Non-invasive Imaging of Oxygen Extraction Fraction in Adults with Sickle Cell Anaemia

Overview

Journal Brain

Publisher Oxford University Press

Specialty Neurology

Date 2016 Jan 30

PMID 26823369

Citations 75

Authors

Lori C Jordan

Melissa C Gindville

Allison O Scott

Meher R Juttukonda

Megan K Strother

Adetola A Kassim

Sheau-Chiann Chen

Hanzhang Lu

Sumit Pruthi

Yu Shyr

Manus J Donahue

Affiliations

Soon will be listed here.

Abstract

Sickle cell anaemia is a monogenetic disorder with a high incidence of stroke. While stroke screening procedures exist for children with sickle cell anaemia, no accepted screening procedures exist for assessing stroke risk in adults. The purpose of this study is to use novel magnetic resonance imaging methods to evaluate physiological relationships between oxygen extraction fraction, cerebral blood flow, and clinical markers of cerebrovascular impairment in adults with sickle cell anaemia. The specific goal is to determine to what extent elevated oxygen extraction fraction may be uniquely present in patients with higher levels of clinical impairment and therefore may represent a candidate biomarker of stroke risk. Neurological evaluation, structural imaging, and the non-invasive T2-relaxation-under-spin-tagging magnetic resonance imaging method were applied in sickle cell anaemia (n = 34) and healthy race-matched control (n = 11) volunteers without sickle cell trait to assess whole-brain oxygen extraction fraction, cerebral blood flow, degree of vasculopathy, severity of anaemia, and presence of prior infarct; findings were interpreted in the context of physiological models. Cerebral blood flow and oxygen extraction fraction were elevated (P < 0.05) in participants with sickle cell anaemia (n = 27) not receiving monthly blood transfusions (interquartile range cerebral blood flow = 46.2-56.8 ml/100 g/min; oxygen extraction fraction = 0.39-0.50) relative to controls (interquartile range cerebral blood flow = 40.8-46.3 ml/100 g/min; oxygen extraction fraction = 0.33-0.38). Oxygen extraction fraction (P < 0.0001) but not cerebral blood flow was increased in participants with higher levels of clinical impairment. These data provide support for T2-relaxation-under-spin-tagging being able to quickly and non-invasively detect elevated oxygen extraction fraction in individuals with sickle cell anaemia with higher levels of clinical impairment. Our results support the premise that magnetic resonance imaging-based assessment of elevated oxygen extraction fraction might be a viable screening tool for evaluating stroke risk in adults with sickle cell anaemia.

Citing Articles

Brain Age Modeling and Cognitive Outcomes in Young Adults With and Without Sickle Cell Anemia.

Ford A, Fellah S, Wang Y, Unger-Levinson K, Hagan M, Reis M JAMA Netw Open. 2025; 8(1):e2453669.

PMID: 39821401 PMC: 11742535. DOI: 10.1001/jamanetworkopen.2024.53669.

Cerebral hemodynamics and oxygen metabolism in patients with milder and severe forms of sickle cell disease and thalassemia.

Afzali-Hashemi L, Baas K, Schrantee A, Nur E, Vu C, Choi S Hemasphere. 2024; 8(12):e70022.

PMID: 39624832 PMC: 11610621. DOI: 10.1002/hem3.70022.

Cerebral microvascular physiology associated with white matter lesion burden differs by level of vascular risk in typically aging older adults.

Gassner G, Damestani N, Wheeler N, Kufer J, Yadav S, Mellen S J Cereb Blood Flow Metab. 2024; :271678X241300394.

PMID: 39568243 PMC: 11580122. DOI: 10.1177/0271678X241300394.

Cerebral vascular shunting and oxygen metabolism in sickle cell disease.

Song A, Richerson W, Richerson W, Aumann M, Aumann M, Waddle S Blood Adv. 2024; 9(2):386-397.

PMID: 39546745 PMC: 11787477. DOI: 10.1182/bloodadvances.2024014201.

Cerebral Oxygen Metabolic Stress in Children and Adults With Large Vessel Vasculopathy Due to Sickle Cell Disease.

Wang Y, Fellah S, Reis M, Guilliams K, Fields M, Steger-May K Neurology. 2024; 103(11):e210032.

PMID: 39546738 PMC: 11573263. DOI: 10.1212/WNL.0000000000210032.

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