Abstract 4612

Silent infarcts have been reported in approximately 20% of children with SCD. The prevalence in SCD adult patients has not been studied previously.

METHODS

We studied 187 patients (mean age 29 years) Each of these patients underwent a neurological examination, duplex scan of carotids and TCD image with atoxic contrast (micro bubbles). Eighty of these patients were sorted to perform MRI and MRA to study lacunar infarction, encephalomalacia, leukoencephalopathy, Moya Moya syndrome and aneurysm (measured by number and size).

RESULTS

The overall prevalence of silent infarcts was 52%. Comparing the two methods regarding sensitivity and specificity, obtained respectively 88 and 85%. The positive predictive value of the TCD image with contrast was 80%. There was only one case of intracranial aneurysm, observed by both imaging methods. The other asymptomatic patients with abnormal TCD (low definition of image contrast or absence of flow to TCD image) presented diagnostic criteria of vascular occlusion with secondary collateral (Moya Moya Syndrome).

CONCLUSIONS

Use of atoxic contrast (micro bubbles) increases the sensitivity of TCD image for diagnosis of intracranial lesions in SCD adults patients, even in asymptomatic individuals, enabling the diagnosis of silent infarcts.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
diagnostic imaging, microbiology procedures, moyamoya disease, aneurysm, cranial lesion, encephalomalacia, intracranial aneurysm, leukoencephalopathies, magnetic resonance angiography, magnetic resonance imaging

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2009 by The American Society of Hematology
2009
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