Siegel M J, Luker G D, Glauser T A, DeBaun M R
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
Radiology. 1995 Oct;197(1):191-4. doi: 10.1148/radiology.197.1.7568822.
To evaluate flow velocity measurements in the middle cerebral artery (MCA) and/or neurologic examination for detection of cerebral infarction in sickle cell disease (SCD).
Twenty-four pediatric patients aged 6 1/2-17 years with SCD underwent magnetic resonance (MR) imaging, MR angiography, neurologic examination, and transcranial Doppler ultrasonography (US). Transcranial Doppler studies were evaluated for maximum flow velocity in the right and left MCAs. Combinations of cut-off values were used to determine the sensitivity and specificity of transcranial Doppler US for detection of infarction.
Neurologic examination had 58% sensitivity and 92% specificity for cerebral infarction. Maximal flow velocity > 200 cm/sec or < 100 cm/sec (including no flow) helped identify nine of 12 patients with infarcts proved at MR imaging, with only one false-positive result (sensitivity, 75%; specificity 92%). The combination of neurologic examination and transcranial Doppler US produced 92% sensitivity and 83% specificity for cerebral infarction.
The combination of transcranial Doppler US and neurologic examination has potential as a screening technique for infarction in SCD.
评估大脑中动脉（MCA）血流速度测量和/或神经学检查在镰状细胞病（SCD）中检测脑梗死的作用。
24例年龄在6.5 - 17岁的SCD患儿接受了磁共振（MR）成像、磁共振血管造影、神经学检查和经颅多普勒超声检查（US）。评估经颅多普勒检查中左右MCA的最大血流速度。使用不同的临界值组合来确定经颅多普勒超声检测梗死的敏感性和特异性。
神经学检查对脑梗死的敏感性为58%，特异性为92%。最大血流速度>200 cm/秒或<100 cm/秒（包括无血流）有助于识别12例经MR成像证实有梗死的患者中的9例，仅有1例假阳性结果（敏感性75%；特异性92%）。神经学检查和经颅多普勒超声联合应用对脑梗死的敏感性为92%，特异性为83%。
经颅多普勒超声和神经学检查联合应用有潜力作为SCD梗死的筛查技术。
