Abstract Archives of the RSNA, 2014
Brain ADC Histogram Analysis in Sickle Cell Disease Patients: Correlation with Clinical Presentation and Longitudinal Changes in Histogram Parameters
Presented on December 3, 2014
Presented as part of NRS-WEA: Neuroradiology Wednesday Poster Discussions
Memi Watanabe MD, Presenter: Nothing to Disclose
Karen Buch MD, Abstract Co-Author: Nothing to Disclose
Hernan Jara PhD, Abstract Co-Author: Patent holder, qMRI algorithms
Research Grant, General Electric Company
Royalties, World Scientific Publishing Co
Osamu Sakai MD, PhD, Abstract Co-Author: Speaker, Bracco Group
Speaker, KYORIN Holdings, Inc
Speaker, Eisai Co, Ltd
To investigate the potential changes in apparent diffusion coefficient (ADC) histograms of the normal-appearing brains in patients with sickle cell disease (SCD) associated to the clinical manifestations.
Following IRB approval, a retrospective review of brain diffusion-weighted imaging (DWI) performed during 2005-2008 identified 62 MRI studies of 44 SCD patients (age range 2-48 years) with no apparent brain abnormalities on conventional MRI. All subjects were imaged at 1.5T MR scanner with a protocol including DWI (3,899/74ms TR/TE, 89 EPI-factor and b=0, 1,000smm-2). After generation of ADC histogram of the whole intracranial volume, ADC peak value and histogram width were derived. The clinical chart was re-reviewed, focusing on hematological studies, clinical course and diagnosis. Statistical analyses were performed using t-test and Fisher’s exact test correlating clinical and histogram parameters.
Significant correlations were noted between ADC peak values and clinical parameters (hemoglobin level: r=-0.37, P=0.003, hematocrit: r=-0.37, P=0.003, reticulocyte count: r=0.32, P=0.011), while no significant correlations were observed for histogram widths. Of 62 DWI studies, 36 DWI were imaged for acute presentations often with crisis-related or stroke-like symptoms and showed significant increases in histogram widths (P=0.0.14), but not in ADC peak values (P=0.06), compared to DWI performed for non-acute indications. One patient who developed multiple cerebral hemorrhages 3 days later showed increases in both histogram parameters. Four patients were diagnosed with acute craniofacial bone infarcts and another 3 with labyrinthine hemorrhage. Those patients with acute extracranial pathologies showed increases in ADC peak value and/or histogram width during the course, excluding 2 younger patients aged 2 and 6 years, where large age-related changes in ADCs are expected.
In SCD patients with normal-appearing brains by conventional MRI, abnormalities in ADC histograms may be suggestive of acute pathological conditions such as intracranial hypertension. Therefore, careful imaging evaluation and clinical observation should be considered.
Abnormal ADC histogram in a SCD patient may be suggestive of pathological condition despite normality on conventional MRI, and careful imaging evaluation and clinical observation should be considered.
Brain ADC Histogram Analysis in Sickle Cell Disease Patients: Correlation with Clinical Presentation and Longitudinal Changes in Histogram Parameters. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045683.html