral arteries and basilar artery were recorded.
Results: Children with sickle cell anemia demonstrated significantly elevated cerebral blood flow velocities in both the carotid and vertebrobasilar systems when compared to the control group. In the patient group, the mean±SD TAMMV values were 107.7±23.1 cm/s in the right MCA and 113.3±28.2 cm/s in the left MCA, whereas in the control group, these values were 77.9±16.4 cm/s and 78.1±14.8 cm/s, respectively. In three patients (7.5%) with sickle cell anemia, MCA TAMMV exceeded 170 cm/s. A negative correlation was observed between age and cerebral blood flow velocities. Additionally, RI and PI values for all examined vessels were significantly higher in the patient group compared to controls.
Conclusion: Transcranial Doppler ultrasonography is a valuable, non-invasive modality for assessing stroke risk in children with sickle cell anemia. Routine screening using TCD may facilitate timely preventive interventions.

Anahtar Kelimeler

ultrasonography,Doppler,Transcranial , Anemia,Sickle cell , Stroke

Etik Beyan

This prospective study was approved by the Ethics Committee of Çukurova University Faculty of Medicine (Approval date/number:2011/07).

Orak hücre anemili çocuklarda transkraniyal Doppler incelemesi

Öz

Amaç: Bu çalışmanın amacı, orak hücre anemili çocuklarla sağlıklı çocuklar arasında transkraniyal Doppler ultrasonografi ile beyin kan akım hızlarını karşılaştırarak, orak hücre anemili bireylerde inme geçirme riskini değerlendirmektir.
Gereç ve Yöntem: Prospektif olarak tasarlanan bu çalışmaya, 40 orak hücre anemili çocuk (16 kız, 24 erkek) ve 40 sağlıklı çocuk (22 kız, 18 erkek) olmak üzere toplam 80 çocuk dahil edilmiştir. Katılımcıların yaşları 3 ile 20 arasında değişmektedir. Beyin kan akımı ölçümleri, transtemporal ve oksipital pencerelerden transkraniyal Doppler cihazı kullanılarak gerçekleştirilmiştir. Orta Serebral Arter (OSA), Anterior Serebral Arter (ASA), Posterior Serebral Arter (PSA), vertebral arterler ve baziler arterin zaman ortalamalı maksimum ortalama hızı (TAMMV), Rezistif İndeks (RI) ve Pulsatilite İndeksi (PI) değerleri kaydedilmiştir.
Bulgular: Orak hücre anemili çocuklarda, kontrol grubuna kıyasla hem karotis sisteminde hem de vertebrobaziler sistemde beyin kan akım hızlarının anlamlı derecede arttığı saptanmıştır. Hasta grubunda sağ OSA TAMMV ortalaması ± SS 107,7 ± 23,1 cm/s, sol OSA TAMMV 113,3 ± 28,2 cm/s olarak ölçülmüştür. Kontrol grubunda ise bu değerler sırasıyla 77,9 ± 16,4 cm/s ve 78,1 ± 14,8 cm/s bulunmuştur. Orak hücre anemili üç çocukta (%7,5), OSA kan akım hızı 170 cm/s’nin üzerinde bulunmuştur. Serebral arterlerin ortalama kan akım hızları ile yaş arasında negatif korelasyon tespit edilmiştir. Ayrıca, hasta grubunda tüm damarlar için RI ve PI değerleri kontrol grubuna göre anlamlı derecede yüksek bulunmuştur.
Sonuç: Transkraniyal Doppler ultrasonografi, orak hücre anemili çoçuklarda inme riskinin değerlendirilmesinde değerli ve invaziv olmayan bir yöntemdir. Transkraniyal Doppler kullanılarak yapılan rutin taramalar, zamanında koruyucu müdahalelerin uygulanmasını kolaylaştırabilir.

Anahtar Kelimeler

Transkraniyal Doppler Ultrasonografi , Orak hücre anemi , inme

Etik Beyan

Bu prospektif çalışma Çukurova Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylanmıştır (Onay tarihi/sayısı: 2011/07).

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